Our Lady of Fatima University
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NCM 101- Group 41 D
Ponce, Exequiel M.
Ruales, Jemmalyn B.
Santiago, Sarah R.
Santos, Ran Robert F.
Valera, Rona M.
August 30, 2008
I. Introduction
II. Objectives
-General Objectives
-Specific Objectives
III.Nursing History
IV. Physical Assessment
V. Anatomy and Physiology
VI. Pathophysiology
VII.Nursing Care Plan
VIII.Drug Study
IX. Health Teachings
X. Evaluation
Pneumonia is an inflammatory illness of the lung. Frequently,
it is described as lung parenchyma/alveolar inflammation and
abnormal alveolar filling with fluid. The alveoli are microscopic
air-filled sacs in the lungs responsible for absorbing oxygen from
the atmosphere. Pneumonia can result from a variety of causes,
including infection with bacteria, viruses, fungi or parasites, and
chemical or physical injury to the lungs. Its cause may also be
officially described as idiopathic- that is unknown when infectious
cause has been excluded. Typical symptoms associated with
pneumonia included cough, fever, chest pain, fever, and difficulty
in breathing. Diagnostic tools include x-rays and examination of
the sputum treatment depends on the cause of pneumonia,
bacterial pneumonia is treated with antibiotics.
Pneumonia is a common illness which occurs in all age groups,
and is a leading cause of death among elderly and people who are
chronically and terminally ill. Vaccines to prevent certain types of
pneumonia are available. The prognosis depends on the type of
pneumonia, the appropriate treatment any complications and the
person’s underlying health.
People with infectious pneumonia often have a cough
producing greenish or yellow sputum, or phlegm and a high fever
that may be accompanied by shaking chills. Shortness of breath is
also common, as is pleuritic chest pain, a sharp or stabbing pain,
either experienced during deep breaths or coughs or worsened by
it. People with pneumonia may cough up blood, experience
headaches, or develop sweaty and clammy skin. Other possible
symptoms are loss of appetite, fatigue, blueness of the skin,
nausea, vomiting, mood swings, and joint pains or muscle aches.
Less common forms of pneumonia can cause other symptoms; for
instance, pneumonia caused by Legionella may cause abdominal
pain and diarrhea, while pneumonia caused by tuberculosis or
Pneumocystis may cause only weight loss and night sweats. In
elderly people manifestations of pneumonia may not be typical.
They may develop a new or worsening confusion or may experience
unsteadiness, leading to falls. Infants with pneumonia may have
many of the symptoms above, but in many cases they are simply
sleepy or have a decreased appetite. Symptoms of pneumonia
need immediate medical evaluation. Physical examination by a
health care provider may reveal fever or sometimes low body
temperature, an increased respiratory rate, low blood pressure, a
high heart rate, or a low oxygen saturation, which is the amount
of oxygen in the blood as indicated by either pulse oximetry or
blood gas analysis. People who are struggling to breathe, who are
confused, or who have cyanosis (blue-tinged skin) require
immediate attention. Physical of the lungs may be normal, but
often shows decreased expansion of the chest on the affected
side, bronchial breathing on auscultation with a stethoscope
(harsher sounds from the larger airways transmitted through the
inflamed and consolidated lung), and rales heard over the
affected area. Percussion may be dulled over the affected lung,
but increased rather than decreased vocal resonance (which
distinguishes it from a pleural effusion). While these signs are
relevant, they are insufficient to diagnose or rule out pneumonia;
moreover, in studies it has been shown that two doctors can
arrive at different findings on the same patient.
Pneumonia fills the lung's alveoli with fluid, keeping oxygen
from reaching the bloodstream. The alveolus on the left is
normal, while the alveolus on the right is full of fluid from
pneumonia.
A: Normal chest x-ray
B: Abnormal chest x-ray
with shadowing from pneumonia
in the right lung
Pneumonia as seen on chest x-ray.
PERSONAL HISTORY
This is a case of a fifty-three years old female patient she
was born on March 16, 1955. She is a Filipino, a roman catholic
and lives at # 153 Cainsin, Malolos, Bulacan.
CHIEF COMPLAINT
Cough and fever
HISTORY OF PRESENT ILLNESS
Three weeks prior to admission patient started to have
cough with associated chest pain and fever persistent signs and
symptoms consulted then patient was admit.
PAST MEDICAL HISTORY
The patient has asthma since she was 4 years old.
GENERAL NORMAL ABNORMAL
APPERANCE
SKIN
FACE
NECK
LUNGS
ABDOMEN
EXTREMITIES
VITAL SIGNS
BP- 150/80
RR- 24 cpm
PR- 76 bpm
T- 36.6 C
GENERAL OBJECTIVES
The participants apply the knowledge that they learned,
practice and enhance their skills, and at the same time for them
to develop their attitude. The client and her family will be able to
understand what pneumonia is. This case study will serve as a
future reference.
SPECIFIC OBJECTIVES
• Collect data for base to serve as baseline
• Inform the family what is pneumonia and it’s
classification
• Instruct the client and her family with the importance
of check-up and follow up visits taking prescribed
medications on time
• Demonstrate nursing measures in caring for a client
with pneumonia
• Evaluate the effectiveness of nursing care rendered
M The patient and her significant others were informed about
the importance of taking proper medications on the right
dose, route, and time as prescribed by the physicians.
E Encouraged her significant others to provide quiet
environment to promote non pharmacological pain
management.
T Instructed her significant others how to manage the patient
when in pain related to bronchial asthma.
H Demonstrated proper hand washing and encouraged good
grooming to promote self-esteem.
O Emphasized the importance of attending follow up check up
to monitor the status of the client.
D Encouraged her significant others to provide diet as
ordered by physicians and explained its importance on the
present situation of the patient.
S Instructed her significant others when at home to watch
out when the patient is in pain to prevent accident that may
contribute in worsening of the present situation.
After the case study the participants were able to meet
this objective.
This case study was able to present information regarding
bronchial asthma and its mechanism.
The lung is the essential respiration organ in air-breathing
animals, including most tetrapods, a few fish and a few snails. The
most primitive animals with a lung are the lungfish (vertebrate)
and the pulmonate snails (invertebrate). In mammals and the more
complex life forms, the two lungs are located in the chest on
either side of the heart. Their principal function is to transport
oxygen from the atmosphere into the bloodstream, and to release
carbon dioxide from the bloodstream into the atmosphere. This
exchange of gases is accomplished in the mosaic of specialized
cells that form millions of tiny, exceptionally thin-walled air sacs
called alveoli.
In humans, the trachea divides into the two main bronchi that
enter the roots of the lungs. The bronchi continue to divide
within the lung, and after multiple divisions, give rise to
bronchioles. The bronchial tree continues branching until it
reaches the level of terminal bronchioles, which lead to alveolar
sacs. Alveolar sacs are made up of clusters of alveoli, like
individual grapes within a bunch. The individual alveoli are tightly
wrapped in blood vessels, and it is here that gas exchange
actually occurs. Deoxygenated blood from the heart is pumped
through the pulmonary artery to the lungs, where oxygen
diffuses into blood and is exchanged for carbon dioxide in the
hemoglobin of the erythrocytes. The oxygen-rich blood returns
to the heart via the pulmonary veins to be pumped back into
systemic circulation. Human lungs are located in two cavities on
either side of the heart. Though similar in appearance, the two
are not identical. Both are separated into lobes, with three lobes
on the right and two on the left. The lobes are further divided
into segments, then lobules, hexagonal divisions of the lungs that
are the smallest subdivision visible to the naked eye. The
connective tissue that divides lobules is often blackened in
smokers and city dwellers. The medial border of the right lung is
nearly vertical, while the left lung contains a cardiac notch. The
cardiac notch is a concave impression molded to accommodate the
shape of the heart. Lungs are to a certain extent ‘overbuilt’ and
have a tremendous reserve volume as compared to the oxygen
exchange requirements when at rest. This is one of the reasons
that individuals can smoke for years without having a noticeable
decrease in lung function while still or moving slowly; in situations
like these only a small portion of the lungs are actually perfuse
with blood for gas exchange. As oxygen requirements increase
due to exercise, a greater volume of the lungs is perfuse, allowing
the body to match its CO2/O2 exchange requirements. The
environment of the lung is very moist, which makes it hospitable
for bacteria. Many respiratory illnesses are the result of
bacterial or viral infection of the lungs.
Our Lady of Fatima University
M
a
r
u
l
a
s
,
V
a
l
e
n
z
u
e
l
a
C
i
t
y
NCM 101- Group 41 D
Ponce, Exequiel M.
Ruales, Jemmalyn B.
Santiago, Sarah R.
Santos, Ran Robert F.
Valera, Rona M.
August 30, 2008
XI. Introduction
XII.Objectives
-General Objectives
-Specific Objectives
XIII.Nursing History
XIV.Physical Assessment
XV. Anatomy and Physiology
XVI.Pathophysiology
XVII.Nursing Care Plan
XVIII.Drug Study
XIX.Health Teachings
XX. Evaluation
Pneumonia is an inflammatory illness of the lung. Frequently,
it is described as lung parenchyma/alveolar inflammation and
abnormal alveolar filling with fluid. The alveoli are microscopic
air-filled sacs in the lungs responsible for absorbing oxygen from
the atmosphere. Pneumonia can result from a variety of causes,
including infection with bacteria, viruses, fungi or parasites, and
chemical or physical injury to the lungs. Its cause may also be
officially described as idiopathic- that is unknown when infectious
cause has been excluded. Typical symptoms associated with
pneumonia included cough, fever, chest pain, fever, and difficulty
in breathing. Diagnostic tools include x-rays and examination of
the sputum treatment depends on the cause of pneumonia,
bacterial pneumonia is treated with antibiotics.
Pneumonia is a common illness which occurs in all age groups,
and is a leading cause of death among elderly and people who are
chronically and terminally ill. Vaccines to prevent certain types of
pneumonia are available. The prognosis depends on the type of
pneumonia, the appropriate treatment any complications and the
person’s underlying health.
People with infectious pneumonia often have a cough
producing greenish or yellow sputum, or phlegm and a high fever
that may be accompanied by shaking chills. Shortness of breath is
also common, as is pleuritic chest pain, a sharp or stabbing pain,
either experienced during deep breaths or coughs or worsened by
it. People with pneumonia may cough up blood, experience
headaches, or develop sweaty and clammy skin. Other possible
symptoms are loss of appetite, fatigue, blueness of the skin,
nausea, vomiting, mood swings, and joint pains or muscle aches.
Less common forms of pneumonia can cause other symptoms; for
instance, pneumonia caused by Legionella may cause abdominal
pain and diarrhea, while pneumonia caused by tuberculosis or
Pneumocystis may cause only weight loss and night sweats. In
elderly people manifestations of pneumonia may not be typical.
They may develop a new or worsening confusion or may experience
unsteadiness, leading to falls. Infants with pneumonia may have
many of the symptoms above, but in many cases they are simply
sleepy or have a decreased appetite. Symptoms of pneumonia
need immediate medical evaluation. Physical examination by a
health care provider may reveal fever or sometimes low body
temperature, an increased respiratory rate, low blood pressure, a
high heart rate, or a low oxygen saturation, which is the amount
of oxygen in the blood as indicated by either pulse oximetry or
blood gas analysis. People who are struggling to breathe, who are
confused, or who have cyanosis (blue-tinged skin) require
immediate attention. Physical of the lungs may be normal, but
often shows decreased expansion of the chest on the affected
side, bronchial breathing on auscultation with a stethoscope
(harsher sounds from the larger airways transmitted through the
inflamed and consolidated lung), and rales heard over the
affected area. Percussion may be dulled over the affected lung,
but increased rather than decreased vocal resonance (which
distinguishes it from a pleural effusion). While these signs are
relevant, they are insufficient to diagnose or rule out pneumonia;
moreover, in studies it has been shown that two doctors can
arrive at different findings on the same patient.
Pneumonia fills the lung's alveoli with fluid, keeping oxygen
from reaching the bloodstream. The alveolus on the left is
normal, while the alveolus on the right is full of fluid from
pneumonia.
A: Normal chest x-ray
B: Abnormal chest x-ray
with shadowing from pneumonia
in the right lung
Pneumonia as seen on chest x-ray.
PERSONAL HISTORY
This is a case of a fifty-three years old female patient she
was born on March 16, 1955. She is a Filipino, a roman catholic
and lives at # 153 Cainsin, Malolos, Bulacan.
CHIEF COMPLAINT
Cough and fever
HISTORY OF PRESENT ILLNESS
Three weeks prior to admission patient started to have
cough with associated chest pain and fever persistent signs and
symptoms consulted then patient was admit.
PAST MEDICAL HISTORY
The patient has asthma since she was 4 years old.
GENERAL NORMAL ABNORMAL
APPERANCE
SKIN
FACE
NECK
LUNGS
ABDOMEN
EXTREMITIES
VITAL SIGNS
BP- 150/80
RR- 24 cpm
PR- 76 bpm
T- 36.6 C
GENERAL OBJECTIVES
The participants apply the knowledge that they learned,
practice and enhance their skills, and at the same time for them
to develop their attitude. The client and her family will be able to
understand what pneumonia is. This case study will serve as a
future reference.
SPECIFIC OBJECTIVES
• Collect data for base to serve as baseline
• Inform the family what is pneumonia and it’s
classification
• Instruct the client and her family with the importance
of check-up and follow up visits taking prescribed
medications on time
• Demonstrate nursing measures in caring for a client
with pneumonia
• Evaluate the effectiveness of nursing care rendered
M The patient and her significant others were informed about
the importance of taking proper medications on the right
dose, route, and time as prescribed by the physicians.
E Encouraged her significant others to provide quiet
environment to promote non pharmacological pain
management.
T Instructed her significant others how to manage the patient
when in pain related to bronchial asthma.
H Demonstrated proper hand washing and encouraged good
grooming to promote self-esteem.
O Emphasized the importance of attending follow up check up
to monitor the status of the client.
D Encouraged her significant others to provide diet as
ordered by physicians and explained its importance on the
present situation of the patient.
S Instructed her significant others when at home to watch
out when the patient is in pain to prevent accident that may
contribute in worsening of the present situation.
After the case study the participants were able to meet
this objective.
This case study was able to present information regarding
bronchial asthma and its mechanism.
The lung is the essential respiration organ in air-breathing
animals, including most tetrapods, a few fish and a few snails. The
most primitive animals with a lung are the lungfish (vertebrate)
and the pulmonate snails (invertebrate). In mammals and the more
complex life forms, the two lungs are located in the chest on
either side of the heart. Their principal function is to transport
oxygen from the atmosphere into the bloodstream, and to release
carbon dioxide from the bloodstream into the atmosphere. This
exchange of gases is accomplished in the mosaic of specialized
cells that form millions of tiny, exceptionally thin-walled air sacs
called alveoli.
In humans, the trachea divides into the two main bronchi that
enter the roots of the lungs. The bronchi continue to divide
within the lung, and after multiple divisions, give rise to
bronchioles. The bronchial tree continues branching until it
reaches the level of terminal bronchioles, which lead to alveolar
sacs. Alveolar sacs are made up of clusters of alveoli, like
individual grapes within a bunch. The individual alveoli are tightly
wrapped in blood vessels, and it is here that gas exchange
actually occurs. Deoxygenated blood from the heart is pumped
through the pulmonary artery to the lungs, where oxygen
diffuses into blood and is exchanged for carbon dioxide in the
hemoglobin of the erythrocytes. The oxygen-rich blood returns
to the heart via the pulmonary veins to be pumped back into
systemic circulation. Human lungs are located in two cavities on
either side of the heart. Though similar in appearance, the two
are not identical. Both are separated into lobes, with three lobes
on the right and two on the left. The lobes are further divided
into segments, then lobules, hexagonal divisions of the lungs that
are the smallest subdivision visible to the naked eye. The
connective tissue that divides lobules is often blackened in
smokers and city dwellers. The medial border of the right lung is
nearly vertical, while the left lung contains a cardiac notch. The
cardiac notch is a concave impression molded to accommodate the
shape of the heart. Lungs are to a certain extent ‘overbuilt’ and
have a tremendous reserve volume as compared to the oxygen
exchange requirements when at rest. This is one of the reasons
that individuals can smoke for years without having a noticeable
decrease in lung function while still or moving slowly; in situations
like these only a small portion of the lungs are actually perfuse
with blood for gas exchange. As oxygen requirements increase
due to exercise, a greater volume of the lungs is perfuse, allowing
the body to match its CO2/O2 exchange requirements. The
environment of the lung is very moist, which makes it hospitable
for bacteria. Many respiratory illnesses are the result of
bacterial or viral infection of the lungs.
