Understanding Pneumonia Causes and Symptoms

Aug 22, 2024

Pneumonia Overview

Introduction

  • Lecture by Sal Red Sterner.
  • Part of an interview series on respiratory disorders.
  • This is part one of pneumonia; part two will cover nursing interventions, antibiotic use, and a mnemonic for remembering key information.

Definition of Pneumonia

  • Pneumonia: A lower respiratory tract infection that inflames the alveoli.
  • Alveolar sacs are crucial for gas exchange (oxygen in, carbon dioxide out).

Key Players in Pneumonia

  • Germs: Bacteria, viruses, or fungi can cause inflammation in the alveoli.
  • Lung Parenchyma: Key structures include alveoli, alveolar ducts, and bronchioles.

Normal Gas Exchange

  • Oxygen travels from the nose to the trachea, branching into bronchi and entering the alveoli for gas exchange with the blood via capillaries.
  • Carbon dioxide is exhaled from the alveoli, and oxygen is transported to the body through red blood cells.

Pathophysiology of Pneumonia

  • Inflammation causes alveoli to fill with fluid, impairing gas exchange.
  • Resulting hypoxemia (low oxygen in the blood) and respiratory acidosis due to carbon dioxide retention.

Risk Factors for Pneumonia

  • Previous Infections: Influenza, cold.
  • Weakened Immune System: Infants, elderly, HIV patients, and those on immunosuppressive medications.
  • Immobility: Bedridden patients, strokes, dementia (risk of aspiration).
  • Underlying Lung Problems: COPD, post-surgery patients.

Respiratory Acidosis

  • ABG Values: High CO2, low O2, and low pH.
  • Compensation: Kidneys may retain bicarbonate to balance pH.

Causes of Pneumonia

  • Bacterial: Streptococcus pneumoniae is the most common.
  • Atypical Bacteria: Mycoplasma pneumoniae causes walking pneumonia, which is milder.
  • Viral: Influenza, RSV (common in pediatrics).
  • Fungal: Less common, affects those with weakened immune systems.

Types of Pneumonia

  1. Community-Acquired: Occurs outside of healthcare settings.
  2. Hospital-Acquired: Develops 48-72 hours after admission, usually with stronger, antibiotic-resistant bacteria.

Diagnosis of Pneumonia

  • Auscultation: Coarse crackles, rhonchi, or abnormal breath sounds.
  • Chest X-ray: Identifies lung infiltrates.
  • Sputum Culture: Identifies causative organism.

Signs and Symptoms (Mnemonic: PNEUMONIA)

  • P: Productive cough or pleuritic pain
  • N: Neuro changes (confusion in elderly)
  • E: Elevated labs (high white blood cells, CO2)
  • U: Unusual breath sounds (crackles, rhonchi)
  • M: Mild to high fever (may exceed 104°F)
  • O: Oxygen saturation decrease (<90%)
  • N: Nausea and vomiting
  • I: Increased heart rate and respiratory rate
  • A: Aching all over, activity intolerance, shortness of breath

Conclusion

  • This lecture covers part one of pneumonia; check out part two for nursing interventions and quiz.
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