Bronchopneumonia Definition

Bronchopneumonia is an acute or chronic inflammation of the lungs, in which the alveoli and / or interstitial are affected. Pneumonias are the most common cause of death among infectious diseases. They take the fifth place in the statistics of diseases causing death.

Etiologic Agent
Streptococcus Pneumoniae

Mode of Transmission
Droplet Direct Contact

Incubation Period
1-3 days

Types

Aspiration pneumonia: Caused by inhaling saliva, food or stomach contents Chemical pneumonitis: Caused by inhaling chemicals Infiltrative pneumonia: Caused by cancer that invades the lung, such as leukemia and lymphoma Infectious pneumonia: Bacterial pneumonia Viral pneumonia Fungal pneumonia Tuberculosis

Clinical Manifestation
1. Difficulties and pain when breathing o Pleural pain o Shallow breath and snoring o Tachypnoea 2. Breath sounds over the area to experience consolidation o Decreases, then disappears o Crackles, rhonchi, egophony 3. Asymmetrical chest movement 4. Chills and fever 38.8 C to 41.1 C, delirium 5. Diaphoresis

6. 7. 8. 9. 10. 11. 12. 13. 14.

Anorexia Malaise Thick cough, productive Greenish yellow sputum and then turned into a reddish or rusty Nervous Cyanosis Area circumoral Bluish nail bed Psychosocial problems: disorientation, anxiety, fear of death

Risk Factor

Elderly Any condition that weakens the immune system, such as: Diabetes Organ transplant Chemotherapy AIDS Prior surgical removal of the spleen Congestive heart failure Dementia Drug abuse Living in crowded living conditions: Day care Nursing home Lung disease: Cystic fibrosis COPD Asthma Male gender Premature birth Recent surgery Sickle cell anemia Smoking

Diagnosis
If you have pneumonia, you may be working hard to breathe, or breathing fast. The health care provider will hear crackles 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 xray if pneumonia is suspected.

Some patients may need other tests, including:

Arterial blood gases to see if enough oxygen is getting into your blood from the lungs CBC to check white blood cell count CT scan of the chest Gram's stain and culture of your sputum to look for the bacteria or virus that is causing your symptoms Pleural fluid culture if there is fluid in the space around the lungs

Treatment
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 Breathing treatments (possibly) You are more likely to be admitted to the hospital if you: Have another serious medical problem Have severe symptoms Are unable to care for yourself at home, or are unable to eat or drink Are older than 65 or a young child 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 viral or bacterial pneumonia, so you may receive antibiotics. Your doctor may tell you to take antibiotics. Antibiotics help most people with pneumonia get better. Don't miss any doses. Take the medicine until it is gone, even if you start to feel better. Do NOT take cough medicine or cold medicine unless your doctor says it is okay. Coughing helps your body get rid of mucus from your lungs. Breathing warm, moist (wet) air helps loosen the sticky mucus that may make you feel like you are choking. These things may help: Place a warm, wet washcloth loosely over your nose and mouth. Fill a humidifier with warm water and breathe in the warm mist. Coughing helps clear your airways. Take a couple of deep breaths two or three times every hour. Deep breaths will help open up your lungs. Tap your chest gently a few times a day and lie with your head lower than your chest. This can help bring up mucus from the lungs. If you smoke any tobacco products, STOP. Do not allow smoking in your home. Drink plenty of liquids (as long as your health care provider says it is okay) Drink water, juice, or weak tea Drink at least 6 to 10 cups a day Do NOT drink alcohol

Get plenty of rest when you go home. If you have trouble sleeping at night, take naps during the day.

Nursing Intervention
I. Assess for: Respiratory status including rate, depth, ease, shallow or irregular breathing, dyspnea, use of accesory muscles, and diminished breath sounds, rhonchi or crackles on auscultation - provides data baseline. Changes in mental status, skin color, cyanosis - indicates possible decrease in oxygenation. Quality of cough and ability to raise secretions including consistency and characteristics od sputum - removal of secretions prevents obstruction of airways and stasis leading to further infection and consolidation of lungs; clearing airways facilitates breathing. II. Monitor, record, describe: Respiratory rate, quality and breath sounds q2-q4 - indicates airway resistance, air movement, severity of disease. ABGs, oximeter reading - decreased oxygen levels result in hypoxemia. III. Administer: Oxygen therapy via cannula - maintain optimal oxygen level. Antitussives/expectorants (terpin hydrate, guaifenesin) - acts on bronchial cells to increase fluid production and promote expectoration; guaifenesin reduces surface tension of secretions; both relieve non-productive cough Mucolytic (acetylcysteine) - decrease viscosity of mucus for easier removal. Antibiotic (ampicillin, cephalexin) - acts by binding to cell wall organisms preventing synthesis and destroying pathogens. IV. Perform or Provide: Position of comfort in semi or high fowlers and change position q2h - facilitates breathng and allows for full expansion of lungs. Encourage coughing if sounds is moist; if dry and hacking, increase fluid intake and administer cough suppresant - reduces continual irritation to throat and liquefies secretions. Coughing and deep breathing exercise q2h; use incintive spirometer 5-10 breaths if tolerated - coughing clears airway by propelling secretions to mouth deep breathing promoes ventilation and prolongs expiratory phase. Assist with coughing by splinting chest; humidified air with cool mist - loosens seretions and improves ventilation, moistens mucous membranes Postural drainage and percussion PRN - mobilizes secretion. Suction secretions if cough ineffective - removal if unable to bring up secretions. Oral care after expectoration and provide tissues and bag for disposal - promotes comfort and prevents transmission of organisms to others.

Health Teaching
* Get a flu vaccine. A flu virus is a common cause of pneumonia, so a yearly flu vaccine may help you stay well. * Don't smoke and avoid other people's smoke. Smoke bothers your lungs and makes it harder for them to fight off infections. * Keep asthma under control. If you have asthma, follow your treatment plan. You may need extra medicine to open up your airways. * Get a pneumonia vaccine. Your healthcare provider may suggest this vaccine if you're 65 or older, have a chronic disease (such as lung, heart, or kidney disease; sickle-cell anemia; or diabetes), or are getting over a severe illness. You shouldn't get the vaccine if you're sick or pregnant. * Stay active. Even a little exercise may help your lungs fight off infections in the future.