Pneumonia: Risks and Interventions

What is Pneumonia: it’s a lower respiratory tract system that can be caused by aspiration, inhalation, or by hematogenous (originating from blood) spread. Classifications of pneumonia are based on causative agents, and they are bacterial, viral, fungal (which are rare) and chemical.

Who usually gets pneumonia? Debilitated people who have secretions accumulated in their lungs and depressed gag reflex, are sedated, cigarette smokers, immunosuppressed, immobile and has neuromuscular disorders. These people have increased risk.

How do you assess for Pneumonia? Tachypnea – shallow respirations using accessory muscles to breath. Shaking and chills (not often in elderly, their symptoms include confusion, lethargy, anorexia and rapid respiration rate). Pain and dullness during percussion over affected lung areas. Crackles heard on auscultation. Radiography shows infiltration or pleural effusion. White Blood Cells (WBC) are elevated. Arterial Blood Gas (ABG) indicated hypoxemia. SpO2 is decreased. Be wary of fever as it can cause dehydration, increased metabolism and increased demand of oxygen.

Plans and Interventions for Pneumonia: assess sputum for volume, color, consistency and clarity. Assist to cough productively by encouraging deep breathing, turn and reposition, and use of incentive spirometer. Provide humidity to loosen secretions and if necessary suction the airway. You can also encourage drinking up to 3 liters of fluids per day to help liquefy secretions. Assess lung sounds before and after coughing for any improvements – depth and pattern. ABG monitor should show PO2 greater than 80mmHg and PCO2 lower than 45mmHg. Check skin color, mental status, for restlessness and irritability. Irritability and restlessness are early signs of cerebral hypoxia where brain is lacking oxygen.

How to do prevent and treat pneumonia: Annual pneumonia and flu immunizations become important for susceptible patients. Avoid sources of infections; get rid of indoor pollutants such as aerosols, dust and smoke, and stop smoking. Consume sensible nutrition, and balance between rest and activity. Besides frequent turning, head of the bed should be elevated.


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