Filamer Christian College

College of Nursing Roxas City CLINICAL TEACHING PLAN Pneumonia

A. Pre-entry Competencies of Students: I. Knowledge in a. explaining the anatomy and physiology of respiratory system b. discussing the fundamental concept of nutrition and therapy c. enumerating different diets that is used in the hospital II. Skills: in a. execute preparation of different kinds of procedure based on the clients medical status b. performing comprehensive health assessment c. demonstrate the proper manipulation of equipments d. Performing the vital signs taking accurately III. Orientation activities for Students A. Checking of requirements. a. Duty Bag with the following contents: b. 3 ballpens (red, blue, black) c. Penlight d. Ruler (6 inches) e. Jotdown Notebook (clinical) f. Pentel pen g. Adhesive Tape

h. Tongue depressor i. Stethoscope j. Sphygmomanometer k. Thermometer l. Sterile Water B. Check the prescribed Clinical duty uniform. a. Nurses Cap b. Name Plate c. Apron d. Stockings e. White Shoes f. Hair Style and Hair Net A. Orientation about the ward/department a. Endorsement b. Prayer c. Nurses Lining d. Assigning the students to their respective patient e. Morning rounds with the clinical instructor

IV. General Objectives: At the end of the rotation (36 hours) the students will be able to gain knowledge , enhance skills and develop good attitudes as they perform their duty in Private Pavilion West.

Intermediate Objectives Nursing Competencies to be achieved After one hour of ward class, the student will be able to: A. Cognitive a. Define what is pneumonia

Clinical Activities Health Educator Learners

Method of Evaluation

Giving of handouts and discussing about pneumonia. The educator will provide a handout to the students pertaining pneumonia.

The students are encouraged to read and understand the given hand-outs to them. It will enhance their ideas about the topic and they can go through the notes as well as follow the topic the teacher is discussing on. The students are expected to listen attentively and understand what the educator discussed.

Pre-test (20 items)

b. Identify the different types of pneumonia.

The educator will discuss about the different types of pneumonia. It is also indicated to the hand outs.

c. Enumerate the difference between the community acquired and hospital acquired

The educator will differentiate the community acquired pneumonia and hospital pneumonia by explaining.

The students will List the difference of community acquired and hospital acquired.

pneumonia.

d. Enumerate Signs and symptoms pneumonia.

The educator will explain the different signs and symptoms of pneumonia,

The students are expected to Jot down and understand the important datas.

e. Specify the Common findings pneumonia

The educator will explain the findings in pneumonia.

The Student can Jot down and understand the imp ortant datas.

f. Be able to learn the nursing management for pneumonia.

The educator will explain the nursing management for pneumonia.

The student will listen attentively. .

Post test (15 items)

B. Affective

a. Develops self y awareness about the prevention of pneumonia.

Motivate the students to be aware of the patient with pneumonia and let them understands the prevention of pneumonia.

The student will build selfconfidence in handling patient with pneumonia.

b. Appreciate the y Methods in eliminating pneumonia to the client.

The educator can explain the importance of the methods in eliminating the pneumonia so that the learner will appreciate it

The student will Understand and instil in mind that doing such procedure can help the patient from recovering in a disease

C. Psychomotor y

a. Demonstrate on how to auscultate the patient. b. Perform on how to position the patient in semi-fowler.

The educator can exhibit on how to auscultate the patient.

The student will demonstrate the proper auscultating.

Return demonstration

The educator instructs the learner to position the patient in semi-fowler position to aid the patients breathing.

The student will demonstrate and explain why it is necessary for the client with pneumonia.

c. Assess the patients fluid and output, skin turgor.

The health educator will perform on how to assess fluid intake and output and skin turgor.

The student will identify the proper ways in assessing fluid intake and output and skin turgor.

Definiton:

Pneumonia is an inflammatory process affecting the bronchioles and alveoli. Although it is usually is associtated with an acute infection pneumonia also can result from radiation therapy, chemical ingestion or inhalation, or aspiration of foreign bodies or gastric content. Types of pneumonia Pneunonia is classified according to its etiology and presenting symptoms. Bacterial pneumonias are referred to as typical pneumonias, caused by: Mycoplasmas pneumoniae-is the most common cause of atypical pneumonia develop gradually, with the prolonged clinical course is rarely fatal Chlamydia pneumoniae-is a common cause of pneumonia and URIs requires long-term treatment with broad-spectrum antibiotics. Chlamydia psittaci-cause psittacosis, a flulike disease progressing to irregular consolidation and interstitial pneumonia is transmitted from birds and sheep. Legionella pneumophila- is a fastidious bacterium that resides in aquatic environments. Radiation pneumonia results from the damage to the normal lung mucosa during radiation therapy for the breast or lung cancer. Chemical pneumonia results from ingestion of kerosene or inhalation of volatile hydrocarbons(kerosene, gasoline or other chemical) which may occur in industrial settings. Broncho pneumonia means that the infection is patchy, diffuse and scattered throughout both lungs. Lobar pneumonia means that the inflammation is confined to one or more lobes of the lungs. Another classification of pneumonia refers to whre the client acquired the inflammatory process. There are four majir categories. Communiity acquired pneumonia (CAP) which means that the client contracted the illness in a community settings within 48 hours of admission to a health care facilities. Hospital acquired pneumonia (HAP) or nosocomial pneumonia occurs in a health caresettings more than 48 hours after admission. Peumomia in the immuno compromised host is a third cathegory this types include pneummocystis carnli pneumonia. Fungal pneumonia and pneumonia related to tuberculosis

Aspiration pneumonia the distribution of lung involvement in broncho pneumonia and lobar pneumonia. Signs and symptoms People with pneumonia often have a cough produsing greenish or yellow sputum, or phlegm and high fever that may be accompanied by shaking chills shortness of breath is also common, as pleuritic chest pain, a sharp or stabbing pain, either experienced during deep breaths or coughs worsened by them. People with pneumonia may cough up blood, experienced headaches, or develop sweaty and clammy skin, nausea, vomiting, mood swings and joint painsor muscle aches. Less common forms of pneumonia can cause other symptoms; for instance, pneumonia caused by tuberculosis or Pneumocystis may cause only on weight loss and night sweats. In elderly people, manifestations of pneumonia are seldom typical. They may develop a new or worsening confusion(delirium) or may experience unsteadiness, leading to falls. Infants with pneumonia may have many symptoms above, but in many cases they are simply sleepy or have a decreased appetite. Diagnostic findings Auscultation of the chest reveals whezzing, crackles and decreased breath sounds. The nail beds, lips and oral mucosa may be cyanotic. Sputum culture and sensitivity studies can help identify infection microorganism and effective antibiotics for treatment in cases of bacterial pneumonia. A chest film shows area of infiltrates and consolidation. A complete blood count discloses and elevated WBC count. Blood cultures also may be done to detect any microorganisms in the blood. Nursing management The nurse auscultates lung sounds and monitors the client for signs of respiratory difficulty. He or She checks oxygenation status with pulse oximetry and monitoring arterial blood gases (ABGs). Assessment of coughand sputum production also are necessary. The nurse place the client to a semi-fowlers position to aid breathing and increase the amount of air taken with each breath. Increased fluid intake is important to encourage because it helps to loosen secretion and replace fluid lost through fever and increased respiratory rate. The nurse monitor fluid intake and output skin turgor, vital signs and serum electrolyte. He or she administer antipyretics as indicated and ordered.

Preventing Promote coughing and expectoration of secretion if client experiences increased mucus production. Change position frequently if client is immobilized for any reason Encourage deep-breathing and coughing exercise at atleast every 2-hours Administer chest physical therapy as indicated Suction client if he or she cannot expectorate Prevent aspiration in client at risk Prevent infections Cleanse respiratory equipment on a routine basis Promote frequent oral hygiene Administer sedatives and opioids carefully to avoid respiratory depression Encourage client to stop smoking and reduce alcohol intake