not my original words,from instructor notes, from Egan's Fundamental's of Respiratory Care 10th edition, Clinical Manifestation and Assessment of Respiratory Disease
involves an entire lobe of the lung
aka Bilateral Pneumonia, Involves both lungs
A mild case of Pneumonia
C.A.P. /Community Acquired Pneumonia
Pneumonia Contracted in an outpatient Setting
H.A.P./ Hospital Acquired Pneumonia
Develops after 48 hours of admission,excludes C.A.P. ,is THE 2ND MOST COMMON NOSOCOMIAL INFECTION IN THE U.S.
HCAP/ HealthCare-Associated Pneumonia aka Nursing Home Acquired Pneumonia
often caused by MRSA
According to Egan's Hospital Acquired Pneumonia is defined as
a lower respiratory tract infection that develops in hospitalized patients more than 48 hours after admission and excludes community acquired infections that are incubating at the time of admission
Often occurs after an Upper Respiratory Infection such as a cold or flu
Early Signs of Bacterial Pneumonia are
Shaking chills, Shaking, high fever, sweating, chest pain, increased RR and productive cough
Bacterial Pneumonia is divided into 3 categories of causative organisms
Gram Positive, Gram Negative and Anaerobic organisms
Ventilator Acquired Pneumonia/ V.A.P.
a lower Respiratory tract infection that develops more than 48-72 hours after endotracheal intubation
What is the most common cause of Bacterial Pneumonia?
Streptococcal pneumonia a gram positive organism, is responsible for more than 80% of all bacterial pneumonia, transmitted by aerosol from a cough or sneeze,with most strains being sensitive to penicillin and its derivatives
How many Causes are there of Pneumonia
Etiology: There are over 30 causes of Pneumonia
There are two gram positive bacterial causes of Pneumonia other than Streptococous pneumoniae which are
Staphylococcus aureus which is typically responsible for most "Staph" infections and Staphylococcus epidermidis ( and or Staphylococcus aureus) which is part of Normal Skin Flora
Staphylococcal pneumonia typically follows what type of infection?
A viral infection,
What patient population is Staphylococcal Pneumonia found in ?
Staphylococcal pneumonia is most often found in Children and Immunosuppressed Adults and can be transmitted directly by aerosol through a cough or sneeze or indirectly by contaminated objects.
Hospital acquired pneumonia is often caused by what organism?
Staphylococci and is increasingly becoming antibiotic resistant
MRSA stands for
Multiple Drug- Resistant S. aureus
What is the most common cause of epiglottitis in small children and /or a secondary pneumonia after a viral infection?
Haemophilus influenza (Gram Negative Organism)
Haemophilus influenzae is transmitted by
aerosol or contact with contaminated objects
There are 7 Gram Negative organisms responsible for bacterial pneumonia, what are they?
Haemophilus influenza, Klebsiella pneumonia, Pseudomonas aeruginosa, Moraxella caterrhalis, Escherichia coli, Serratia species and Entrobactter species
Pseudomonas aeruginosa is a gram-Negative organism that frequently cultured from the respiratory tract of the chronically ill and is
green and sweet smelling
Moraxella catarrhalis is a natural inhabitant of the human pharynx and it is the 3rd most common cause of:
exacerbation of chronic bronchitis
Escherichia coli is a natural inhabitant of the intestinal tract and sometimes causes
There are four atypical organisms responsible for bacterial pneumonia, they are :
Acute Alveolar hyperventilation with hypoxemia ( uncompensated respiratory alkalosis)
ABG results in a severe pneumonia will reveal
Acute Ventilatory Failure with hypoxemia (uncompensated respiratory acidosis)
CXR can show
increased density, air bronchograms and Pleural effusions
A CT can show
Alveolar consolidation and air bronchograms
While examining the CXR, the presence of Right middle lobe infiltrates will obscure
the right heart border
While examining the CXR, the presence of lower lob infiltrates will obscure
the right diaphragm
While examining the CXR, the presence of lingular infiltrates will obscure
the left heart border
While examining the CXR, the presence of left lower lobe infiltrates will obscure
the left diaphragm
Air Bronchograms on the CXR appear as
an outline of air-containing bronchi beyond the normal point of visibility and develop as a result of an infiltration or consolidation that surround the bronchi, producing a contrasting air column on the radiograph
Respiratory Care Management of Pneumonia includes
Oxygen, Bronchial Hygiene Therapy, and Hyperinflation
Medical management of Pneumonia includes
Antibiotics , Analgesics, Ribavirin if RSV infection is involved, Aerosolized Pentamidine if PCP present
Management of a Pleural Effusion includes
Thoracentesis ; Fluid analysis
= perforation of chest wall with needle for the aspiration of fluid from a pleural effusion for diagnostic or therap putic purposes or for the removal of a specimen for biopsy