3. LEARNING OBJECTIVES
1. Define pneumonia, lung abscess, pleural
effusion.
2. State cause, pathophysiology, clinical
manifestations, diagnosis, and treatment of
each condition.
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4. PNEUMONIA
DEFINITION:
• Is an acute inflammation of the lung
parenchyma (lung tissues) often caused by micro
organism (& occasionally inhaled irritant).
• Is a lower respiratory tract infection.
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7. TYPE OF PNEUMONIA
1. Community-Acquired Pneumonia (CAP)
– Occurs in community & during < 48 hours of
hospitalization.
– Is the most common type of pneumonia.
2. Hospital-Acquired Pneumonia (HAP)
- Pneumonia occurring 48 hours or more
during a hospital stay for another illness.
Higher risk client on a mechanical ventilator eg.
Ventilator-associated pneumonia (VAP).
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8. CONTD.
3. Health Care-associated Pneumonia (HCP)
– Pneumonia in other health care settings, such as
nursing homes, dialysis centers, and outpatient
clinics.
4. Aspiration Pneumonia
- Due to inhale foreign body, food, drink, vomit, or
saliva from your mouth into lungs that occur in
condition of poor gag reflex eg. Brain injury,
dysphagia, or excessive use of alcohol or drugs.
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9. CONTD.
5. Atypical Pneumonia
- Is most commonly caused by mycoplasma.
Legionnaires’ disease or chlamydia and
usually appears in children and young
adults.
6. Hypostatic pneumonia
- Results from the collection of fluid in the dorsal
region of the lungs and occurs especially in those
(as the bedridden or elderly, etc).
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18. HEALTH EDUCATION
1. Limit infection spread by:
Staying at home for first 2-3 days.
Covering mouth, nose when cough & sneeze.
Wearing mask if in public.
Washing hand frequently.
2. Complete antibiotic course if prescribed to
prevent resistance.
3. Drink plenty of water to liquefy & mobilize
secretion.
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19. CONTD.
4. Eat balance nutrition diet & plenty of rest to
boost immunity.
Prevent upper respiratory infection.
Avoid overcrowding & keep a distance with person
with upper respiratory infection.
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24. PATHOPHYSIOLOGY
Alveoli that are filled with fluid, pus & microbes
become consolidated (solid)
▼
Consolidated tissue becomes necrotic tissue
called abscess
▼
Necrotic process can spread & abscess can rupture to
empty its content into bronchus (or pleural cavity)
▼
Form cavity filled with air & fluid (cavitations)
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25. CLINICAL MANIFESTATION
• Occurs after 2 weeks after the precipitating
event.
• Early manifestation – same as pneumonia.
• When abscess rupture:
(a) Large amount foul smelling, purulent, blood
streaked sputum
(b) Abnormal breath sound e.g crackles in the
region of the abscess.
(c) Chest percussion – dull tone
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27. TREATMENT
1. Antibiotic IV
2. Postural drainage to promote drainage from
the lungs.
3. Bronchoscopy (if indicated)
(a) Drainage of abscess
(b) Resection
4. Chest tube insertion (if pleural space
involved)
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28. COMPLICATION
1. Pleurisy
– Inflammation of the pleura.
2. Septicemia if not treated
- Systemic infection caused by multiplication of
microorganisms in circulating blood.
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30. PLEURAL EFFUSION
DEFINITION:
• Is a collection of excess fluid in the pleural
space.
• Note: Large pleural effusion compresses
adjacent lung tissue, thus, impair lung
expansion.
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32. CAUSES
1. Transudative pleural effusions.
– Caused by fluid leaking into the pleural space.
– This is caused by elevated pressure in, or low
protein content in, the blood vessels.
– Congestive heart failure is the most common
cause.
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33. CONTD.
2.Exudative pleural effusions.
- Result from leaky blood vessels caused by
inflammation (irritation and swelling) of the
pleura.
- This is often caused by lung disease eg. Lung
cancer, lung infections (TB, pneumonia, drug
reactions)
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34. PATHOPHYSIOLOGY
Aspiration of gastric content or bacteria enter the lung
▼
Inflammatory response
▼
Cavity extend to bronchus
▼
Abscess become encapsulated
▼
Tissues necrotize
▼
Increase production of sputum
▼
Purulent sputum
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36. DIAGNOSIS
1. Chest X Ray
2. Pleural fluid analysis (look for bacteria,
amount of protein, cancerous cell)
3. Sputum culture & sensitivity
4. Bronchoscopy
5. Thoracentesis (a sample of fluid is removed
with a needle inserted between the ribs)
6. Thoracic CT
7. Ultrasound of the chest
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