Michael Emory NUR 101 / MTCC PNE 2014                                                     Pneumonia       Pneumonia is a very serious infection or inflammation that can manifest one or both of your of your lungs. Many small germs, such as bacteria, viruses, and fungi, can cause pneumonia, however as I understand it, there are two main types Pneumonia; bacterial pneumonia and viral pneumonia. ("Understanding Pneumonia  N.p., n.d. Web. 12 Dec. 2013.)       Bacterial pneumonia can attack anyone from infants to the very old. People who are alcoholics, smokers, debilitated, post-operative patients, people with respiratory diseases or viral infections and people who have weakened immune systems are at greater risk. Pneumonia bacteria are present in some healthy throats. When body defenses are weakened in some way, by illness, old age, malnutrition, general debility or impaired immunity, the bacteria can multiply and cause serious damage. Usually, when a person’s resistance is lowered, bacteria work their way into the lungs and inflame the air sacs and a person’s temperature may rise to as high as 105 degrees Fahrenheit. ("Understanding Pneumonia  N.p., n.d. Web. 12 Dec. 2013.)      Another of the more common types is viral pneumonia. Half of all pneumonias are believed to be caused by viruses. More and more viruses are being identified as the cause of respiratory infection, and though most attack the upper respiratory tract, some of the organisms settle in small air sacs called alveoli and continue multiplying. As the body sends white blood cells to attack the infection, the sacs become filed with fluid and pus - causing pneumonia, especially in children. Most of these pneumonias are not serious and last a short time. Pneumonia coupled with the influenza virus may be severe and occasionally fatal. The virus invades the lungs and multiplies, but there are almost no physical signs of lung tissue becoming filled with fluid. It finds many of its victims among those who have pre-existing heart or lung disease or are pregnant. (Dasaraju, Purushothama - Web. 12 Dec. 2013.)       A pneumonia diagnosis usually begins with a physical exam and a discussion about your symptoms and medical history. A doctor may suspect pneumonia if they hear coarse breathing, wheezing, crackling sounds, or rumblings when listening to the chest through a stethoscope. Chest x-rays and blood tests may be ordered to confirm a pneumonia diagnosis. A chest x-ray can confirm pneumonia and determine its location and extent in the lungs. Blood tests measure white blood cell count to determine the severity of pneumonia and can be used to determine whether the infection is bacterial, viral, fungal, etc. An analysis of sputum also can be used to determine the organism that is causing the pneumonia. Under some circumstances a more invasive diagnostic tool is the bronchoscopy - a procedure whereby the patient is under anesthesia and a thin, flexible, and lighted tube is inserted into the nose or mouth to directly examine the infected parts of the lung. ( Medical News Today -Web. 11 Dec. 2013.)      In the United States, more than 3 million people develop pneumonia each year. Most people with pneumonia recover, but about 5% will succumb to the condition. The initial symptoms of viral pneumonia are the same as influenza symptoms: fever, a dry cough, headache, muscle pain, and weakness. Within 12 to 36 hours, there is increasing breathlessness; the cough becomes worse and produces a small amount of mucus. There is a high fever and there may be blueness of the lips. It can have over 30 different causes this means it is affected in different parts of the body. The main parts are lungs, stomach, and the temperature of the body. If you have pneumonia then you may suffer from fever, chills, cough, rapid breathing, breathing with grunting or wheezing sounds. Some other signs may include: Labored breathing that makes a child’s rib muscles retract (when muscles under the rib cage or between ribs draw inward with each breath), vomiting, chest pain, abdominal pain, loss of appetite. In extreme cases, bluish or grey color of the lips and fingernails.( Medical News Today -Web. 11 Dec. 2013.)      Increased awareness of pneumonia and vigilance in observations and basic nursing care will help nurses to identify possible cases of pneumonia, and facilitate early intervention and better quality of care for patients. Nursing treatment for pneumonia should include oxygen therapy as an essential component of treatment for all patients with pneumonia. Its aim is to maintain their saturations above 93%. Physiotherapy is often beneficial to help teach patients how to breathe properly, control their breathing and good posture to promote good lung expansion. Deep breathing helps to open the air passages in your lungs. Coughing helps to bring up sputum (mucus) from your lungs. You can deep breathe and cough on your own, or with the help of an incentive spirometer. Any signs of dehydration and hypotension should be addressed immediately as good hydration makes it easier for patients to expectorate secretions. Nutrition should also be considered. Many patients with severe pneumonia will experience nausea and therefore have a poor appetite however; their calorific requirement is raised due to the presence of infection. An adequate calorie intake should be sought to enable the body to fight the infection. (“Pneumonia 2: Nursing Practice  Web. 13 Dec. 2013.)      If you develop pneumonia, your chances of a fast recovery are greatest under certain conditions: if you’re young, if your pneumonia is caught early, if your defenses against disease are working well, if the infection hasn’t spread, and if you’re not suffering from other illnesses. The drugs used to fight pneumonia are determined by the germ causing the pneumonia and the judgment of the doctor. After a patient’s temperature returns to normal, medication must be continued according to the doctor’s instructions, otherwise the pneumonia may recur. Relapses can be far more serious than the first attack. Besides antibiotics, patients are given supportive treatment: proper diet and oxygen to increase oxygen in the blood when needed. In some patients, medication to ease chest pain and to provide relief from violent cough may be necessary. The most common place where it occurs is the lungs or the stomach. In 1996 (latest data available), there were an estimated 4.8 million cases of pneumonia resulting in 54.6 million restricted-activity days and 31.5 million bed days. In 2000, there were approximately 1.3 million hospitalizations, 1.3 million emergency room visits, and 63,548 deaths recorded in the United States. ( Foundations of Nursing, White & Duncan, 3rd Edition. 2011.)

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