Because of these findings, the nurse closely monitors the oxygen flow and the client’s respiratory status. Advice the mother on home care: a. Guidelines for Preventing Health-Care-Associated Pneumonia, 2003 pdf icon [179 pages] CDC and the Healthcare Infection Control Practices Advisory Committee developed these recommendations. Identify interventions to prevent/reduce risk/spread of/secondary infection. If the patient then develops pneumonia, the organisms producing the pneumonia may require treatment with more toxic antibiotics. Most cases of pneumonia are treated with “comfort care” measures that ease symptoms. See Risk Stratification under Clinical Presentation. Rationale: Elevated temperature and prolonged fever increases metabolic rate and fluid loss through evaporation. Pneumonia is classified according to the types of germs that cause it and where you got the infection. This will only be achieved with the appropriate pain management. Nursing management of patients with pneumonia is dependent on the needs of the individual, the symptoms and the targeted treatment required. Pneumonia is suspected when a doctor hears abnormal sounds in the chest, and the diagnosis is confirmed by a … The approach to managing these patients has lacked uniformity because of the paucity of clinical trials, complexity of underlying comorbid diseases, and heterogeneity of administrative structures. In a recumbent, immobilized patient, lung ventilation can become altered, leading to such respiratory complications as: Respiratory acidosis, ateclectasis, and hypostatic pneumonia, Appneustic breathing, atypical pneumonia and respiratory alkalosis, Cheyne-Strokes respirations and spontaneous pneumothorax, Kussmail’s respirations and hypoventilation. Good luck! Assist with comfort measures to reduce fever and chills: addition or removal of bedcovers, comfortable room temperature, tepid or cool water sponge bath. Acute respiratory distress syndrome (ARDS). So when it comes to therapeutic management there are some specific medical interventions and nursing interventions that we need to do. Switching from one therapy to another will be determined by the progress of the patient. Check pulses (location, rate, rhythm and strength); temperature (peripheral and central), skin color and moisture, skin turgor, capillary refill time (central and Peripheral); skin, lip, oral mucosa and nail bed color. Pilcher J, Beasley R. Acute use of oxygen therapy. We will begin by reviewing the pathophysiology, risk factors, signs and symptoms, and nursing interventions for pneumonia. Rationale: Restlessness, irritation, confusion, and somnolence may reflect hypoxemia and decreased cerebral oxygenation. Rationale: This may results in upper airway colonization with antibiotic resistant bacteria. Supportive treatment includes hydration, antipyretics, antihistamines, or nasal decongestants. [Context Link] The affected lung or lungs may also collapse. The Pneumococcal vaccine helps to reduce the risk of bacterial pneumonia. Nursing Interventions: The artificial airway also prevents the upper respiratory system from humidifying and heating air to enhance mucociliary clearance. Force fluids to at least 3000 mL/day or as individually appropriate. Dyspnea, shortness of breath and chest pain are indications of this complication. Observe for deterioration in condition, noting hypotension, copious amounts of bloody sputum, pallor, cyanosis, change in LOC, severe dyspnea, and restlessness. The nurse is caring for four clients on a stepdown intensive care unit. Alternative antibiotic treatment that is pathogen directed will, therefore, be required. For meds, we’ll give antibiotics or antivirals, depending on the source, we’ll give antipyretics for the fever and analgesics to ease any pain so they can breathe deeper. She holds Bachelor of Nursing degree from Charles Darwin University, a Postgraduate Certificate in E-Health (Health Informatics) from the University of Tasmania and a Certificate in Clinical Governance for Patient Safety and Quality Care. Encourage pneumovax and annual flu shots for high-risk patients. 2015; 38:98-100. This guide provides basic information on the different classifications of pneumonia in adults. Offer warm, rather than cold, fluids. Rationale: Information can enhance coping and help reduce anxiety and excessive concern. Demonstrate fluid balance evidenced by individually appropriate parameters, e.g., moist mucous membranes, good skin turgor, prompt capillary refill, stable vital signs. The blood pressure decreased to 104/76 during administration. Rationale: Facilitates healing process and enhances natural resistance. Encourage use of relaxation and/or breathing exercises. Excessive oxygen administration may lead to apnea by removing that stimulus. These cases can be challenging to nurse but utilise the extensive knowledge of experienced veterinary nurses and allow us to demonstrate our skills. Consideration should be given to the use of humidified oxygen therapy to help facilitate easier expectoration. Rationale: During initial 6–8 wk after discharge, patient is at greatest risk for recurrence of pneumonia. Antibiotics fight against the bacteria by: Destroying or inhibiting bacteria growth helps the body’s natural immune system to fight the bacterial infection. Treatment of atelectasis, pleural effusion, shock, respiratory failure, superinfection is instituted, if needed. A thorough nursing assessment is necessary to establish nursing diagnoses, plan nursing care, set realistic goals, implement nursing interventions and to enable the evaluation process. Assess respiratory rate, depth, and ease. Viral pneumonia does not result in consolidation. Rationale: Early discontinuation of antibiotics may result in failure to completely resolve infectious process and may cause recurrence or rebound pneumonia. Check for residual formula regular intervals. Schedule respiratory treatments at least 1 hr before meals. The presence of exudate results in a less functional area for oxygen-carbon dioxide exchange, interfering with gas exchange and resulting in consolidation in the lung. The home health nurse is planning for the day’s visits. The nurse is preparing her plan of care for her patient diagnosed with pneumonia. 2009. Assist with self-care activities as necessary. Sources: Pneumonia disease can be defined as an infection in the lungs parenchyma. Different types of pneumonia are classified into various groups. This then causes capillary leak, edema, and exudate. http://www.nlm.nih.gov/medlineplus Analgesics are given to improve cough effort by reducing discomfort, but should be used cautiously because they can decrease cough effort and depress respirations. People most at risk are older than 65 or younger than 2 years of age, or already have health problems. You are evaluating an HIV-positive patient who is receiving IV pentamidine (Pentam) as a treatment for Pneumocystis carinii pneumonia. Fluid intake should be maintained at approximately 3000 mL/day so that the secretions remain thin. Instruct the mother to continue breastfeeding. Medicine Today. PRIYATMA KHINCHA 2. Flu-related pneumonia may be treated with antiviral medicine if caught early in the course of illness. The nurse should ensure that all the necessary information has been collected, is complete, and has been documented appropriately. The care plan should be updated as required, The use of any airway or respiratory devices should be recorded as should any aids or equipment, Administration of medications should be clearly documented including the patient’s response to medication and any adverse reactions. Then, an example nursing care plan will be explored to illustrate the knowledge a nursing student needs to know in order to care for a patient with pneumonia. Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses. The bronchi and alveoli are filled with capillaries that assist in adding oxygen to and removing carbon dioxide from the blood. Respiratory support includes endotracheal intubation, high inspiratory oxygen concentrations, and mechanical ventilation. Vancomycin and flucloxacillin are both narrow-spectrum antibiotics used to treat bacterial pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA). Rationale: Promotes expectoration, clearing of infection. Adherence with the prescribed medication regimen is key to recovery and preventing resurgence of pneumonia. Nursing Management of Pneumonia In this post, we will review the nursing management of pneumonia. The clinical judgments made by the nurse based on the patient’s health conditions and needs form the nursing diagnosis. Postural drainage may not be as effective in interstitial pneumonias or those causing alveolar exudate or destruction. The physician diagnosed pneumonia. nursing management of pneumonia ppt is an acute inflammatory disorder of lung parenchyma that results in edema of lung tissues and movement of fluid into the alveoli. Assist and encourage oral hygiene after emesis, after aerosol and postural drainage treatments, and before meals. The following antivirals are examples of those used to treat viral pneumonia: Fungi is the least common cause of pneumonia, however, Mattila et al. 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