Nursing Interventions for Pneumonia Care

Aug 17, 2024

Pneumonia Part 2

Nursing Interventions

Monitoring

  • Respiratory System: Auscultate lung sounds for coarse crackles, wheezing, or bronchial breath sounds.
  • Vital Signs: Monitor respiratory rate and oxygen saturation (should be >95%).
  • Skin Color: Check for cyanosis, especially in lips.
  • Arterial Blood Gas Results: Monitor for abnormal levels, risk of hypoxemia.
  • Sputum Culture: Collect if ordered to identify pneumonia cause.

Assessment

  • Suction Needs: May need nasotracheal suctioning.
  • Respiratory Treatments: Call respiratory therapist if treatments are needed (e.g., bronchodilators, chest percussion).

Education

  • Incentive Spirometer: Use 10 times every 1-2 hours while awake.
  • Hydration: Essential to keep secretions thin; adjust based on individual conditions (e.g., heart or renal failure).
  • Immobility: Turn frequently, elevate head of bed to 30 degrees.
  • Vaccination: Encourage flu shots and Pneumovax for eligible individuals (e.g., those aged 65+).
  • Smoking Cessation: Support quitting smoking.
  • Avoiding Infection: Avoid sick people, practice hand hygiene.

Medications

General

  • Antipyretics: For fever control.
  • IV Fluids: For hydration.
  • Antiviral Drugs: For viral pneumonia, e.g., Tamiflu.

Antibiotics

  • Treatment depends on bacteria type, patient tolerance, and allergies.

Antibiotic Categories

  1. Vancomycin: Treats severe cases, but monitor for ototoxicity (hearing loss).
  2. Macrolides (e.g., Zithromax): Narrow-spectrum; alternative for penicillin allergies.
  3. Tetracyclines (e.g., Doxycycline):
    • Broad-spectrum; not for pregnant women or children <8.
    • Can cause photosensitivity and decrease birth control effectiveness.
    • Avoid milk products and antacids.
  4. Fluoroquinolones (e.g., Levaquin):
    • Broad-spectrum; used for severe infections.
    • Side effects: C. diff infections, tendon rupture, QT interval prolongation.
  5. Cephalosporins (e.g., Rocephin):
    • Various generations, with 3rd & 4th being broad-spectrum.
    • Monitor for penicillin cross-allergy.
  6. Penicillins (e.g., Penicillin G):
    • Narrow-spectrum; monitor for cephalosporin allergy.
    • May decrease birth control effectiveness.