HARER HEALTH SCIENCE COLLEGE

DEPARTMENT OF C/NURS
NAME Group 5
YOHANNES DERESE 0582/14
TIGIST TOLOSA 0576/14
FEBEN GIRMA 0534/14
YITBAREK TEKABE 0581/14
REBKA KETEMA 0567/14
MEGERSA JEMAL 0552/14
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SUBMMITED TO MR ZELALEM
Pneumonia

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 Objectives
After the end of this chapter the student will be able to:

 Define Pneumonia

 classify pneumonia

 Explain the Etiology of Pneumonia

 Reflect on the significance of patient education

 Apply evidence-based nursing practices in assessing and

monitoring pneumonia

 Demonstrate proper techniques for Management Strategies

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What is pneumonia?

Definition

Pneumonia is 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

Pneumonia 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 systems.

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Classification of pneumonia
 Based on the Setting of Acquisition
Community-Acquired Pneumonia (CAP): Acquired outside of a healthcare
setting. It is the most common type of pneumonia and can be caused by bacteria,
viruses, or fungi.

Hospital-Acquired Pneumonia (HAP): Acquired during a hospital stay, typically

after 48 hours of admission. It often involves more resistant organisms and can be
more severe.

•Ventilator-Associated Pneumonia (VAP):

A type of HAP that occurs
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in people who are on mechanical ventilation for more than

 Based on the Causative Agent
Bacterial Pneumonia: Caused by bacteria; common pathogens include
Streptococcus pneumoniae, Homophiles influenzae, and Staphylococcus aureus.
Viral Pneumonia: Caused by viruses; common viral pathogens include influenza
virus, respiratory syncytial virus (RSV), and coronaviruses (including SARS-CoV-2).

Fungal Pneumonia: Caused by fungi; more common in immunocompromised

individuals. Common fungi include Histoplasma, Coccidioides, and Cryptococcus.

 Aspiration Pneumonia: Occurs when food, liquid, or vomit is inhaled into the
lungs, often involving anaerobic bacteria.
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 Based on Immune Status
Typical Pneumonia: Generally affects healthy
individuals with normal immune function.

Atypical Pneumonia: Often affects individuals with

compromised immune systems

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Etiology of pneumonia

 Bacterial Causes
 Streptococcus pneumonia: The most common cause of community-acquired pneumonia.
 Homophiles influenzae: Particularly in individuals with chronic lung
diseases.
 Mycoplasma pneumoniae: Often associated with atypical pneumonia,
especially in younger populations.
 Chlamydia pneumoniae: Can cause mild respiratory infections.
 Legionella pneumophila: Causes Legionnaires' disease, often linked
to contaminated water sources.
 Staphylococcus aureus: Including Methicillin-resistant
Staphylococcus aureus (MRSA), can cause severe pneumonia.
Klebsiella pneumoniae: More common in individuals
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8

health issues or alcohol abuse.

 Viral Causes
 Influenza Virus: A significant cause of viral pneumonia, especially during
flu season.
 Respiratory Syncytial Virus (RSV): Common in infants and
young children.

Adenovirus: Can cause respiratory infections in all age groups.

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 Aspiration Pneumonia
 Occurs when food, liquid, or vomit is inhaled into the
lungs, leading to infection. This can happen in individuals
with swallowing difficulties or altered consciousness.

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Risk factor
 Age
 Chronic Lung Diseases:
 Heart Disease:
 Diabetes:
 Kidney Diseas

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Clinical manifestation

 Fever:

Chills:

Fatigue:

-Cough

Shortness of Breath (Dyspnea)

Chest Pain: Plea

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Investigation

 CXR
 CBC
 Sputum gram stain
 Blood culture
 ABG
 Urea/Electrolytes

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Diagnosis

Clinical Evaluation

Imaging Studies

 Physical Examination:

 Laboratory Tests

 Additional Tests

Differential Diagnosis

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Management

 Initial Assessment

Severity Assessment: Use tools like the CURB-65 score (Confusion,

Urea, Respiratory rate, Blood pressure, Age ≥ 65) or the Pneumonia
Severity Index (PSI) to determine the severity of pneumonia and the
need for hospitalization.

Vital Signs Monitoring: Continuous monitoring of respiratory rate, oxygen saturation,

heart rate, and blood pressure.

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 Antibiotic Therapy

Empirical Antibiotic Treatment: Initiate broad-spectrum antibiotics as soon as pneumonia is suspected,

particularly in severe cases.

Outpatient: Options may include amoxicillin,

doxycycline, or macrolides (e.g., azithromycin).

 Inpatient (non-ICU): Options may include beta-lactam antibiotics (e.g., ceftriaxone) plus macrolide or respiratory

fluoroquinolones.

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 Oxygen Therapy: Administer supplemental oxygen to maintain adequate oxygen saturation (SpO2 > 92%).

Hydration: Ensure adequate fluid intake, either orally or intravenously if the patient is unable to maintain
hydration.

Antipyretics and Analgesics

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 Complications

Pleural Effusion

 Lung Abscess

Sepsis

 Respiratory Failure

 Bronchiectasis

Pulmonary Fibrosis

Empyema

Meningitis

 Acute Respiratory Distress Syndrome (ARDS)

Cardiac Complications

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Nursing management

1. Assessment
 Vital Signs: Monitor temperature, respiratory rate, heart rate, and blood pressure.
Look for signs of fever or hypoxia.

Respiratory Assessment: Assess lung sounds (e.g., wheezing, crackles), respiratory

effort, use of accessory muscles, and oxygen saturation levels.

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Patient History: Obtain a detailed history including onset of symptoms, duration, previous respiratory
issues, and any comorbidities.

 Physical Examination: Check for signs of dehydration, cyanosis, clubbing of fingers, or signs of respiratory
distress.

Diagnostic Tests: Review results from chest X-rays, sputum cultures, blood tests (CBC, blood cultures), and
any other relevant imaging or diagnostics.

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2. Planning

Goals: Establish clear patient-centered goals such as improved respiratory function,

reduced fever, effective cough, and prevention of complications.

Interdisciplinary Collaboration: Work with the healthcare team to develop a

comprehensive care plan that may include medications (antibiotics, bronchodilators),
respiratory therapy, and nutritional support.

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3. Implementation

Administer Medications

 Administer prescribed antibiotics and monitor for effectiveness and side effects.

Provide bronchodilators or corticosteroids as ordered to reduce inflammation and

open airways.
 Oxygen Therapy:

Administer supplemental oxygen to maintain adequate oxygen saturation levels

(typically >92%).
 Monitor the patient’s response to oxygen therapy.
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4. Evaluation

Monitor Progress:

Evaluate the patient's response to treatment by assessing vital signs,

respiratory status, and overall clinical condition regularly.

Assess for resolution of fever and improvement in respiratory function (e.g.,

decreased work of breathing, improved oxygen saturation).

 Follow-Up Care:
Ensure follow-up appointments are scheduled for continued assessment and

monitoring.
 Discuss signs and symptoms that would require immediate medical

attention.
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5. Patient Education
Provide information on:

 The importance of completing prescribed antibiotics.

 Recognizing signs of worsening condition (e.g., increased shortness of breath, high fever).

Lifestyle modifications such as smoking cessation and vaccination (e.g., pneumococcal vaccine) to prevent
future infections.

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End of lecture

Are you Ready for the examination ?

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True or False (10 Question)
 1. Pneumonia is an infection that inflames the air sacs in the
lungs.

 2. Community-Acquired Pneumonia (CAP) is only caused by

bacteria.

 3. Ventilator-Associated Pneumonia (VAP) occurs in patients

on mechanical ventilation for less than 24 hours.

 4. Streptococcus pneumonia is the most common cause of

bacterial pneumonia.

 5. Fungal pneumonia is more common in individuals with

strong immune systems.

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True or False (10 Question)
 6. Aspiration pneumonia occurs when food or liquid enters
the lungs.

 7. Influenza pneumonia is often complicated by secondary

bacterial infections like S. aureus.

 8. A chest X-ray (CXR) is not useful in diagnosing pneumonia.

 9. Oxygen therapy is only used in severe cases of pneumonia.

 10. The CURB-65 score helps assess the severity of

pneumonia.

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Multiple Choice Questions (20)
 1. What is the most common cause of bacterial pneumonia?
a) Influenza virus b) Streptococcus pneumonia
c) Candida albicans d) Escherichia coli

 2. A nursing home resident develops pneumonia 3 days after

hospitalization. This is classified as:
A) CAP B) HCAP
C) VAP D) HAP

 3. Which diagnostic test is most commonly used to confirm pneumonia?

a) ECG b) MRI
c) Chest X-ray (CXR) d) Urinalysis

 4. What is a common symptom of pneumonia?

a) Joint pain b) Cough with phlegm
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c) Hair loss d) Blurred vision
Multiple Choice Questions (20)
 5. Which of the following is NOT a complication of pneumonia?
a) Pleural effusion b) Sepsis
c) Hypertension d) Lung abscess

 6. Which antibiotic is commonly used for outpatient pneumonia

treatment?
a) Insulin b) Paracetamol
c) Warfarin d) Amoxicillin

 7. What is the purpose of the CURB-65 score?

a) To assess pneumonia severity b) To diagnose fungal
infections
c) To measure blood sugar levels d) To evaluate kidney function

 8. Which group is at the highest risk for severe pneumonia?

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a) Teenagers b) Elderly (over 65)
c) Athletes d) Vegetarians
Multiple Choice Questions (20)
9. What is a key nursing intervention for pneumonia patients?
a) Restricting fluid intake b) Avoiding vaccinations
c) Encouraging smoking d) Monitoring oxygen
saturation

10. Which organism causes Legionnaires' disease?

a) Legionella pneumophila b) Mycoplasma
pneumoniae
c) Staphylococcus aureus d) Klebsiella pneumoniae

11. What is a common viral cause of pneumonia?

a) Influenza virus b) E. coli
c) Streptococcus pyogenes d) Candida albicans

12. Which of the following is a sign of hypoxia in pneumonia patients?

a) Cyanosis (bluish skin) b) Excessive07/15/2025
sweating 30

c) Hair loss d) Increased appetite

Multiple Choice Questions (20)

13. What is the primary treatment for bacterial pneumonia?

a) Antiviral drugs b) Antibiotics
c) Antifungal drugs d) Painkillers only

14. Which of the following is a preventive measure for pneumonia?

a) Smoking b) Avoiding water intake
c) Pneumococcal vaccine d) Skipping flu shots

15. What is a common complication of severe pneumonia?

a) Increased energy levels b) Improved lung function
c) Weight gain d) Respiratory failure

16. Which type of pneumonia is associated with contaminated water

sources?
a) Aspiration pneumonia b) Fungal 07/15/2025
pneumonia 31

c) Viral pneumonia d) Legionella pneumonia

Multiple Choice Questions (20)
17. What is a key feature of atypical pneumonia?
a) No cough present b) Sudden high fever only
c) Milder symptoms but longer duration d) Only affects children

18. Which of the following is NOT a typical symptom of pneumonia?

a) Fever b) Joint swelling
c) Shortness of breath d) Chest pain

19. What is the first step in managing pneumonia?

a) Assessing severity (e.g., CURB-65) b) Immediate
surgery
c) Stopping all medications d) Ignoring symptoms

 20 . A 70-year-old smoker presents with fever, chills, and rusty sputum.

CXR shows lobar consolidation. What is the likely pathogen?
A) Legionella B) S. pneumoniae
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C) Pneumocystis D) H. influenzae
 Matching Questions:

Column A Column B
A. A complication of pneumonia where fluid accumulates in the
1.common -Acquired pleural space.

pnemonia(CAP) B. A tool used to assess the severity of pneumonia and the

need for hospitalization.
2. Ventilator-Associated C. The most common cause of bacterial community-acquired
Pneumonia (VAP) pneumonia.
D. Administered to maintain oxygen saturation levels above
3. Streptococcus 92%.
pneumoniae E. Occurs when food, liquid, or vomit is inhaled into the lungs.
4. Aspiration Pneumonia F. A type of pneumonia acquired outside of healthcare settings.

5. CURB-65 score G. A diagnostic test to identify bacterial causes of pneumonia.

6. Pleural Effusion H. A viral pathogen that can cause pneumonia, especially
during flu season.
7. Oxygen Therapy I. A type of HAP that occurs in patients on mechanical
ventilation for over 48 hours.
8. Sputum Gram Stain
J. Includes monitoring vital signs, administering medications,
9. Influenza Virus and patient education.
K. Gram-positive diplococci; rust-colored sputum
10. Nursing Management
L. . Multidrug-resistant; common in07/15/2025
cystic fibrosis 33
Answer  Multiple
 choice
True or False
1.B 11.A
1.True 2.False  Matching
2.D 12.A
3.False
3.C 13.B 1.F 2.I 3.C
4.True 5.False
6.True 4.B 14.C
4.E 5.B 6.A
5.C 15.D
7.True 8.False 7.D 8.G 9.H
9.False 6.D 16.D
7.A 17.C 10.J
10.True
8.B 18.C
9.D 19.A
10.A 2
0.B

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