Pathologic Conditions
- Definition: Inflammation of the lungs.
- Pathophysiology: Infection and inflammation lead to alveolar edema, promoting spread of the infecting organism. The involved lobe undergoes solidification caused by exudates (referred to as consolidation in x-ray reports). Ventilation-perfusion (V/Q) mismatch and right-to-left shunting occur at the site in which alveoli are filled with inflammatory exudates and O2–CO2 exchange is impaired.
- Etiology: Bacterial or viral infection, chemical irritants, aspiration, stasis of fluids from severely impaired respirations or infrequent turning of immobilized patient. Immunosuppressed patients are at high risk.
- Manifestations: Fever, chills, cough, dyspnea, tachypnea, tachycardia, pain in chest, crackles, increased fremitus and egophony, and dullness on percussion of affected lobes.
- Med Tx: Antimicrobial agents, O2, chest physiotherapy, incentive spirometry, hydration, ABG assessment.
- Nsg Dx: Impaired gas exchange, ineffective breathing pattern, hyperthermia, fluid volume deficit, pain, anxiety, knowledge deficit.
- Nsg Care: Encourage immunization (pneumococcal vaccine) for the aged and those with chronic illnesses. Closely monitor VS, ABG results, and response to medical therapy. Administer analgesics with care and attention to respiratory response. Encourage deep breathing and coughing. Provide education.
- Prognosis: Varies greatly and is affected by coexisting and complicating factors. Mortality is high without appropriate antibiotic therapy.