Predisposing factors:

Modifiable: Non Modifiable

-Lifestyle -Hereditary
-Diet -Age
-Gender
Precipitating factors:
-Stress
-Presence of Pathogens
Possible agents
Typical Atypical
S. Pne!oniae M. Pne!oniae
H. "nflen#ae $. pne!onia
S. Ares Legionella spp.
"n%asion of bacteria or %irs in the body
&rganis!s enter the
'espiratory tract
(y inspiration or aspiration
Acti%ation of defense
Mechanis!
LEGEND:
Pleral effsion
$AP
DM
$o!!on to all
S)S* doctor+s order*
nrsing !anage!ent
D.& Doctor+s order
N.M. Nrsing !anage!ent
Direct
----- Not direct
62
G,N,'AL ASS,SSM,NT
-. y)o* !ale* (P: /-0)/10* (M": /2.-1* Pre !orbid diet: high in carb* high in fats
Persistent cogh 3/ !onth4* 5hite phleg!* 364 s!o7ing 38 years / pac7 a day4* 364 alcoholis!*
9a!ily history of: DM type ""* HPN* 'espiratory Diseases* 9ree lance electrician* concilor*
5ith periodic bris7 5al7ing* $:' "!pression: Pne!onia retrogressing* $onco!itant ,:tensi%e PT( highly entertained.
Loose effecti%eness of
Defense !echanis!
Penetration in the lo5er lngs
3Al%eoli4
(acteria 5ill !ltiply
$oloni#ation of bacteria
in the lngs
(acteria 5ill release
Da!aging to:ins
"nfection in the
Lngs
"nfla!!atory process
;aso dililation
"ncrease blood flo5
Plas!a and $H&N rich
Lea7age flid
Al%eolar sacs 5ill be
filled 5ith flid
Decrease o:ygen Lng consolidation Hypo:e!ia
Possible $o!plications:
"ncrease blood pressre in the
Lngs< respiratory arrest
"f treated:
reco%ery
not treated:
death
Predisposing factors:
-age
-se:
Precipitating factors
-increase $(G
Altered !etabolis!
rt. lifestyle
"!paired beta cell fnction
Peripheral inslin
resistance
"ncrease Hepatic
Glcose prodction
"ncrease beta cell
secretion
Hyperglyce!ia
3=.>!!)!ol4
(ody atte!pts to
!aintain nor!al
glcose le%el
"ncrease postprandial
Glcose le%el
Absolte inslin
deficiency de to
progressi%e beta cell
failre
Type ""* DM
Diagnostic e:a!s:
9(S
H(A/$
D.&.
Ad!inister inslin
9or H(A/$* 9(S*
Lipid profile
N.M
"nstrct the pt. to a%oid
s5eet foods.
$linical Manifestation:
,:cessi%e s5eating
Trace of sgar in the rine
63
v
"ncrease sti!lation of Mast cells
"ncrease sti!lation of Goblet cells
'elease of hista!ine "ncrease !cs prodction
"ncrease %asclar per!eability
"ncrease hydrostatic pressre
"ncrease flid shifting in the plera
"ncrease flid collection
"ncrease co!pression in the lngs
"rritation of pleral space
S&( and $hest disco!fort
"!pair!ent of gas e:change
Heart rate increases as the
co!pensatory !echanis!
of the body
Dyspnea
364 5hee#e
$hanges in ''
and rhyth! of
breathing
D.&.
Gi%e
Acetylcystein
=00!g p.o.
Salbta!ol /neb ?1
N.M.
"ndependent:
-"nstrct the pt. to increase flid
inta7e
-!oti%ate pt. to e:pertorate
Dependent:
-"nstrct the pt. to dilte
acetylcystein in half glass of 5ater
Dyspnea
$apilliary refill in
8 seconds
Nasal flaring
D.&.
Albterol
3Salbta!ol4
/neb ?1
N.M.
Ad%ise pt. to
'inse !oth
After inhalation
"ncrease arterial pressre Peripheral %aso constriction
64
"ncrease blood flo5 in the site
"ncrease blood pressre
3Hypertension4
$linical !anifestation:
(P of ==0)/.0!!Hg
D.&.
$atapres >8 !cg)tab* / tab P'N
for (P@ /.0)/00
!!Hg
65