Pneumonia Keerapa phusunti MD Chokchai hospital Pathophysiology Pathogens

Pathogens • เชอกอโรคทพบบอย – S. pneumoniae – M. pneumoniae – H. influenza – respiratory

Treatment Outpatient : Healthy (No risk for DRSP) แนะนำ ใหใช Azithromycin , Clarithromycin Outpatient

Treatment Inpatient แนะนำ ใหใช β-lactam รวมกบ macrolide (Azithromycin , Clarithromycin , Roxithromycin) หรอ Levofloxacin

Nursing interventions • • Improve airway patency Rest to conserve energy Maintenance of proper

Improve airway patency • Chest physical therapy • Remove secretion and humidification • Hydration

Promote rest and conserve energy • Encourage avoidance of overexertion and possible exacerbation of

Promote fluid intake • Increase in fluid intake to at least 2 L per

Maintain nutrition • Milk and milk products and sweets should be avoided to decrease

Hospital acquired pneumonia • HAP or VAP are important causes of morbidity and mortality

Definition HAP • Pneumonia that occurs 48 hours or more after admission and did

Risk factor • Risk factor which emerged from multivariate analyses Ø Age > 55

Prevent HAP • Basic practices ü avoid sedative drug üChange ventilator circuit only if

Prevent HAP • Special approaches ü regular oral care with chlorhexidine üTooth brushing üPhophylactic

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Pneumonia Keerapa phusunti, MD. Chokchai hospital

Pathophysiology

Pathogens • เชอกอโรคทพบบอย – S. pneumoniae – M. pneumoniae – H. influenza – respiratory virus

Treatment Outpatient : Healthy (No risk for DRSP) แนะนำ ใหใช Azithromycin , Clarithromycin Outpatient : risk for DRSP แนะนำใหใชใช β-lactam รวมกบ macrolide (Azithromycin , Clarithromycin , Roxithromycin หรอ Levofloxacin

Treatment Inpatient แนะนำ ใหใช β-lactam รวมกบ macrolide (Azithromycin , Clarithromycin , Roxithromycin) หรอ Levofloxacin ในรปแบบ intravenous form

Nursing interventions • • Improve airway patency Rest to conserve energy Maintenance of proper fluid volume Maintenance of adequate nutrition nurseslabs. com/pneumonia/#nursing-management

Improve airway patency • Chest physical therapy • Remove secretion and humidification • Hydration for thin loosing pulmonary secretion

Promote rest and conserve energy • Encourage avoidance of overexertion and possible exacerbation of symptoms • Semi-Fowler’s position

Promote fluid intake • Increase in fluid intake to at least 2 L per day to replace insensible fluid losses

Maintain nutrition • Milk and milk products and sweets should be avoided to decrease mucus production • Onion and garlic should be consumed it is beneficial • tea leaves and water and inhale the steam, helps to decongest • Include zinc in diet for boosts up immunity • Increase intake of vitamin C, it has antioxidant property

Hospital acquired pneumonia • HAP or VAP are important causes of morbidity and mortality

Definition HAP • Pneumonia that occurs 48 hours or more after admission and did not appear to be incubating at the time of admission

Risk factor • Risk factor which emerged from multivariate analyses Ø Age > 55 Ø Chronic Lung disease Ø Depressed concious Ø Aspiration agent increase gastric p. H (H 2 blocker, PPI, antacids) Ø Previous ATB Ø Paralysis Ø Malnutrition, CKD, Anemia Ø Use sedative drug

Prevent HAP • Basic practices ü avoid sedative drug üChange ventilator circuit only if visibly soiled or malfunction üElevate the head of bed to 30⁰to 45⁰

Prevent HAP • Special approaches ü regular oral care with chlorhexidine üTooth brushing üPhophylactic probiotics

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