الالتهاب الرئوي

Definition

Pneumonia is an infection of the alveoli, which fill with pus and fluid, impairing oxygen exchange.

Types

• Community-acquired: commonest cause Streptococcus pneumoniae
• Hospital or ventilator-associated: more resistant bacteria such as Pseudomonas
• Aspiration: with poor swallowing or reduced consciousness

Symptoms

• Fever and chills
• Productive cough
• Pleuritic chest pain and fast breathing
• In the elderly it may present only as confusion

Examination and diagnosis

• Crackles and changed breath sounds over the affected area
• Chest X-ray showing consolidation
• Sputum and blood cultures before antibiotics when possible

Treatment

• Antibiotic by type and severity
• Oxygen, fluids and antipyretics

Nursing care

• Encourage coughing, deep breathing and the incentive spirometer
• Early mobilisation and head-of-bed elevation
• To prevent ventilator pneumonia: head of bed at 30–45 degrees and oral care

Exam point

Prevention: pneumococcal and influenza vaccines, hand hygiene, and early mobility after surgery.