CHAPTER 2 Respiratory System^115
- Explain to the patient:
- Disease process.
- Need for coughing and deep breathing.
Pneumonia
WHAT WENT WRONG?
Infectious pneumonia may be due to a variety of microorganisms and can be
community-acquired or hospital-acquired (nosocomial). A patient can inhale bacteria,
viruses, parasites, or irritating agents, or a patient can aspirate liquids or foods. He
or she can also develop increased mucous production and thickening alveolar fluid
as a result of impaired gas exchange. All of these can lead to inflammation of the
lower airways.
Organisms commonly associated with infection include Staphylococcus
aureus, Streptococcus pneumoniae, Haemophilus influenza, Mycoplasma pneumo-
niae, Legionella pneumonia, Chlamydia pneumoniae(parasite), andPseudomonas
aeruginosa.
PROGNOSIS
Prognosis will vary depending on patient’s age, preexisting lung disease, infect-
ing organism and response to antibiotics. Patients at risk for pneumonia are: older
patients; those with respiratory disease; patients with comorbid conditions such
as heart, liver, or kidney disease; and patients who develop complications (such as
atelectasis or pleural effusion). Patients at greater risk for complications from
pneumonia will be treated within the hospital, while those at lower risk may be
treated at home. Patients with respiratory rates over 30, tachycardia, altered men-
tal status, or hypotension also are considered higher-risk.
Patients without other coexisting conditions, who do not appear to have the
higher-risk symptoms listed above, can usually be safely treated as outpatients.
Patients with comorbidities (higher-risk coexisting symptoms) or who appear ill
are usually treated in the hospital. Some require critical care treatments and must
be closely monitored. There is still a significant mortality rate from pneumonia,
despite the recognition of pneumonia and use of antibiotics.
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