Lecture By sr.Fareedah Khojali CETD Head Nurse,Meeqat Hospital,Madina

1. PNEUMONIA:Is an inflammation of the
lung tissue affecting one
or both sides of the chest
that often occurs as a
result of infection.

2. Anatomy

3. Respiratory Emergencies

4. PATHOPHYSIOLOGY:Pneumonia is a serious infection or inflammation of
lungs. The air sacs in the lungs fill with pus or other
liquid. Oxygen has trouble reaching your blood. If
there is too little oxygen in your blood, your body cells
can’t work properly. Because of this and spreading
infection through the body . Pneumonia affects your
lungs in two ways. Lobar pneumonia affects a section
(lobe) of a lung. Bronchial pneumonia (or
bronchopneumonia) affects patches throughout both
lungs .

6. Causes
1-)Bacteria
2-)Viruses
3-)Fungal
4-)parasite
5-)Idiopathic

7. Risk factors:1-)All ages. Most commonly and
those at highest risk:
-Elderly
-Children
2-) weak immune systems
3-)Smoker
4-)chronic illnesses especially lung
problems

8. Classifications:-_By:1-) Causes
A- Bronchiolitis obliterans organizing pneumonia( is caused by
inflammation of the small airways of the lungs)
B- Eosinophilic pneumonia(often occurs in response to infection with
parasite or after exposure to certain types of environmental factors.)
C- Chemical pneumonia
D- Aspiration pneumonia
E Dust pneumonia
F- Necrotizing pneumonia(pneumonias that cause substantial necrosis
of lung cells)
2-)location acquired A- Community acquired (CAP )
B- hospital acquired
3-)Area of lung affected
-1-Bronchopneumonia 2- lobar pneumonia
4-) Clinical (acute or chronic)
5-)The patient's immune status

10. Signs and Symptoms:The symptoms of pneumonia may differ depending
on what is causing it, but some common symptoms
may include:
• Painful cough
•Shaking chills
• fever
• pleuritic chest pain
• tachycardia
• tachypnea
• U RTI
• respiratory distress
• fatigue
• orthopnea
• poor appetite

11. Diagnosis:1-) by History.
2-) x-ray
3-) Sputum examination
4-) blood culture
5-) CBC

12. Transmission:is caused by the inhalation of infected
microorganisms spread through contact with an
infected person. The microorganisms enter the body
through the mouth, nose and eyes. If the body's
resistance is down, the natural process of fighting off
diseases is weakened and the microorganisms are free
to spread into the lungs and the lungs' air sacs. The air
sacs become filled with fluid and pus from the
infectious agent, making it more difficult for the body
to get the oxygen it needs, and the person may become
sick,

14. Differential diagnosis: -
1.) Pulmonary infarction
2. )TB
3. )Pulmonary edema
4.) Bronchiectasis
5.) Pulmonary embolism
6.) Lung cancer
7. )Acute allergic alveolitis

15. • Medical management:-
depends on the severity of
symptoms and the type of
organism causing the infection by
administration of appropriate
antibiotic as determined by the
results of gram stain and culture
*

16. Medical management:1-) Hydration
2-) Analgesic/Antipyretic
3-) Oxygen
4-) Antibiotics
5-) Physiotherapy .

17. Nursing managements:1-)Improving AIRWAY PATENCY by:-Proper position
-Removing secreations
-Encourages hydration and humidification
-Encourages patient to deep breath and coughing
- If the patient is immobile it is imperative that the
patient be turned every two hours and encouraged to
cough and deep breath
-Chest physiotherapy
- Administering oxygen as prescribed and
monitoring for the effects.
-Monitoring vital signs including oxygen level
--Monitoring lung sounds watching for edema and
patients feeling of shortness of breath.

18. Nursing managements:2.) Promoting rest
3.)Promoting fluid intake
4.) Maintaining nutrition,
5.)Promoting the patients knowledge about
his/her disease process .
6.) Monitoring and managing potential
complications.
7.) Promoting home and community-based care
by- teaching patients self care ,
- continuing care.

19. Complications
Hypotension.
2.) shock and respiratory failure
3.)Atelectasis and pleural effusion (fluid
around the lung)
4.) Super infection
5.) Empyema (pus in the pleural cavity),
-6.) Hyponatremia (low blood sodium)
7.) rarely an abscess in the lung
1.)

20. Preventions of Pneumonia
1-)Practice good hygiene.
 Cough or sneeze on tissue .
 Use separate drinking glasses.
 Wash your hands often with warm soapy water or Alcohol
based gel when soap and water not available
2-)Get an influenza shot every year
3-)Practice good preventive measures
by:-eating a proper diet
-getting regular exercise and plenty of sleep.
4-)Do not smoke
5-) Avoid exposure to secondary smoke .

21. Thanks
SIS-FAREEDA MOH’D
MGH CETD NURSE
20 14

22. DEFINITION
Asthma :*Is the common chronic inflammatory
disease of the airways characterized by
variable and recurring symptoms,
reversible airflow obstruction, and
bronchospasm .

23. Causes:The cause of asthma is not known, but
there is evidence that many factors play a
part
1-)Genetic factors
2-)Environmental factors:
3-)Dietary changes
4-)Lack of exercise
5-)Occupational exposure

24. Pathophysiology :Airway inflammation is the primary problem in asthma.
An initial event in asthma appears to be the release of
inflammatory mediators triggered. The mediators are
released from bronchial mast cells, alveolar
macrophages, and epithelial cells. Some mediators
directly cause acute bronchoconstriction.” The
inflammatory mediators also direct the activation of
eosinophils and neutrophils, and their migration to the
airways, where they cause injury. called “late-phase
asthmatic response” results in epithelial damage,
airway edema, mucus hyper secretion and hyper
responsiveness of bronchial smooth muscle Varying
airflow obstruction leads to recurrent episodes of
wheezing, breathlessness, chest tightness and cough

25. Types of Asthma :-
1.) Child-Onset Asthma
2.) Adult-Onset Asthma
3.) Exercise-Induced Asthma
4.) Cough-Induced Asthma
5.) Occupational Asthma
6.) Nocturnal Asthma
7.) Steroid-Resistant Asthma (Severe
Asthma)

26. Diagnosis :1-)Peak flow measurements
2-)Lung function tests
3-)Blood tests to measure eosinophil count (a
type of white blood cell) and IgE (a type of
immune system protein called an
immunoglobulin)
4-)Arterial blood gas
5-)Chest x-ray

27. Asthma triggers:-A trigger is any thing or
condition that causes inflammation in the
airways, which then leads to asthma
symptoms
*Infections such as colds, flu, or
pneumonia
*Allergens such as food, pollen, mold, dust
and pet dander
*Exercise

28. Asthma triggers:*Air pollution and toxins
*Weather, especially extreme
changes in temperature
*Drugs (such as aspirin,)
*Emotional stress and anxiety
*Singing, laughing, or crying
*Smoking, perfumes, or sprays

29. Risk factors for asthma :1-)Genetics
2-)Allergies
3-)Medical Conditions
-Respiratory infections in childhood
-Low birth weight
-Obesity
-Congestive heart failure
-Pulmonary embolism
4-)Gender
5-) Ethnic Background
6-) Medications

30. Clinical manifestations :1-)Coughing, especially at night
2-)Wheezing
3-)Shortness of breath
4-)Chest tightness, pain, or pressure

31. Early warning signs:* Frequent cough, especially at night
*Losing your breath easily or shortness of breath
*Feeling very tired or weak when exercising
*Wheezing or coughing after exercise
*Feeling tired, easily upset
*Decreases or changes in a peak expiratory flow
*Signs of a cold,
*upper respiratory infection, or allergies
(sneezing, runny nose, cough, congestion, sore
throat, and headache)
*Trouble sleeping

32. Symptoms of worsening asthma:-
*Cough that won’t go away
(day and night)
*Wheezing
*Tightness in the chest
*Shortness of breath
*Poor response to medicines
(bronchodilators)

33. Late, severe symptoms:* Severe wheezing (both when breathing in and
out)
*Coughing that won’t stop
*Very rapid breathing
*Inability to catch your breath
*Chest pain or pressure
*Tightened neck and chest muscles
*Difficulty talking
*Inability to fully exhale
*Feelings of anxiety or panic
*Pale, sweaty face
*Blue lips or fingernails

34. Managements:- cannot be cured, but
appropriate management can control the disorder and
enable people to enjoy a good quality of life
1.) The first step in asthma management is
environmental control by
* Clean the house at least once a week and wear a mask
while doing it
*Avoid pets with fur or feathers
*Wash the bedding (sheets, pillow cases, mattress pads)
weekly in hot water
*Encase the mattress, pillows and in dust-proof covers
*Replace bedding made of down, foam rubber
*Consider replacing carpeting with hardwood floors
*Use the air conditioner
*Keep the humidity in the house low

35. Managements:2.) The second step is to monitor lung function.
*Asthmatics use a peak flow meter to gauge their
lung function
* listen to breath sounds
*pulse oxymetry ,and vital signs
3.) The third step in managing asthma involves the
use of medications. There are two major groups of
medications used in controlling asthma
- Anti inflammatory (corticosteroids) and
bronchodilators.
-immunotherapy may help those there are not
control symptoms or used medications.

36. Nursing managements:*The goal of nursing care in a patient’s having an
asthma attack is to make sure there is adequate
oxygen intake.
1-) Evaluate respiratory rate/depth and breath sounds
2-). Assist client to maintain a comfortable position
3-)Encourage/instruct in deep-breathing and directed coughing
exercises
4-)Obtain history of recent medication use, particularly
theophylline preparations, steroids and inhalers.
5-)Obtain baseline data on respiratory function, using
a peak flow meter, listen to breath sounds

37. *Nursing managements:6-) the nurse must following physician order to:-Administer inhaled rapid acting bronchodilators to open up
the airways.
-Administer corticosteroids such as prednisone to reduce
inflammation in the airways.
-Administer low flow humidified oxygen to prevent
hypoxemia.
-Administer intravenous fluids to prevent dehydration and oral
intake looses secretions in the airways.
7-)-the nurse has to ensure that long term asthma medications
like inhaled corticosteroids long acting bronchodilators are
administered as prescribed by the physician.

38. *Nursing management:8-)Check results of diagnostic procedures .
9-)Assess vital signs every 15 to 30 minutes in initial treatment
period; retake temperature at least once;
10-)observe for changes in level of consciousness
(e.g., depression due to hypoxemia or excitation due to
aminophylline and/ or epinephrine
11-)Removing any potential allergen or trigger from
environment like flowers or perfumes
12-)Maintaining a quite calm environment to reduce anxiety and
promote normal respiratory rate
13-)Monitoring the side effects of administered medications
14-)Monitoring the arterial blood gases as an indication of
improvement or deterioration
-15-)Prepare for mechanical ventilation if patient cannot breathe
on his own

39. *Patient Teaching :*Providing information that will help prevent asthmatic episodes and teaching
patients skills required to administer asthmatic medications properly. These
skills and information are as follows
1-)The need to identify and eliminate any actual or potential allergen,
substance or condition that could precipitate an asthma attack.
2-)The need to permit no smoking around
3-)The need to report frequent use of rapid acting bronchodilators.
The need to take long term medication as prescribed even when there are no
asthma attacks.
4-)How to use an inhaler and a spacer.
5-)How to use a peak flow meter and the significance of the readings.
6-(Assisting the patient to create an asthma management and emergency
plan.
7-)When to contact a healthcare provider or seek emergency services

40. complications of asthma:-:
1-)Decreased ability to exercise and take part
in other activities
2-)Lack of sleep due to nighttime symptoms
3-)Permanent changes in the function of the
lungs
4-)Persistent cough
5-)Trouble breathing that requires breathing
assistance (ventilator
6-) Pneumothorax
7-) Respiratory failure
8-)Death

41. Preventions :*You can reduce asthma symptoms by avoiding
known triggers and substances that irritate the
airways.
*Eliminate tobacco smoke from the home. (Smoking
outside the house is not enough. Family members and
visitors who smoke outside carry smoke residue
inside on their clothes and hair

46. Thanks
SIS-FAREEDA MOH’D
MGH CETD NURSE
2012