Pneumonia

@risk:
people over 65 with chronic cardiac or respiratory conditions, dm, alcoholism or other chronic diseases
immunocompromised people
chronic renal failure
people receiving chemotherapy

Prevention is a key component in managing pneumonia.
Pneumonia and flu vaccine. Revacination of pneumonia vaccine recommended for age >65 and who were immunized 5 years previously. Flu vaccine is yearly.

S/S:
fever, SOB, purulent sputum, rhonchi, crackles, pain, labored breathing
Vitals: increased HR, respiratory rate and temperature, decrease spO2, 
Elderly and immunocompromised: decrease LOC may be the only symptoms

Medications:
Antibiotics to eradicate the infection, culture 1st to identify the right antibiotics to be prescribed
Bronchodilators yp reduce bronchospasm and improve ventilation
agent to break up mucus or reduce its viscosity i.e mucomyst

Treatments:
increase fluid intake to 2500-3000 mL per day - to liquify secretion, making it easy to expectorate and cough up. IV fluids and nutrition
Incentive spirometry to promote deep breathing, coughing and clearance of respiratory secretions.
Endotracheal suctioning if cough is ineffective
Bronchoscopy can also be use to perform pulmonary toilet and remove secretions
Oxygen therapy
Chest physiotherapy
Promote rest to reduce metabolic and oxygen needs

Priority Nursing Diagnosis:
Ineffective airway clearance
Ineffective breathing pattern
Activity intolerance

Considerations:
High Fowler position promotes lung expansion
frequent position change and ambulation facilitate movement of secretions
Coughing, deep breathing and suctioning help clear airways
A liberal fluid intake helps liquify secretions, facilitating clearance