Kingdom of Saudi Arabia ‫المملكة العربية السعودية‬

Ministry of Education ‫وزارة التعليم‬

University of Hail ‫جامعة حائل‬
Master of Science in ‫كلية التمريض‬
Nursing

Pneumonia

Prepared By: Fahad Fehaid Aloudah -20210501

Instructor: Dr.Habib Meabibed alrashedi
 Learning Objectives

Recognize the epidemiology and morbidity of pneumonia

Define pneumonia and types of lower respiratory tract infections
Understand features involved in the pathophysiology of
pneumonia
Recognize the entity known as Community Acquired Pneumonia
(CAP)
Appreciate the spectrum of pneumonia clinical presentation
Identify common complications of pneumonia
 Introduction

Pneumonia is an infection that inflames the air sacs in

one or both lungs. The air sacs may fill with fluid or
pus (purulent material), causing cough with phlegm or
pus, fever, chills, and difficulty breathing. A variety of
organisms, including bacteria, viruses and fungi, can
cause pneumonia.
Pneumonia can range in seriousness from mild to life-
threatening. It is most serious for infants and young
children, people older than age 65, and people with
health problems or weakened immune systems.
 Definition of Pneumonia

An acute or chronic inflammatory condition of the lower

respiratory tract and lung parenchyma that is most
commonly due to an infection and results in a clinical
syndrome of respiratory symptoms such as cough,
shortness of breath, and pleuritic chest pain associated
with fever and malaise and accompanied by
radiographic abnormalities.
 Classification.

Pneumonia is often classified by: 1. Place of acquisition of the infection.

the setting, 2. Typical versus atypical pneumonia
timing of infection, syndrome.
clinical presentation, 3. Radiographic pattern
infecting pathogen, 4. Acute versus chronic pneumonia.
radiographic pattern, 5. Pneumonia in the
comorbid status of the patient. immunocompromised patient
Place of acquisition of the infection. This determines which pathogens are likely to
cause the disease.
Community-acquired pneumonia (CAP) occurs without prior contact to the
healthcare system in the outpatient setting or within 48 hours of hospital
admission.
b. Hospital-acquired pneumonia (HAP) is defined as a pneumonia that occurs 48
hours after admission and was not incubating at the time of admission (e.g., no
signs of pulmonary infection on hospital admission).
c. Ventilator-associated pneumonia (VAP) occurs greater than or equal to 48 to 72
hours after endotracheal intubation.
d. Healthcare-associated pneumonia (HCAP) occurs in a patient who had been
hospitalized for more than 2 days duration within the last 90 days; is residing in a
nursing home or long-term care facility; received intravenous antibiotics,
chemotherapy, or wound care in the last 30 days; and/or attended a hospital or
hemodialysis clinic within 30 days.
Typical versus atypical pneumonia syndrome: This is a historical classification
system that refers to the distinguishing clinical features of pneumonia syndromes
that are often linked to particular pathogens.
Radiographic pattern: Lobar pneumonia, Bronchopneumonia, and Interstitial
pneumonia
Acute versus chronic pneumonia: a. Acute pneumonia has an abrupt onset,
measured in days. b. Chronic pneumonia develops over weeks to months and can
have an infectious or noninfectious etiology.
Pneumonia in the immunocompromised patient: The etiology depends on the
nature of the immunosuppression.
 Pathogenesis

Pathogens enter the lower respiratory tract

most commonly by micro aspiration from a
colonized oropharynx;
however, droplet inhalation of suspended
aerosolized microorganisms can play a role in
the pathogenesis of certain infections (e.g.,
respiratory viruses and Mycobacterium
tuberculosis).
 High-risk’ patients for developing the disease

1. Community-acquired pneumonia.
Alcoholism and smoking;
Age greater than 65 years.
Recent viral upper respiratory tract infection.
Underlying pulmonary diseases (e.g., chronic obstructive pulmonary
disease [COPD],
Immunosuppression (e.g., HIV infection, solid organ or stem cell
transplantation).
Medical comorbid conditions (e.g., heart failure, chronic kidney disease).
Stroke or sedating medications.
 2. Hospital-acquired pneumonia/ventilator-associated
pneumonia risk factors

Severity of underlying illness

(e.g., malnutrition, uremia, neutropenia) .
Prior surgery .
Prior and recent antibiotic administration.
Presence of invasive respiratory devices .
Supine positioning.
Enteral feeding with nasogastric or
orogastric tubes.
Stress ulcer prophylaxis.
Blood transfusions.
Poor oral hygiene.
 Clinical Manifestations

1. Community-Acquired Pneumonia:
Typical.
Atypical.
2. Healthcare-Associated: This is usually a subacute
process associated with malaise, cough, and fever.
 Control and
screening of the
disease
 Patient approach

A. History
B. Physical Examination
1. Vital signs.
2. Head, eyes, ears, nose, and throat (HEENT)
examination.
3. Pulmonary examination:
a. Inspection.
b. Palpation and percussion.
c. Auscultation

C. Laboratory Studies
 Radiologic Studies

1. The posterior–anterior and lateral plain-film

radiographic technique.
2. CT scans.

DIAGNOSTIC CRITERIA

A. Radiology.
B. Clinical/Laboratory.
C. Pulmonary.
 PREVENTION.

Influenza Virus Vaccination:

To permit time for production of protective antibody levels,
vaccination optimally should occur before onset of influenza activity
in the community. V
Streptococcus pneumoniae Vaccination:
For the prevention of invasive pneumococcal disease, the
pneumococcal polysaccharide vaccine is recommended for persons
at or above 65 years of age and for those aged 19 to 64 years with
selected high-risk concurrent diseases, according to current Advisory
Committee on Immunization Practices (ACIP) guidelines.
 Summary and key points.

Pneumonia is a medical condition characterized by inflammation and

infection of the lungs. It can be caused by a variety of pathogens such as
bacteria, viruses, fungi, or parasites. Pneumonia is a serious condition that
can affect people of all ages, but it is more common in older adults, infants,
and people with weakened immune systems.
Symptoms of pneumonia can vary depending on the cause, but they
typically include coughing, fever, chest pain, shortness of breath, fatigue,
and chills. Diagnosis of pneumonia usually involves a physical exam, chest
X-ray, and laboratory tests such as blood and sputum cultures.
Treatment for pneumonia typically involves antibiotics for bacterial
infections, antiviral medication for viral infections, and supportive care
References.