Overview
The lecture covers the pathophysiology, signs, symptoms, and key nursing considerations for pneumonia, emphasizing the most testable concepts for exams.
Pathophysiology of Pneumonia
- Pneumonia causes severe inflammation in the lungs, filling alveoli with mucus, fluid, and debris.
- Alveoli (air sacs) are where gas exchange between oxygen and carbon dioxide occurs.
- Fluid-filled alveoli impair gas exchange, leading to hypoxia (low oxygen) and acidosis (from CO2 buildup).
Most Tested Nursing Diagnoses
- Impaired gas exchange is the primary nursing diagnosis for clients with pneumonia.
- Ineffective breathing pattern develops as the body struggles for air.
Signs and Symptoms (Most Tested)
- Altered mental status: restlessness, agitation, and confusion—early indicators of hypoxia.
- Fever: temperature above 100.4°F (38°C).
- Productive cough with yellow sputum due to infection.
- Fine or coarse crackles in lungs, heard on auscultation, from fluid and mucus.
- Dyspnea (shortness of breath).
- Pleuritic chest pain with pleural friction rub: sharp, stabbing, or burning pain on inspiration or coughing—indicates worsening pneumonia.
Complications and Additional Signs
- Pleural friction rub: sounds like rocks or sandpaper rubbing together; must be reported to the healthcare provider.
- Other, less critical signs include unequal chest expansion, bronchial breath sounds (high-pitched), and increased tactile fremitus (vibrations felt by hand over chest).
Key Terms & Definitions
- Alveoli — tiny lung sacs where oxygen and carbon dioxide are exchanged.
- Hypoxia — low oxygen levels in the blood.
- Acidosis — buildup of acid in the body, often from excess CO2.
- Pleurisy (Pleuritic Pain) — inflammation of the pleura causing sharp chest pain with breathing.
- Pleural Friction Rub — grating sound from inflamed pleural surfaces rubbing during respiration.
Action Items / Next Steps
- Write down and memorize the top six signs and symptoms of pneumonia.
- Note "impaired gas exchange" as the highest priority nursing diagnosis.
- Report pleuritic chest pain with friction rub to the healthcare provider immediately.