Pneumonia is an infection of one or both of lung, usually caused by an infection. Pneumonia can result from a variety of causes, including infection with bacteria, viruses, fungi, or Mycoplasma (parasites), and chemical or physical injury to the lungs.
Pneumonia often is a complication of another condition, such as the flu. For most people, pneumonia can be treated at home. It often clears up in 2 to 3 weeks. But older adults, babies, and people with other diseases can become very ill. They may need to be in the hospital.
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Symptoms of pneumonia can vary greatly, depending on any underlying conditions people may have and the type of organism causing the infection. The pneumonia symptoms can helps in identifying the form of pneumonia it self.
The pneumonia often start during or after an upper respiratory infection, such as influenza or a cold. General signs and symptoms of pneumonia may include:
- A single episode of shaking chills followed by fever
- Chest pain on the side of the infected lung. Severe abdominal pain sometimes occurs in people with pneumonia in the lower lobes of the lung
- Cough, which may be dry at first, but eventually produces phlegm (sputum)
- Nausea, vomiting, and muscle aches
- Rapid breathing and heartbeat
- Shortness of breath
Symptoms of pneumonia indicating a medical emergency include the following:
- Blood in sputum
- Bluish-toned (cyanotic) skin
- High fever
- Labored and heavy breathing
- Mental confusion or reduced mental function in the elderly
- Rapid heart rate
- Weight loss
Ironically, people in high-risk groups such as older adults and people with chronic illnesses or weakened immune systems may have fewer or milder symptoms than less vulnerable people do. Older adults may have different, fewer, or milder symptoms, such as no fever or a cough with no mucus (a dry or nonproductive cough). The major sign of pneumonia in older adults may be when there is a change in how clearly they think (confusion or delirium) or when a lung disease they already have gets worse.
In children, symptoms may depend on age:
- In infants younger than 1 month of age, symptoms may include having little or no energy (lethargy), feeding poorly, grunting, or having a fever.
- In children, symptoms of pneumonia are often the same as in adults. Your doctor will look for signs such as cough and a breathing rate over 60 breaths per minute.
Conditions that may look like pneumonia include bronchitis, chronic obstructive pulmonary disease (COPD), and tuberculosis.
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There are about 30 different causes of pneumonia. However, they all fall into one of these categories:
- Infective pneumonia: Inflammation and infection of the lungs and bronchial tubes that occurs when a bacteria, virus, mycoplasma and fungus gets into the lungs and starts to reproduce.
- Aspiration pneumonia: An inflammation of the lungs and bronchial tubes caused by inhaling vomit, mucous, or other bodily fluids (Agents such as petroleum solvents, dry cleaning fluid, lighter fluid, kerosene, gasoline, and liquid polishes and waxes are the most likely causes.). Aspiration pneumonia can also be caused by inhaling certain chemicals.
Risk factors to develop of pneumonia are;
- Age about 65 or older, if they have other medical condition, It will more prone to developing pneumonia. Very young children if they don't take full immune system, they are also at risk to develop of pneumonia.
- Certain diseases. These include immune deficiency diseases such as HIV/AIDS and chronic illnesses such as cardiovascular disease, emphysema and other lung diseases, and diabetes. If immune system on the human has been impaired by chemotherapy or long-term use of immunosuppressant drugs, they are also at increased risk of pneumonia.
- Smoking, alcohol abuse. Smoking will make an irritants such as tobacco smoke paralyze the cilia, causing secretions to accumulate. If these secretions contain bacteria, they can develop into pneumonia. Alcohol interferes with the normal gag reflex as well as with the action of the white blood cells that fight infection.
- Hospitalization in an intensive care unit. Pneumonia acquired in the hospital tends to be more serious than other types of pneumonia. People who need mechanical ventilation are particularly at risk because the breathing tube bypasses the normal defenses of the upper respiratory tract, prevents coughing, may allow the stomach's contents to back up into the esophagus where they can be inhaled (aspirated), and can harbor bacteria and other harmful organisms.
- Having Chronic obstructive pulmonary disease (COPD) and using inhaled corticosteroids for more than 24 weeks. Research indicates that this greatly increases the risk of developing pneumonia, possibly serious pneumonia.
- Exposure to certain chemicals or pollutants. The risk of developing some uncommon types of pneumonia may be increased if someone work in agriculture, in construction or around certain industrial chemicals or animals. Exposure to air pollution or toxic fumes can also contribute to lung inflammation, which makes it harder for the lungs to clear themselves.
- Surgery or traumatic injury. People who've had surgery or who are immobilized from a traumatic injury have a higher risk of pneumonia because surgery or serious injuries may make coughing — which helps clear your lungs — more difficult, and lying flat can allow mucus to collect in your lungs, providing a breeding ground for bacteria.
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How serious pneumonia is depends on their overall health and the type and extent of pneumonia they have. Pneumonia disease often can be treated successfully for the younger and healthy people.
Anyhow, Pneumonia complications may include:
- Bacteria in your bloodstream.
Pneumonia can be life-threatening when inflammation from the disease fills the air sacs in your lungs and interferes with your ability to breathe. In some cases the infection may invade your bloodstream (bacteremia). It can then spread quickly to other organs.
- Fluid accumulation and infection around your lungs.
Sometimes fluid accumulates between the thin, transparent membrane (pleura) covering your lungs and the membrane that lines the inner surface of your chest wall — a condition known as pleural effusion. Normally, the pleurae are smooth, allowing your lungs to slide easily along your chest wall when you breathe in and out. But when the pleurae around your lungs become inflamed (pleurisy) — often as a result of pneumonia — fluid can accumulate and may become infected (empyema).
- Lung abscess.
A cavity containing pus (abscess) that forms within the area affected by pneumonia is another potential complication.
- Acute respiratory distress syndrome (ARDS).
The pneumonia involves most areas of both lungs, making breathing difficult and depriving your body of oxygen. Underlying lung disease of any kind, but especially COPD, makes you more susceptible to
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The medical provider will put a suspect pneumonia to the patient based on their medical history and a physical exam. They will ask to the patient about recent infection or the presence of any chronic respiratory infection. Also reveal any exposure he/she has had to other people suffering from pneumonia, including history of smoking along with drug and reported of alcohol abuse.
Important test to help putting diagnose of Pneumonia are;
- Physical examination.
During the exam, the doctor listens to the lungs with a stethoscope to check for abnormal bubbling or crackling sounds (rales) and for rumblings (rhonchi) that signal the presence of thick liquid.
- Chest X-rays.
X-rays can confirm the presence of pneumonia and determine the extent and helps in identifying white areas within the lung (location of the infection, abscesses and pleural effusion).
- Blood and mucus tests.
A white blood cell count that reflects elevated levels points towards a possible infection by viruses, bacteria or other organisms. The doctor also may examine a sample of mucus or blood to help identify the particular microorganism that's causing the illness.
- Bronchoscopy is a procedure which may be done as a part of pneumonia diagnosis, In severe cases a lung biopsy might be conducted on the patient.
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Pneumonia treatments are vary, depends on the severity of symptoms and the type of organism which causing the infection. Patients with pneumonia are generally treated with Antibiotics as the most common cause of the condition, Respiratory support with oxygen, if needed categorizing severity and determining the need for Hospitalization.
If the Pneumonia is cause by viral, typical antibiotics will NOT be effective. The doctor will choose an antibiotic based on a number of things, including age, symptoms and how severe they are.
- Bacterial pneumonia.Bacterial pneumonia (caused by the streptococcus pneumonia bacteria).
- Doctors usually treat bacterial pneumonia with antibiotics with such as penicillin, ampicillin-clavulanate (Augmentin) and erythromycin.
- Bacterial pneumonia (caused by the hemophilus influenza bacteria) is treated with antibiotics, such as cefuroxime (Ceftin), ampicillin-clavulanate (Augmentin), ofloxacin (Floxin), and trimethoprim-sulfanethoxazole (Bactrim and Septra).
- Bacterial pneumonia (caused by legionella pneumophilia and staphylococcus aureus bacteria) are treated with antibiotics, such as erythromycin.
Antibiotics usually work well with younger, otherwise healthy people who have strong immune systems. Taking the antibiotics should be complete the entire course (at least 3 days), Stopping medication too soon may cause the pneumonia to return (resistant to antibiotics).
- Viral pneumonia.
Antibiotics aren't effective against most viral forms of pneumonia, This type of pneumonia usually resolves over time.
- Mycoplasma pneumonia.
This kind of pneumonia treated with antibiotics, such as erythromycin, clarithromycin (Biaxin), tetracycline or azithromycin (Zithromax).
- Fungal pneumonia.
The doctor prescibed an antifungal medication for the patient who diagnosed as pneumonia cause by fungus.
Many people with Pneumonia can be treated at home with antibiotics. The Patients who has mild pneumonia are usually treated using oral macrolide antibiotics (azithromycin, clarithromycin, or erythromycin). The patients who has pneumonia and developed of other serious illnesses, such as heart disease, chronic obstructive pulmonary disease, or emphysema, kidney disease, or diabetes are often given one of the following medicine:
- Fluoroquinolone (levofloxacin (Levaquin), sparfloxacin (Zagam), or gemifloxacin (Factive), moxifloxacin (Avelox)
- High-dose amoxicillin or amoxicillin-clavulanate, plus a macrolide antibiotic (azithromycin, clarithromycin, or erythromycin)
In addition to the pharmaceutical intervention, the doctor will also recommend the patient to do the therapeutic coughing, breathing exercises, proper diet, cough suppressants, pain relievers and fever reducers, such as aspirin (not for children) or acetaminophen.
When hospitalization is needed, oxygen therapy and artificial ventilation may be required. Sometimes you may spend three or four days in the hospital receiving intravenous antibiotics and then continue to recover at home with oral medication.
Nursing priorities for patient with pneumonia are;
- Maintain/improve respiratory function.
- Prevent complications.
- Support recuperative process.
- Provide information about disease process/prognosis and treatment.
Discharge Goal on admitted patient with pneumonia are;
- Ventilation and oxygenation adequate for individual needs.
- Complications prevented/minimized.
- Disease process/prognosis and therapeutic regimen understood.
- Lifestyle changes identified/initiated to prevent recurrence.
- Plan in place to meet needs after discharge.
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Some one who has diagnosed as pneumonia, better for them to follow the steps bellow which can help them recover more quickly and decrease their risk of complications:
- Get plenty of rest. Even they start to feel better, they have to be careful not to do an over activity.
- Stay at home from school or work until after the body's temperature returns to normal and stop coughing up mucus. These advice depends partially on how sick they were. The pneumonia can recur within a week, That's way it may be better not to return to a full workload until they are sure their getting well.
- Drink plenty of fluids, especially water. Remember, Liquids keep us from becoming dehydrated and help loosen mucus in our lungs.
- Take the entire course of any prescribed medications. Stopping medication too soon can cause your pneumonia to come back and contributes to the development of antibiotic-resistant bacteria.
- Keep all of the follow-up appointments. Someone may feel better, but his/her lungs may still be infected. So, it's important to have contact with the doctor or medical provider to monitor the progresses of pneumonia treatment.
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Some steps that can help you to prevent getting pneumonia are:
- A vaccine known as pneumococcal conjugate vaccine (PCV) and available in the market with his name Prevnar, can help protect young children under the age of two to against pneumonia. These vaccine has composition (Ingredients) such as Streptococcus pneumoniae, diphtheria CRM protein, casamino acids, yeast extract, ammonium sulphate, aluminium.
- The vaccine for older adults is called the pneumococcal polysaccharide vaccine (PPSV). These vaccine can protects against 23 types of pneumococcal bacteria, including those most likely to cause serious disease. Other vaccines can prevent common diseases in which pneumonia may be a complication ; Vaccination of children for measles, Yearly vaccinations (shots) for influenza and Vaccination with the chickenpox vaccine (varicella-zoster vaccine).
- Healthy lifestyle.
- Don't smoke. Smoking damages your lungs, This means the lung can become infected more easily.
- Some other lifestyle factors also can increase your risk of developing pneumonia, such as alcohol abuse, and intravenous drug abuse.
- Good hygiene.
- Wash your hands. A very common method for transmitting a cold is by shaking hands. Everyone should always wash your hands before eating and after going somewhere outside to keep clean your hands from germ. These germs enter your body when you touch your eyes or rub the inside of your nose.
- Throw used tissues away immediately, in a bin or toilet. Germs can live for several hours after they leave your nose or mouth.
- Help to stop germs spreading to other people by cover your mouth and nose with a tissue, to catch the germs when you cough or sneeze.
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