Community Acquired

Pneumonia

Bacteria:
Streptococcus pneumoniae

Predisposing
Factors

Modifiable: Non- Modifiable:

Bed ridden. Unable to turn. Age (94) , Sex (Female), Hip Fracture,
Development of bacteria History of Colon Cancer

Weak immune system.

History of colon cancer

Hip fracture. Bed ridden. Unable to

turn. Growth and development of
Streptococcus pneumoniae

Organism enters the respiratory tract through

inspiration/aspiration

Acute inflammation occurs that causes excess

water and plasma proteins go to the
dependent areas of the lower lobes
 RBCs, fibrin, and polymorphonuclear
leukocytes infiltrate the alveoli

Containment of the bacteria within the

segments of pulmonary lobes by cellular
recruitment

Consolidation of leukocytes and fibrin within

the affected area

Stage of congestion:
Engorgement of alveolar spaces with fluid
and hemorrhagic exudates

Proliferation and rapid spread of organism

through the lobe

Stage of red hepatization:

Coagulation of exudates occurs resulting to
the red appearance of the affected lung

Stage of gray hepatization:

The decrease in number of RBC in the
exudates is replaced by neutrophils; which
infiltrate the alveoli making the lung tissue to

PNEUMONIA
Complained of difficulty of breathing, patient had
productive cough, Wheezing sounds in the lungs,
crackles in the lungs.
Cough, Dyspnea, Chills, Fever, Vomiting, Chest pain or
angina, Cyanosis , Loss of Appetite, Crackling and
bubbling sounds in the chest during inhalation are usually
indicators of pneumonia. Wheezing may also be present.
(Community Acquired Pneumonia 2007, Welte)
Cough (with mucus-like, greenish, or pus-like sputum chills
with shaking ), fever, easy fatigue, chest pain (sharp or
stabbing increased by deep breathing or increased
by coughing), headache, loss of appetite, nausea and
vomiting, general discomfort, uneasiness, or ill feeling
(malaise), joint stiffness (rare), muscular
stiffness (rare), rales (Pathophysiology 6th
edition, McCance et.al) People with infectious pneumonia
often have a productive cough, fever accompanied
by shaking chills, shortness of breath, sharp or
stabbing chest pain during deep breaths, and an
increased respiratory rate. (Pneumonia: update on
diagnosis and management 2006, Hoare Z; Lim WS)

Diagnostic Test:
Chest x-ray

Surgery: Medication Nursing Intervention:

n/a Management:  Assess Vital Signs
Medicines prescribed: especially
Combivent Respiratory Status
Meropenem  Monitor breath
Carbocisteine sounds note
changes in sputum
production
 Maintain adequate
fluid intake
 Appropriate diet as
ordered by the
physician
 Coughing and deep
breathing exercise
 Chest Physiotherapy