A Written Report on

Pneumonia

In Partial Fulfilment of the

Requirements in NCM 102 RLE

IMCI ROTATION

Submitted to:
Mrs. Bevan B. Balbuena, RN, MAN
Clinical Instructor
Submitted by:
Hilario, Chloe Jane Emmanuelle B.
BSN 2A
November 5, 2014

According to the World Health Organization, pneumonia is the leading cause of

childhood death worldwide. Higher-quality etiological data are required to reduce this
mortality burden. Pneumonia kills an estimated 1.1 million children under the age of five
years every year more than AIDS, malaria and tuberculosis combined. According to
the Philippines Health Statistics of 2010, pneumonia ranks as the second leading cause
of infant mortality in 2010, which accounts for 2,628 deaths. Furthermore, the number of
lives saved could more than double to 1.3 million if both prevention and treatment
interventions to reduce pneumonia deaths were delivered universally.

Objectives:

To define pneumonia

To identify the etiology of pneumonia

To enumerate the signs and symptoms of pneumonia

To identify the mode of transmission of pneumonia

To describe the pathophysiology of pneumonia

To distinguish the medical and nursing management for diarrhea

Pneumonia is a form of acute respiratory infection that affects the lungs. The
lungs are made up of small sacs called alveoli, which fill with air when a healthy person
breathes. When an individual has pneumonia, the alveoli are filled with pus and fluid,
which makes breathing painful and limits oxygen intake. The most common symptoms
of pneumonia are:

Cough (with some pneumonias you may cough up greenish or yellow mucus, or
even bloody mucus)

Fever, which may be mild or high

Shaking chills

Shortness of breath, which may only occur when you climb stairs
Additional symptoms include:

Sharp or stabbing chest pain that gets worse when you breathe deeply or cough

Headache

Excessive sweating and clammy skin

Loss of appetite, low energy, and fatigue

Confusion, especially in older people

Pneumonia is caused by a number of infectious agents, including viruses, bacteria

and fungi. The most common are:

Streptococcus pneumoniae the most common cause of bacterial pneumonia in

children;

Haemophilus influenzae type b (Hib) the second most common cause of

bacterial pneumonia;

respiratory syncytial virus is the most common viral cause of pneumonia;

in infants infected with HIV, Pneumocystis jiroveci is one of the commonest

causes of pneumonia, responsible for at least one quarter of all pneumonia
deaths in HIV-infected infants.

Pneumonia can be spread in a number of ways. The viruses and bacteria that are
commonly found in a child's nose or throat, can infect the lungs if they are inhaled. They
may also spread via air-borne droplets from a cough or sneeze. In addition, pneumonia
may spread through blood, especially during and shortly after birth. More research
needs to be done on the different pathogens causing pneumonia and the ways they are
transmitted, as this has critical importance for treatment and prevention.

The pathophysiology of pneumonia include

Pneumonia results from the proliferation of microbial pathogens at the alveolar

level and the host's response to those pathogens.

Microorganisms gain access to the lower respiratory tract in several ways.

The most common is by aspiration from the oropharynx.

Small-volume aspiration occurs frequently during sleep (especially in the elderly)

and in patients with decreased levels of consciousness.

Many pathogens are inhaled as contaminated droplets.

The gag reflex and the cough mechanism offer critical protection from aspiration.

In addition, the normal flora adhering to mucosal cells of the oropharynx, whose
components are remarkably constant, prevents pathogenic bacteria from binding
and thereby decreases the risk of pneumonia caused by these more virulent
bacteria.

Once engulfed, the pathogens even if they are not killed by macrophages are
eliminated via either the mucociliary elevator or the lymphatics and no longer
represent an infectious challenge.

Only when the capacity of the alveolar macrophages to ingest or kill the
microorganisms is exceeded does clinical pneumonia become manifest.

In that situation, the alveolar macrophages initiate the inflammatory response to

bolster lower respiratory tract defenses.

The host inflammatory response, rather than the proliferation of microorganisms,

triggers the clinical syndrome of pneumonia.

Pneumonia should be treated with antibiotics. Most cases of pneumonia require

oral antibiotics, which are often prescribed at a health centre. These cases can also be
diagnosed and treated with inexpensive oral antibiotics at community level by trained
community health workers. Hospitalization is recommended only for severe cases of
pneumonia, and for all cases of pneumonia in infants younger than two months of age.
Preventing pneumonia in children is an essential component of a strategy to reduce
child mortality. Immunization against Hib, pneumococcus, measles and whooping cough
(pertussis) is the most effective way to prevent pneumonia. Adequate nutrition is key to
improving children's natural defences, starting with exclusive breastfeeding for the first
six months of life. In addition to being effective in preventing pneumonia, it also helps to
reduce the length of the illness if a child does become ill. Addressing environmental
factors such as indoor air pollution (by providing affordable clean indoor stoves, for
example) and encouraging good hygiene in crowded homes also reduces the number of
children who fall ill with pneumonia. In children infected with HIV, the antibiotic
cotrimoxazole is given daily to decrease the risk of contracting pneumonia.

References:
Admin. (2007, December 15). Nursing Crib. Retrieved November 4, 2014, from Nursing
Crib Web Site: http://nursingcrib.com/case-study/pneumonia-case-study/
Wardlaw, T., Johansson, E. W., & Hodge, M. (2006). World Health Organization.
Retrieved November 4, 2014, from World Health Organization:
http://whqlibdoc.who.int/publications/2006/9280640489_eng.pdf?ua=1
WHO. (2013, November). World Health Organization. Retrieved November 4, 2014,
from World Health Organization:
http://www.who.int/mediacentre/factsheets/fs331/en/