Pneumonia is an inflammatory illness of the lung. It is often described as lung parenchyma or alveolar inflammation leading to abnormal alveolar filling with fluid. Pneumonia can result from a variety of causes, including infection with microorganisms like bacteria, viruses, fungi, or parasites, and chemical or physical injury to the lungs.
Incidence & Statistics
Pneumonia is a common illness in all parts of the world in all age groups. Majority of deaths occur in the newborn period in children, with over two million deaths a year worldwide.
- The World Health Organization estimates that one out of three newborn infant deaths is due to pneumonia.
- It kills more children than any other illness, accounting for 19% of all under-five deaths.
- According to the National Statistical Coordination Board of the Philippines, there are 776,562 of pneumonia in the country in 2004 alone. This could be an implication that pneumonia is one of the leading causes of morbidity and mortality in the country.
- World Health Organization notes Invasive Pneumococcal Disease deaths at 1.6 million people each year.
- Of these, 700,000 to one million are children under five years old and over 90 percent of these deaths occur in developing countries.
- Pneumonia is a top killer in India, China, Nigeria, Pakistan, Bangladesh, Indonesia, and Brazil.
Nursing Care Plans
Here are 5 nursing care plans for pneumonia.
1. Ineffective Airway Clearance
Nursing Diagnosis: Ineffective airway clearance related to presence of secretions secondary to pneumonia.
The inflammation and increased secretions make it difficult to maintain a patent airway, which is cause by decrease ability to expel the excessive mucus produced that will lead to extensive obstruction of the airway.
2. Ineffective Breathing Pattern
Nursing Diagnosis: Ineffective breathing pattern related to presence of tracheo-bronchial secretions and nasal secretions
Alteration on the client’s O2:CO2 ratio due to decreased absorbed oxygen and poor gas exchage related to presence to exudates on the alveolar spaces causes the body to cope by increasing respiratory rate or by hyperventilation. The increase in respiratory rate is elicited to cause an increase in the tidal volume of air that in inspired in order to absorb more oxygen. The increase in respiratory rate may need the assistance of accessory muscle that would be evident by the rising and falling of the shoulders during inspiration and expiration.
3. Impaired Gas Exchange
NDx: Impaired gas exchange related to alveolar capillary membrane changes secondary to inflammation.
Bronchospasm, which occurs in many pulmonary diseases, reduces the caliber of the small bronchi and may cause dyspnea, static secretions and infections. Bronchospasm can sometimes be detected by stethoscope when wheezing or diminished breath sounds are heard. Increase mucous production along with decrease mucous ciliary’s action, contributes to further reduction in the caliber of the bronchi and results in decrease air flow and decrease gas exchange.
4. Risk for Infection
NDx: Risk for infection (spread) related to inadequate secondary defenses(decrease hemoglobin, hematocrit and immunosuppression)
Immuno-suppression due to decrease in hemoglobin, leukopenia, and suppress inflammatory response gives a greater opportunity for pathogenic bacteria to invade and inoculate in a specific body part of a susceptible human body. Thus, leading to a further damage or infection.
Presence of microorganisms stimulates the release of pyrogen from the leukocytes resetting the body’s thermostat to febrile level and then there would be activation of the hypothalamus, which will result in increase in epinephrine and norepinephrine, vasoconstriction of cutaneous vessels. The heat will be produced as peripheral vasodilation results in skin flushing and skin is warm to touch.