Pneumonia is an acute infectious

disease caused by Pneumococcus

and is associated with general
toxemia and a consolidation of one
or more lobes of either or both
lungs.

It is an inflammation of the lungs in
which the air sacs are filled with
pus or exudate so that air is
excluded and the lungs become
solid.

Causative
Agents
Streptococcus pneumoniae
Staphylococcus aureus
Haemophilus influenzae
Klebsiella pneumaniae
(Friendlanders bacilli)

Causes
:
1. Bacteria
2. Viruses
3. Mycoplasma
4. Other infectious agents, such as
fungi
5. Various chemicals
Incubation Period
Ranges from one to three days with a
sudden onset of shaking chills, rapidly
rising and stabbing chest pains
aggravated by coughing and respiration.
Mode of Transmission
Through droplet infection.
Indirect contact.

Pneumonia is sometimes classified according to
where and how the client was exposed to the
disease:
1. Community-acquired pneumonia
2. Nosocomial pneumonia
3. Aspiration pneumonia
4. Pneumocystis carinii pneumonia
5. Actinomycosis
6. Nocardia
Anatomical Classification of
Pneumonia
1. Bronchopneumonia (lobular/ catarrhal
pneumonia)
2. Lobar pneumonia (Croupus pneumonia)
3. Primary atypical pneumonia (viral
pneumonia)
General Classification of
Pneumonia
1. Primary pneumonia produced as a direct
result of inhalation or aspiration of pathogens
or noxious substances. It includes some
cases of pneumococcal pneumonia,
mycoplasma pneumonia and pneumonia
caused by tubercle bacilli.

2. Secondary pneumonia develops as a
complication of the disease. #

Pathogene
sis
1. Properties of the host and the prospective
parasite are important determinants in the
pathogenesis of pneumonia.
2. The lungs and the tracheobronchial tree
below the larynx are normally kept sterile by
the continuous upward movement of the
mucociliary system and the clearing activities
of the alveolar macrophages.

3. From the ambient atmosphere, the
microorganism passes through the
tracheobronchial tree to the parynchyma of the
lungs.
4. The number of bacteria, their virulence and
the health status of the host determine
whether infection will be established.
5. When the bacteria establish themselves in the
alveoli, they multiply and spread to the
adjacent alveoli via the pores of Kohn or by
enzymatic destruction of tissues.
6. Inflammation may spread to the pleural
surface and stimulate effusion, which, when
invaded by bacteria, become empyema.
7. Organisms may also enter the lympathic
system, empty into the bloodstream and
establish bacterimic infectious such as
meningitis, endocarditis and arthritis.
8. The presence of bacteria and their toxins
results in fever and other systemic signs of
infection.
The course of symptomatic disease may be
divided into four stages:
1. Stage of lung engorgement*
2. Red hepatization*
3. Gray hepatization*
4. Stage of resolution*
Clinical Manifestations
The symptoms of pneumonia vary, depending on
the etiologic agent.
1. Sudden onset of chills with rising fever
2. Stabbing chest pain aggravated by
respirations and coughing.
3. Paroxysmal or choking cough
4. The sputum is rusty or prune juice in color.
This is considered pathognomonic to
pneumonia.
5. Pain on the abdomen mistaken as
appendicitis
6. Herpes may appear on the lips
7. Body malaise
8. Respiratory grunting with marked tachypnea
and flaring of the nares.
9. Labored respiration
10. Pulse is rapid and bounding
11. Diaphoresis
12.Convulsion and vomiting in children
Diagnostic Procedures
1. Physical findings for patient with lobar
pneumonia*
2. Chest x-ray is necessary to confirm the
diagnostic examination
3. Sputum analysis, smear and culture is
important
4. The patient may be subjected to
blood/serologic exam.


Modalities of Treatment
1. Antimicrobial therapy varies with each agent*
2. Supportive measures include:
a. Streptococcus
b. Klebsiella
c. Streptococcus
d. Pneumocystis carinii
e. Pen G Na is still the drug of choice
2. Supportive measures include:
a. Humidified oxygen therapy for hypoxia
b. Mechanical ventilation for respiratory failure
c. High calorie diet and adequate fluid intake,
unless contraindicated
d. Absolute bedrest

3. Bronchodilators aminophyllin may be of
some benefit
4. Expectorants
5. Pain relievers for pleuritic pain
Common Nursing Diagnosis
Ineffective airway clearance
Activity Intolerance
Sleep pattern disturbance
High risk for infection
Altered tissue perfusion
Altered nutrition: Less than body requirement
Altered body temp