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Legend Predisposing and Precipitating Factors Signs and Symptoms Management Nursing Diagnosis multiple organ failure/ dysfunction systemic hypoxia
Death
Chest X-Ray PA Lateral: Nebulization: bronchodilators Salbutamol (Ventolin) Salbutamol + Ipatromium bromide (Combivent) 12/04/11 increased density in the right upper right lung & left lower lung due to pneumonia 12/07/11
SaO2= 91%
O2 therapy at 4 L/min
Progression of insterstitial pneumonia to alveolar pneumonia, particularly the right lung with consolidation 12/10/11
efforts to icrease oxygen supply results to faster, shallow and irregular breaths
PRECIPITATING FACTOR: -Age -gender (male) -genetics (history of respiratory illness pneumonia, asthma, chronic bronchitis, etc.) -food or drug allergies v Organisms (staphylococcus and Gram-negative bacilli ) enter the respiratory tract through inspiration or aspiration of oral secretions Antibiotics Normal pulmonary defense mechanisms (cough reflex, mucocilliary transport, and pulmonary macrophages) usually protect against infection. However, in susceptible hosts, these defenses are either suppressed or overwhelmed by the invading organism. Cefuroxime (Zinacef) Azithromycin ( Zithromax) PREDISPOSING FACTOR: - causative organisms include bacteria, viruses, fungi, and protozoan. -previous hospital admission -smoking
Symptoms include: Fever Malaise Cough Increased tactile fremitus on palpitation (for bacteria- caused pneumonia) Wheezing, rales and ronchi on auscultation SaO2 = < 95% (91%) Dyspnea RR = >30 cpm (78 cpm, shallow, irregular and labored Nasal flaring Budesonide (Asmavent)
organism multiplies
inflammation and edema of the lung parenchyma accumulation of cellular debris and exudates
accummulation of mucus on upper respiratory tract Ineffective arirway clearance Impaired gas exchange
secretion of mucus
Fluid build-up affects cellular respiration because of the drowning of the alveoli in mucus
Severity of symptoms depends on the extent of pneumonia present (e.g., partial lobe, full lobe [lobar pneumonia], or diffuse [broncho pneumonia]).