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PNEUMONIA
PNEUMONIA
an infection that inflames the air sacs
in one or both lungs. The air sacs may
fill with fluid or pus (purulent material),
causing cough with phlegm or pus,
fever, chills, and difficulty breathing. A
variety of organisms, including
bacteria, viruses and fungi, can cause
pneumonia.
It can range in seriousness from mild to
life-threatening. It is most serious for
infants and young children, people
older than age 65, and people with
health problems or weakened immune
COMMUNITY-ACQUIRED PNEUMONIA (CAP)
COMMUNITY-ACQUIRED PNEUMONIA (CAP)
An acute infection of the lung parenchyma (the
functional tissue of the lungs) that individuals
develop outside of a hospital setting. It is defined
as pneumonia contracted outside of hospitals or
long-term care facilities, or within 48 hours of
hospital admission in patients without
immunodeficiency or active cancer. CAP is a
common illness that can affect people of all ages.
TYPES OF CAP
TYPES OF CAP
Typical Pneumonia Atypical Pneumonia

Usually caused by Caused by organisms

bacteria such as like Mycoplasma
Streptococcus pneumoniae, Chlamydia
pneumoniae, pneumoniae, or
Haemophilus influenzae, Legionella
or Moraxella catarrhalis.
BASED ON CAUSATIVE ORGANISM
BASED ON CAUSATIVE ORGANISM
CAP can also be classified by the specific pathogen
responsible for the infection. Common bacterial causes
include Streptococcus pneumoniae, Haemophilus
influenzae, and Staphylococcus aureus. Viral causes
include influenza viruses and human rhinovirus.

SEVERITY
SEVERITY
CAP can range from mild to severe, with the
severity influencing the treatment setting
(outpatient vs. inpatient) and approach.
VENTILATION ASSOCIATED PNEUMONIA (VAP)
VENTILATION ASSOCIATED PNEUMONIA (VAP)
Ventilation-associated pneumonia (VAP) is a
lung infection that develops in a patient who
has been on mechanical ventilation for more
than 48 hours. It is a type of hospital-acquired
infection (HAI). VAP is characterized by clinical
signs such as purulent tracheal discharge,
fever, and respiratory distress in the presence
of microorganisms.
TYPES OF VAP
TYPES OF VAP
Early-Onset VAP Late-Onset VAP

Occurs within the first 3-4 Develops after 3-4 days of

days of mechanical mechanical ventilation and
ventilation and is often is typically caused by more
caused by less virulent, virulent, hospital-acquired
community-acquired pathogens like
Pseudomonas aeruginosa,
organisms such as
Acinetobacter, and
Streptococcus pneumoniae
Methicillin-resistant
and Haemophilus
Staphylococcus aureus
influenzae.
(MRSA)
 ASSESSMENT
ASSESSMENT
Signs & Symptoms Clinical History
Cough (dry/productive) Recent RTI (flu, TB, colds)
Shortness of breath Chronic lung disease
Chest pain (pleuritic) (asthma, COPD)
Fever, chills, night sweats Prior hospitalization /
Fatigue, weakness surgery
Loss of appetite, Smoking & alcohol history
headache, muscle aches Allergies & medications
(VAP) Restlessness, (VAP) Duration of
discomfort, ↑ secretions ventilation, aspiration,
prior antibiotics
ASSESSMENT
ASSESSMENT
Risk Factors
Age extremes (very young / elderly)
Smoking, alcohol, substance use
Chronic illness (DM, heart, lung disease)
Malnutrition, poor health status
Immunocompromised state (HIV, cancer,
steroids)
(VAP) Prolonged ventilation, ET
tube/tracheostomy, long ICU stay, supine
position, poor oral care
 ASSESSMENT
ASSESSMENT
General Physical Vital Signs:
Findings: Fever
Cyanosis (lips, nail Tachypnea
beds) Tachycardia
Diaphoresis
Possible
(sweating)
hypotension in
Fatigue and
severe cases
weakness
 ASSESSMENT
ASSESSMENT
Respiratory Findings: Abnormal breath sounds:
Use of accessory crackles (rales), wheezes,
muscles, nasal flaring or bronchial breath
Dyspnea, labored sounds over consolidation
breathing Decreased breath sounds
Productive cough with in affected area
Dullness on percussion
rusty-colored sputum
over affected lung
(pathognomonic for
Decreased chest
Streptococcus
expansion on the affected
pneumoniae)
side
ASSESSMENT
ASSESSMENT

Diagnostic Results (if available):

Chest X-ray: infiltrates or
consolidation
CBC: WBC (leukocytosis)
↓
ABG: hypoxemia ( PaO₂), possible
respiratory alkalosis/acidosis
Positive sputum culture
NURSING DIAGNOSIS
NURSING DIAGNOSIS

1
Impaired Spontaneous Ventilation
Severe cases of pneumonia may deteriorate to respiratory
failure and the inability to breathe independently.

2
Impaired Gas Exchange
Pneumonia causing increased pus and mucus in the
alveoli will interfere with gas exchange and oxygenation.

3
Ineffective Airway Clearance
Pneumonia may increase sputum production causing
difficulty in clearing the airways.
NURSING DIAGNOSIS
NURSING DIAGNOSIS
Ineffective Breathing Pattern

4 Pneumonia is an infection of the lungs that can alter

respiratory patterns, preventing adequate
ventilation.

Risk For Infection

5
Pneumonia is an infection itself as untreated
pneumonia can progress into a secondary infection
or sepsis.
PLANNING
PLANNING
Short-Term: At the end of 8 hours nursing interventions, the
patient will be able to:
Improved Oxygenation: The client will maintain oxygen
saturation above 92% with supplemental oxygen therapy.

Stable Vital Sign : The client's vital signs will stabilize, with
normal temperature, heart rate, and respiratory rate.

Clear Breath Sound : The client will exhibit improved breath

sounds with decreased adventitious sounds.
PLANNING
PLANNING
Short-Term: At the end of 8 hours nursing interventions, the
patient will be able to:

Effective Coughing: The client will demonstrate

effective coughing techniques to clear secretions.

5. Medication Adherence: The client will receive

and tolerate prescribed medications without
adverse effects.
PLANNING
PLANNING
Long-Term: At the end of 6 days nursing interventions, the
patient will be able to:
Normal Chest X-ray: The client's chest x-ray will show
significant improvement or resolution of pneumonia.

Optimal Gas Exchange: The client will maintain optimal gas

exchange as evidenced by stable ABG levels and oxygen
saturation above 92% on room air.

No Complications: The client will experience no complications

related to pneumonia, such as respiratory failure or sepsis.
PLANNING
PLANNING
Long-Term: At the end of 6 days nursing interventions, the
patient will be able to:
Full Participation in Care: The client will actively
participate in actions, such as deep breathing exercises,
coughing, and using incentive spirometry as prescribed.

Discharge Preparation: The client will demonstrate

understanding of discharge instructions, including
medication management, follow-up appointments, and
self-care techniques.
IMPLEMENTATION
IMPLEMENTATION INDEPENDENT
INDEPENDENT

Positioning the patient in semi-Fowler’s or Fowler’s position

Encouraging coughing and deep breathing exercises
Monitoring respiratory status frequently (rate, rhythm,
depth, oxygen saturation, use of accessory muscles)
Encouraging fluid intake (if not contraindicated)
Providing adequate rest periods.
Teaching the patient about proper hand hygiene and
cough etiquette
Providing a calm environment and reducing anxiety
Educating the patient about smoking cessation and
avoiding lung irritants
IMPLEMENTATION
IMPLEMENTATION INTERDEPENDENT
INTERDEPENDENT

Oxygen therapy: IV fluids:

If patient not getting Fluids delivered
enough oxygen, a
directly to your
provider may give
extra oxygen through
vein (IV) treat or
a tube in your nose or prevent
a mask on your face. dehydration.
IMPLEMENTATION
IMPLEMENTATION
Antibiotics:
INTERDEPENDENT
INTERDEPENDENT

These medicines are used to treat bacterial pneumonia.

Antifungal:
can treat pneumonia caused by a fungal infection.

Antiviral:
Physicians may prescribe antivirals such as;
- oseltamivir(Tamiflu®),
- zanamivir (Relenza®) or
- peramivir (Rapivab®) to reduce how long you’re sick and
how sick you get from a virus.
IMPLEMENTATION
IMPLEMENTATION INTERDEPENDENT
INTERDEPENDENT

Pain relievers and fever reducers:

Your provider may recommend medicines like
ibuprofen (Advil®) and acetaminophen (Tylenol®)
to help with body aches and fever.

Cough suppressants:
Check with your healthcare provider before taking
cough suppressants for pneumonia.
IMPLEMENTATION
IMPLEMENTATION NUTRITION/DIET
NUTRITION/DIET

Whole Grains
Whole grains like brown rice, oats, and barley have good carbohydrate
content to give the energy one needs to recover. The selenium content
present in whole grains boosts the immune system as well.
Green Leafy Vegetables
Spinach, kale, and other green leafy vegetables contain antioxidants
that help with the healing of respiratory infections like pneumonia
faster.
Protein-rich Foods
Nuts, beans, seeds, chicken, and fish like salmon have anti-
inflammatory properties. A protein-rich diet helps build new tissues in
the body and replace the damaged lung tissues affected by
pneumonia.
IMPLEMENTATION
IMPLEMENTATION NUTRITION/DIET
NUTRITION/DIET

Yoghurt
Yoghurt has excellent probiotics which promote good bacteria
in the gut, and also suppress the growth of pneumonia-
causing pathogens.
Water
Apart from the above 4 best food to prevent pneumonia,
drinking water is very important. It is important to keep oneself
hydrated with water and other healthy liquids like tender
coconut water. This loosens the mucus that builds up in the
lungs during the pneumonia infection. Water also flushes out
toxins from the body.
IMPLEMENTATION
IMPLEMENTATION SURGICAL
SURGICAL

Thoracotomy:
An incision into the chest wall, allowing direct visualization
and removal of damaged lung tissue.

Lobectomy:
Surgical removal of a lobe of the lung, often used for
localized, severe pneumonia.

Wedge Resection:
Removal of a small, wedge-shaped piece of lung tissue.
IMPLEMENTATION
IMPLEMENTATION SURGICAL
SURGICAL

Chest Tube Insertion:

Used to drain pus (empyema), blood, or air from
the space around the lungs (pleural space).

Decortication:
Removal of a thick, fibrous coating (peel) that
can form on the lung surface in some cases of
empyema, allowing the lung to expand properly.
IMPLEMENTATION
IMPLEMENTATION PATIENT EDUCATION
PATIENT EDUCATION

•Importance of completing prescribed

antibiotic course
•Recognizing early signs of recurrence or
complications (e.g., increasing shortness of
breath, high fever)
•Smoking cessation if applicable
•Importance of flu and pneumococcal
vaccines
•Proper hand hygiene and respiratory etiquette
EVALUATION
EVALUATION
•Patient demonstrates improved respiratory
status (SpO₂ > 92%, clear breath sounds)
•Patient is afebrile and reports decreased chest
pain
•Patient verbalizes understanding of treatment
and preventive measures
•Chest X-ray shows improvement
•No signs of complications or worsening of
condition
T
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