Professional Documents
Culture Documents
Nice To Know:
Pneumococcus can affect more than the lungs. The bacteria can also
cause serious infections of the covering of the brain (meningitis),
the bloodstream, and other parts of the body.
Nice To Know:
Nice To Know:
The incubation period last from 1-3 days with sudden onset of shaking
chills, rapidly raising fever and stabbing chest pain aggravated by
coughing and respiration.It can be transmitted through (a)Droplet
infection – from the mouth and nose of an infected person via the
nasopharynx intimate contact with carrier and (b)Indirect contact – by
contaminated objects is possible, systemic infection inhalation of
caustic or toxic chemicals, and aspiration of food, fluids or vomitus.
Anatomy & Physiology of the Respiratory System
Mechanics of Breathing
The chest contains two lungs, one lung on the right side of the chest,
the other on the left side of the chest. Each lung is made up of
sections called lobes. The lung is soft and protected by the ribcage.
The purposes of the lungs are to bring oxygen (abbreviated O2), into
the body and to remove carbon dioxide (abbreviated CO2). Oxygen is a
gas that provides us energy while carbon dioxide is a waste product or
"exhaust" of the body.
After entering the nose or mouth, air travels down the trachea or
"windpipe". The trachea is the tube lying closest to the neck. Behind
the trachea is the esophagus or "food tube". When we inhale air moves
down the trachea and when we eat food moves down the esophagus. The
path air and food take is controlled by the epiglottis, a gate that
prevents food from entering the trachea. Occasionally, food or liquid
may enter the trachea resulting in choking and coughing spasms.
The trachea divides into one left and one right breathing tube, and
these are termed bronchi. The left bronchus leads to the left lung and
the right bronchus leads to the right lung. These breathing tubes
continue to divide into smaller and smaller tubes called bronchioles.
The bronchioles end in tiny air sacs called alveoli. Alveoli, which
means "bunch of grapes" in Italian, look like clusters of grapes
attached to tiny breathing tubes. There are over 300 million alveoli
in normal lungs. If the alveoli were opened and laid out flat, they
would cover the area of a doubles tennis court. Not all alveoli are in
use at one time, so that the lung has many to spare in the event of
damage from disease, infection or surgery.
Which muscles help in the breathing process?
Many different muscles are used in breathing. The largest and most
efficient muscle is the diaphragm. The diaphragm is a large muscle
that lies under the lungs and separates them from the organs below,
such as the stomach, intestines, liver, etc. As the diaphragm moves
down or flattens, the ribs flare outward, the lungs expand and air is
drawn in. This process is called inhalation or inspiration. As the
diaphragm relaxes, air leaves the lungs and they spring back to their
original position. This is called exhalation or expiration. The lungs,
like balloons, require energy to blow up but no energy is needed to
get air out.
The other muscles used in breathing are located between the ribs and
certain muscles extending from the neck to the upper ribs. The
diaphragm, muscles between the ribs and one of the muscles in the neck
called the scalene muscle are involved in almost every breath we take.
If we need more help expanding our lungs, we "recruit" other muscles
in the neck and shoulders. In some conditions, such as emphysema, the
diaphragm is pushed down so that it no longer works properly. This
means that the other muscles must work extra hard because they aren’t
as efficient as the diaphragm. When this happens, patients may
experience breathlessness or shortness of breath.
CLINICAL LABORATORY TEST
Date taken: 10-JUL-2009
HEMATOLOGY
PARAMETERS ACTUAL UNITS REFERENCE CLINICAL
FINDINGS VALUES IMPLICATIONS /
SIGNIFICANCE
WBC Count 19.8 10.9/L 4-10 HIGH
May be increased with
infections, inflammation,
cancer, leukemia;
decreased with some
medications (such as
methotrexate), some
autoimmune conditions,
some severe
infections, bone marrow
failure, and congenital
marrow aplasia (marrow
doesn't develop
normally
RBC Count 4.52 10.12/L 4.2-6.3 NORMAL
Decreased with anemia;
increased when too
many made and with
fluid loss due to
diarrhea, dehydration,
burns
Hemoglobin 116 9/L 120-180 LOW
measures the amount of
oxygen-carrying protein
in the blood.
Hematocrit 0.35 2/L 0.37-0.54 LOW
measures the
percentage of red blood
cells in a given volume
of whole blood.
FINDINGS:
Bilateral Bronchopneumonia
Paratracheal Adenopathy
CLINICAL MANIFESTATION
All abnormal
Chest discomfort Present formation/accumulation/
reaction in our body
causes inflammatory
response, which
stimulates the nerve
fibers and produces
sensation of pain.
Refers to a high-pitched
harsh sound heard during
inspiration, caused by
* stridor obstruction of the upper
airway.
Because of inadequate
diffusion of oxygen, gas
In advanced cases you may exchange in the lungs, the
see: blood carries insufficient
amount to oxygen to
Cyanosis oxygenate the tissues,
organs of the body.
Chest indrawing
PATIENT DATA
Name: Patient X
Nationality: Filipino
Religion: Evangelical
Hospital Admission:
Brief History
Patient X was rushed to hospital last July 10, 2009 at 4:00 in the afternoon.
Prior to admission hospitalized he was confined first in a hospital in Ragay,
Camarines sur for 4 days. After being discharged, the patient stayed at home for
almost two weeks. His parents decided to bring him to Bicol Medical Center because of
his high fever (39 C), “Halak” (crackles) difficulty of breathing, cyanosis when
crying and convulsion, and were consequently admitted.
The cyanosis exhibited by the patient started when he was only 3 months old
and until now the manifestation still occurs whenever he cries. The patient had a
history of blood infection. According to his mother 3 days after his birth, he became
yellowish and was confined that early in the hospital. After being discharged, there
were several recurrences of jaundice. The diagnosis is Sepsis Neonatorum. At seven
days old, the patient was operated in the abdomen and was confined for one week at
the ICU. Since then, the patient has been undergoing monthly check-up at Tagkawayan
Their preferred pediatrician there had treated him for six consecutive months.
Unfortunately, according to his parent, his condition did not improve at all. His
“Halak” had never been treated successfully.
TABLE OF CONTENTS
I. INTRODUCTION
II. BACKGROUND
VI. PATHOPHYSIOLOGY
VIII. PROGNOSIS
X. DIAGNOSTIC TEST
Mucus production is increased, and the leaky capillaries may tinge the
mucus with blood. Mucus plugs actually further decrease the efficiency
of gas exchange in the lung.
The death rate (or mortality) also depends on the underlying cause of
the pneumonia. Pneumonia caused by Mycoplasma, for instance, is
associated with little mortality. However, about half of the people
who develop methicillin-resistant Staphylococcus aureus (MRSA)
pneumonia while on a ventilator will die. In regions of the world
without advanced health care systems, pneumonia is even deadlier.
Limited access to clinics and hospitals, limited access to x-rays,
limited antibiotic choices, and inability to treat underlying
conditions inevitably leads to higher rates of death from pneumonia.
For these reasons, the majority of deaths in children under five due
to pneumococcal disease occur in developing coutries.
Very Young Children. Small children who develop pneumonia and survive
are at risk for developing lung problems in adulthood, including
chronic obstructive pulmonary disease (COPD). Research suggests that
men with a history of pneumonia and other respiratory illnesses in
childhood are more than twice as likely to die of COPD as those
without a history of childhood respiratory disease.
Investigations
A complete blood count may show a high white blood cell count,
indicating the presence of an infection or inflammation. In some
people with immune system problems, the white blood cell count may
appear deceptively normal. Blood tests may be used to evaluate kidney
function (important when prescribing certain antibiotics) or to look
for low blood sodium. Low blood sodium in pneumonia is thought to be
due to extra anti-diuretic hormone produced when the lungs are
diseased (SIADH). Specific blood serology tests for other bacteria
(Mycoplasma, Legionella and Chlamydophila) and a urine test for
Legionella antigen are available. Respiratory secretions can also be
tested for the presence of viruses such as influenza, respiratory
syncytial virus, and adenovirus. Liver function tests should be
carried out to test for damage caused by sepsis.
Combining findings
One study created a prediction rule that found the five following
signs best predicted infiltrates on the chest radiograph of 1134
patients presenting to an emergency room:
Differential diagnosis
DISCHARGE PLAN
NURSING MANAGEMENT