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Pneumonia is a severe infection of the lungs in which pus and fluids fill
the alveoli causing inflammation of the lungs and prevent the flow of air into
the lungs. Due to this, the body does not get sufficient oxygen and the cells are
unable to function normally.

Pneumonia is a common illness that affect millions of people each year in

the united states and in other European Countries, as well as in Asia most
victims are children around 2-5 years old, and adults 65 and above, and those
people suffering from a wide range of chronic conditions and immune
deficiencies. The most common pneumonia-causing germ called streptococcus
pneumoniae or pneumococcus, is a leading cause of morbidity and mortality
among children world-wide both developed and underdeveloped countries. It
was estimated that 10.6 million children less than 5 years present with
pneumococcal disease every year.

In Philippines, base on the 2006 survey, pneumonia appeared to be the

3rd leading causes of death of children in the country.

In our local area, particular in Tagum City, base on the statistical data
on 2001-2009 survey of our city health officials, among the ten (10) leading
causes of morbidity in all ages, pneumonia is the fourth one, but for infants,
pneumonia is second cause of morbidity next to septicemia. For the ten causes
of mortality in all ages.

Pneumonia and other acute respiratory infection are the 2nd leading
causes of death next to CVA. Among the infant mortality rate is only minimal.

There are many reasons why people got affected with pneumonia.

* Improper hygiene
* poor diet-wrong choices of food
* Exposure to chemical irritants
* uncontrolled vices
* pets at home
* lack of information
* lack of government interventions
* economic status of the country
(ase on the City Health Office record:
Morbidity (all ages) pneumonia and other
Acute Respiratory Infections.

ARI Pneumonia
2007 ² 233 - 773
2008 ² 4,471 - 479
2009 ² 27 - 143

Infants morbidity ² pneumonia only

2007 ² 0
2008 ² 355
2009 ² 50

Mortality (all ages) pneumonia only

2007 ² 224 among the ten leading causes of

2008 ² 92 death, pneumonia is the second
2009 ² 66 leading, heat to CVA

Mortality for infants ² pneumonia only

2007 ²
2008 ² 4 cases only was recorded
2009 ² 4 cases only was recorded
  
    


]ays people can get pneumonia include:

* (acteria and viruses living in your nose, sinuses, or mouth may spread to
your lungs.
* You may breathe in (inhale) contaminated food, liquids, vomit or secretions
by infected person.
* You may breathe some of the germs from the air directly to your lungs.

Germs are likely to occur when our immune system is weak, a germ is
two strong, if our body fails to filter germs out of the air we breathe.

Our mouth and airway are exposed to germs as we inhale air our
immune system, the shape of our nose and throat, our ability to cough and the
fine hair-like structures called cilia, help stop the germs from reaching our
lungs. These acts our natural body protective mechanisms. Example when we
cough. This is the way our body keeps germs from reaching the lungs. Some
people fails to cough because of some reasons. This will cause germs to remain
in the airway rather than being coughed out.

]hen germs do reach your lungs, your immune system will go into
action. It will send many cells to attack the invaders. These will cause the
alveoli to become read.


  
  conditions that increase your chances of getting
pneumonia) include:

ë? Cerebral palsy
ë? Chronic lung disease (COPD, bronchiectasis, cystic fibrosis)
ë? Cigarette smoking
ë? Difficulty swallowing (due to stroke, dementia, Parkinson·s disease, or
other neurological conditions)
ë? Immune system problem (see also: Pneumonia in
immunocompromised host)
ë? Impaired consciousness (loss of brain function due to dementia,
stroke, or other neurologic conditions)
ë? üiving in a nursing facility
ë? Other serious illnesses, such as heart disease, liver cirrhosis, or
diabetes mellitus
ë? Recent surgery or trauma
ë? Recent viral respiratory infection (common cold, laryngitis, influenza)

Ë


The most common symptoms of pneumonia are:

ë? Cough (with some pneumonias you may cough up greenish or yellow

mucus, or even bloody mucus)
ë? Fever, which may be mild or high
ë? Shaking chills
ë? Shortness of breath (may only occur when you climb stairs)

Additional symptoms include:

ë? Confusion, especially in older people

ë? Excessive sweating and clammy skin
ë? Headache
ë? üoss of appetite, low energy, and fatigue
ë? Sharp or stabbing chest pain that gets worse when you breathe deeply
or cough

Ë

If you have pneumonia, you may be working hard to breathe, or breathing fast.

Crackles are heard when listening to your chest with a stethoscope. Other
abnormal breathing sounds may also be heard through the stethoscope or via
percussion (tapping on your chest wall).




The health care provider will likely order a chest x-ray if pneumonia is
suspected.

Some patients may need other tests, including:

ë? Arterial blood gases to see if enough oxygen is getting into your blood
from the lungs
ë? C(C to check white blood cell count.
ë? CT scan of the chest
ë? Gram·s stain and culture of your sputum to look for the organism
causing your symptoms
ë? Pleural fluid culture if there is fluid in the space surrounding the
lungs

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Your doctor must first decide whether you need to be in the hospital. If you are
treated in the hospital, you will receive fluids and antibiotics in your veins,
oxygen therapy, and possibly breathing treatments. It is very important that
your antibiotics are started very soon after your are admitted.

You are more likely to be admitted to the hospital if you:

ë? Have another serious medical problem

ë? Have severe symptoms
ë? Are unable to care for yourself at home, or are unable to eat or drink
ë? Are older than 65 or a young child
ë? Have been taking antibiotics at home and are not getting better

However, many people can be treated at home. If bacteria are causing the
pneumonia, the doctor will try to cure the infection with antibiotics. It may be
hard for your health care provider to know whether you have a viral or
bacterial pneumonia, so you may receive antibiotics.

Patients with mild pneumonia who are otherwise health are sometimes treated
with oral macrolide antibiotics (Azithromycin, clarithromycin, or erythromycin).

Patients with other serious illnesses, such as heart disease, chronic obstructive
pulmonary disease, of emphysema, kidney disease, or diabetes are often given
one of the following:
 ë? Fluoruquinolone (levofloxacin, [üevaquin], gemfloxacin [Factive, or
moxifloxacin [Avelox]
ë? High-dose amoxicillin or amoxicilline-clavulanate, plus a macrolide
antibiotic (azithromycin, clarithromycin, or erythromycin)
ë? Cephalosporin antiobiotics (for example, cefuroxime or cefpodoxime)
plus a macrolide (azithromyci, clarithromyci, or erythromycin)

If the cause is a virus, typical antibiotics will NOT be effective.

Sometimes, however, your doctor may use antiviral medication.

You can take these steps at home:

ë? Control your fever with aspirin, nonsteroidal anti-inflammatory drugs

(NSAIDs, such as ibuprofen or naproxen), or acetaminophen, DO NOT
give aspirin to children.
ë? Do not take cough medicines without first talking to your doctor.
Cough medicines may make it harder for your body to cough up the
extra sputum.
ë? Drink plenty of fluids to help loosen secretion and bring up phlegm.
ë? Get lots of rest. Have someone else do household chores.

 

  !

]ith treatment, most patients will improve within 2 weeks. Elderly or

debilitated patients may need longer treatment.

Those who may be more likely to have complicated pneumonia include:

ë? Older adults or very young children

ë? People whose immune system does not work well
ë? People with other, serious medical problems such as diabetes or
cirrhosis of the liver
Your doctor may want to make sure your chest x-ray becomes normal again
after your take a course of antibiotics. However, it may take many weeks for
your x-ray to clear up.

Ëc'  '
 In case of Complications!

Possible complications include:

ë? Acute respiratory distress syndrome (ARDS), a severe form of

respiratory failure
ë? Empyema or lung abscesses. These are infrequent, but serious,
complications of pneumonia. They occur when pockets of pus form
inside or around the lung. These may sometimes need to be drained
with surgery.
 ë? Respiratory failure, which requires a breathing machine or ventilator
ë? Sepsis, a condition in which there is uncontrolled swelling
(inflammation) in the body, which may lead to organ failure.

"  
   

Call your doctor if you have:

ë? ]orsening respiratory symptoms

ë? Shortness of breath, shaking chills, or persistent fevers
ë? Rapid or painful breathing
ë? A cough that brings up bloody or rust-colored mucus
ë? Chest pain that worsens when you cough or inhale
ë? Night sweats or unexplained weight loss
ë? Signs of pneumonia and weak immune system, as with HIV or
chemotherapy

Infants with pneumonia may not have a cough. Call your doctor if your infant
makes grunting noises or the area below the rib cage is retracting while
breathing.

  


]ash your hands frequently, especially after blowing your nose, going to the
bathroom, diapering, and before eating or preparing foods.

Don·t smoke. Tobacco damages your lung·s ability to ward off infection.

Vaccines may help prevent pneumonia in children, the elderly, and people with
diabetes, asthma, emphysema, HIV, cancer, or other chronic conditions:

ë? A drug called Synagis (palivizumab) is given to some children younger

than 24 months to prevent pneumonia caused by respiratory
syncytial virus.
ë? Flu vaccine prevents pneumonia and other problems caused by the
influenza virus. It must be given yearly to protect against new virus
strains.
ë? Hib vaccine prevents pneumonia in children from Haemophilus
infouenzae type b.
ë? Pneumococcal vaccine (Pnemovax, Prevnar) lowers your chances of
getting pneumonia from Streptococcus pnemoniae.

If you have cancer of HIV, talk to your doctor about additional ways to prevent
pneumonia and other infections.
 "
(acterial
Viral
Fungal
Aspiration
Chemical Irritants

Inflammation of üung Tissue

HYPERTROPHY OF MUCOUS MEM(RANE

o? sputum production
o? ]heezing
o? Dyspnea
o? Cough
o? Rales
o? Rhonchi

CAPIüüARY PERMEA(IüITY
o? Fluid in ISC
o? Consolidation
o? Hypoxemia

INFüAMMATION OF THE PüEURA

o? Chest pain
o? Pleural effusion
o? Dullness
o? breath sounds
o? Vocal fremitus

HYPOVENTIüATION
o? Chest expansion
o? Respiratory Acidosis

PROTECTIVE MECHANISM
o? ](C
o? RR
o? Fever

Nursing Interventions
o? Rest
o? Fluids