Pneumonia is a frequent disease usually brought to the clinic by patients. Pneumonia is an inflammation of the respiratory tract involving the lung parenchyma. It could be life threatening sometimes especially when it is in the secondary phase. Therefore, it is important for a nurse to know the diagnosis for this illness. Nursing diagnosis for pneumonia involves edema formation, increased sputum, in effective clearance of the airway, fatigue and many other respiratory related symptoms.
Pneumonia is an infectious disease which is usually caused by bacteria. It could also be caused by viral infection, fungal or protozoan infection. The two types of pneumonia are primary and secondary pneumonia. The primary pneumonia involves aspiration of foreign substances especially pathogenic substance. However, the secondary pneumonia is due to the spread of bacterial infection to the parenchyma of the lungs from an infected part of the body. Apart from these, pneumonia could also be caused by smoke inhalation and other chemical irritants. Radiation therapy has also been noted as a cause of pneumonia.
Patients with pneumonia would present symptoms like ineffective airway clearance. Since there is excessive secretion of mucus within the tract, the patient will find it very difficult to clear the air passage. The presence of bacteria or foreign substance will stimulate the action of mucus secreting cells found along the pulmonary passage. So there will be an increase in mucus production, so the patient will find it difficult clearing this huge mucus.
As a result of the above, there would be decrease in coughing and decrease in ventilation of the lung. When the air going to the lung is reduced, this leads to fatigue as the tissues are not properly ventilated and supplied with oxygen. So fatigue is a common sign that a patient with pneumonia will present.
In addition, when infection spreads to the lung alveolar, it moves towards the interstitium and therefore could infect the pleura. This could cause the inflammation of the pleura; pleurisy. So it is possible that a pneumonic patient presents pleural pain at the clinic as well.
Also, pneumonic patients will always present a shallow depth of respiration, tachypnea, and the use of accessory muscle when breathing. In some cases, patient may present with changes in mental statue due to inefficiency in oxygen going to the brain. The color of the skin may also changes; cyanosis.
When patients with pneumonia are presented, there are some interventions expected of a nurse to provide. The nurse should auscultate the lung field because there is absence of airflow and adventitious breath. If the patient is admitted in the clinic, it is recommended that the head should be raised so as to lower the diaphragm. This will in turn lower the pressure in the lung and increase the air volume. This helps in proper aeration of lung segments.
Also, mucus suction is important. This could be done mechanically either by stimulating cough or using mucus extractor. This will increase the air flow through the respiratory tract. Other collaborative nursing interventions include; giving respiratory physiotherapy assistant to the patient. This can be done by nebulizer, IPPB or spirometer and it will stimulate easy liquefaction of secretions. Also, drugs like expectorants, analgesics, bronchodilators etc could be administered to the patient. All these will ease coughing and provide relief from the associated pains.
In situation where the nursing diagnosis for pneumonia shows that the pneumonia is severe, X-ray of the chest can be performed to reveal the actual condition of the lungs and the respiratory tract. This procedure would help in finding an appropriate medication to the disease. It is important that nurses note these diagnostic measures as pneumonia is what they will frequently encounter within their profession.