Subject: Pediatric Nursing Topic: Pneumonia

2. Pneumonia, an inflammation of the lungs
caused by infections agent in which the air sacs are
filled with pus or exudates so that air is excluded
and lungs become solid.
Or
Pneumonia is an inflammation of the lung parenchyma

3. NORMAL CHEST X-RAY
Courtesy of Up To Date

4. REVIEW OF LUNG ANATOMY
RUL
RML
RLL
LUL
LLL
Lingula
http://www.meddean.luc.edulumenMedEdGrossAnatomythor
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5. Bacterial :
H.influenza
streptococcal
klebsella
staphylococcal
tuberculous
Viral : Influenza virus, Adenoviruses, Rhinovirus

6. Anatomical classification.
A – lobar pneumonia .
The consolidation involves all or part of lobe
B – Bronchopneumonia
the consolidation involves scattered lobules
C - Interstitial pneumonia .
As in viral pneumonia where inflammatory .
Infiltrate involve mainly interstitial tissue between alveoli.
2 : Etiological classfication.
the cause of pneumonia in patient is often difficult to determine because
direct culture of lung tissue invasive and rarely performed.
- culture obtained from upper respiratory tract or sputum generally not
accurately.

7. LOBAR PNEUMONIA

8. BRONCHOPNEUMONIA
(Bronchitis and Pneumonia occur together)

10. CHEST X-RAY
FOR LOBAR PNEUMONIA
Lobarpneumonia
Consolidation
confined to
one or more
lobes (or
segments of
lobes) of
lungs.
12/12/2011 Pneumonia 10

11. High fever, Shaking Chills
Shortness of breath (Dyspnoea)
Increased breathing rate
Chest pain when you breathe
deeply or cough
Dusky or purplish skin colour
(cyanosis) from poorly oxygenated
blood

12. Fatigue and muscle aches
Nausea, vomiting or diarrhoea
chattering teeth
cough that produces rust-colored
or greenish mucus
sweating
rapid breathing
rapid pulse rate

13. Cigarette smoking , -Abuse alcohol.
Recent viral respiratory infection—a cold,
laryngitis, influenza etc.
Difficulty swallowing (due to stroke, dementia,
or other neurological conditions)
Chronic lung disease such as COPD,
emphysema, asthma
Other serious illnesses, such as heart disease,
liver cirrhosis, or diabetes

14. Impaired consciousness (loss of
brain function due to dementia,
stroke, or other neurologic
conditions)
Are younger than 1 year of age
or older than 65.
Have a weakened or impaired
immune system.
Are malnourished.
-Have been exposed to certain
chemicals or pollutants.

15. Mode of transmission:
Droplet infection - From the
mouth and nose of an infected
person via nasopharynx, through
intimate contact with carriers.
Indirect contact- By contaminated
object is possible; systemic
infection inhalation of caustic or
toxic chemicals, aspiration of food,
fluid or vomitus.

16. Chest X-ray
Blood test
Bronchoscopy
Sputum analysis, smear, culture

17.  If sever problem immediate hospitalization
Give oxygen inhalation if:
1. central cyanosis
2. not able to drink
 Give antibiotic according to doctors order
If age < 2 months
a. benzyle penicilline.
b. gentamicin
If age 2 months to 5 years
a. chloramphenicol
Ttreat fever (if present) : paracetamol 500 mg 6 hourly
a. 2 months – 3years ->¼tab
b. 3 years – 5 years ->½tab
 Treatment of wheezing or stridor (if present):

18. a. If in respiratory distress- rapid acting bronchodilators
nebulized salbutamol (5mg/ml)
b. If not respiratory distress – oral salbutamol tds for 5 days
2 months -3 years ->¼tab (1 tab= 2mg)
12 months – 5 years -> 1 tab
c. Supportive care
d. Reassess daily

19. Maintain a patient airway and
adequate oxygenation.
Teach the patient how to cough
and perform deep breathing
exercises to clear secretions.
Obtain sputum specimen as
needed.
Maintain adequate nutrition to
offset high caloric utilization.

20. Control the spread of infection by
disposing secretions properly.
Control temperature by doing
cooling measures.
Monitor vital signs closely.
Advice mother to give –
a. Feed the child during illness
b. Increase feeding after illness
c. Clear nose if it interferes with
feeding

21. Vaccinations
a. Pneumococcal Vaccine
b. Pneumococcal polysaccharide
vaccine - PPV
c. Hib vaccine (haemophilus
influenzae vaccine type b) in children
Healthy lifestyle
Diet and nutrition
Regular exercise

22. Enough sleep
Quit smoke
Prevent common colds, influenza,
and other upper respiratory infection
Environmental factors such as
exposure to cold, pollution and
physical conditions of fatigue or
alcoholism.

23. Acute respiratory distress syndrom
(ARDS)
Pleural effusion
Lung abscess
Respiratory failure (which requires a
breathing machine or ventilator)
Sepsis (which may lead to organ failure
Otitis media in children