Pneumonia Nursing Essay
Pneumonia is a disease that affects the lungs, causing them to become infected. The lung’s air sacs get filled with pus, causing chills, fever, and breathing problems. Pneumonia is inclined to be more serious for young children, people with weak immune systems, organ donors and recipients, and aged people. The disease may be defined in relation to the area affected in the lung. Lobar pneumonia affects one section or lobe of the lung. The other definition is bronchopneumonia, which spreads to the whole lung (Pathogenesis of infection, n.d.)
How Normal Lungs Work
The human chest has two lungs: one positioned on the right and the other on the left side of the upper body. The two lungs are composed of sections known as lobes. Primary function of the lungs is to bring clean oxygen into the human body and excel carbon dioxide from the body. These organs have various ways of defending themselves from dangerous chemicals, antibodies, and diseases. The human nose filters air when inhaling and stops big particles from reaching the lungs. When a contaminant penetrates the lung, it becomes stuck in a thin layer of sputum or mucus that forms the inside lining of the bronchioles.
The entrance of the throat (epiglottis) opens to allow the phlegm to be gulped down. The epiglottis averts substances from getting into the trachea. Spiting of phlegm is not normal, and it usually means that a person has chronic bronchitis or a contamination, such as pneumonia, cold, or chronic obstructive pulmonary disease. The air passages in the lungs are enclosed by layers of muscles that constrict during inhalation to keep dangerous particles out. Oxygen is taken into the body by inhaling the air through the human nose and mouth. The function of the nose is to filter irritants that are trapped by the hair follicles inside the nose. Solid and liquid substances may get into the trachea, causing choking and persistent coughing.
The windpipe divides to form bronchi, which further divide into bronchioles. They then form small air bags at their ends, referred to as the alveoli, which appear like a bunch of grapefruits connected to small breathing tubes. Various body muscles take part in inhalation. The diaphragm is the biggest and the strongest of these muscles. It is positioned under the two lungs, detaching them from other organs. When the diaphragm shifts down or levels out, the ribs move outward, making the lungs expand, and air goes into the lungs. This process is known as inhalation. During the relaxation phase of the diaphragm, air in the lungs gets out, and they change back to their original state, which is known as exhalation. It can be compared with the balloons that need energy to gust up, but no energy is required to expel the air out (The American Thoracic Society, 2014).
What Is Different With Pneumonia
For pneumonia to occur, a pathogen must get into the alveoli’s of the lungs. The small capillaries become permeable, and protein-rich liquids penetrate into the lung alveoli. It creates less efficient area for oxygen and carbon dioxide exchange. The host becomes deprived of oxygen, and the body preserves potentially harmful carbon dioxide. His/her breathing becomes rapid so as to inhale more oxygen tom the lungs. The outcome of this process is a high production of mucus that may contain blood from the seeping blood vessels. The alveolus is filled with watery substances and remains of the big number of white blood cells, being manufactured to battle the infection (NIH, n.d.).
The bacterial infection process involves various consecutive stages. First phase is the bacterial exposure where the lungs are open to contagious respiratory substances or the use of new medical instruments into the human body. Some of the factors responsible for this stage of contamination are the host’s immune state, internal (endogenous), and external (exogenous) sources. Secondly, the bacteria enter into the body of a person. The pulmonary pathogens get to the lung parenchyma through the direct breathing of bacterial filled aerosols, aspiration of gastric contents, and the direct spread of infection from the upper respiratory system to the lower sections. It can also be through the hematogenous increase of the disease to the lungs from a neighboring contaminated organ.
The bacteria then increase and extend into the body in the third step. The factors shaping this development are the inoculums’ dimension, patient resistance mechanisms, nutrient accessibility for the bacteria, physiochemical aspects like microbial virulence causes. In the fourth stage, there are the occurrence injuries resulting from bacteria. The infections may directly and indirectly harm the lung tissues. This happens through various ways: by mechanical damage, death of cells, reactions such as inflammation, and induction of microbial substances. Finally, the activation of immune resistance and inflammatory reactions happens as a result of injuries to the lung parenchyma (Ignatavicus & Workman, 2013). The two types of pneumonia are introduced subsequently.
Community-Acquired Pneumonia (CAP)
This takes place outside of hospitals and various health care surroundings. It can be acquired by inhalation of germs that exist in the nose, throat, or mouth. Frequent exposure to impure air and repeated aspiration of nasopharyngeal environment makes lung parenchyma vulnerable to dangerous microorganisms. According to Singh (2012), pathophysiologic modes of spread of the pathogens are aerosol inhalation that includes legionella pneumophila, chlamydophila pneumoniae, and mycoplasma pneumoniae; oropharyngeal secretions such as streptococcus pneumoniae. The other mode is hematogenous spread; an example is staphylococcus aureus. Lastly, it is the reactivation of latent microorganisms like pneumocystis jiroveci and mycobacterium tuberculosis. Streptococcus pneumoniae is the frequent cause of community-acquired pneumonia (Sighn & Yudh, 2012).
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Barnet et al. (n.d) in their study suggest that the low zinc problem is a risk issue for pneumonia in older people. The study analyzes the extent of the disease in older people, its etiology, and the deregulation of the immune system linked with the old age. Lack of zinc in the body damages role of the immune system in the body, lowers resistance to pathogens, and is linked with high incidences of pneumonia. Zinc is important for the synthesis of DNA, the formation of membranes, and production of cells in the body. Pneumonia is a major public health problem in the aged people, mostly in nursing homes. The old people take a lot of time to heal from the infection.
The cost of taking care of elderly pneumonia patients living near nursing homes was stated to be 4.4 billion dollars in 2002. The price of treatment in nursing quarters is 480 dollars for each case. Taking of zinc supplements has been proven to advance the role of CD4 T cells among the aged persons (Barnet et al, n.d.).
HAP mostly happens in institutional locations. One can get hospital-acquired pneumonia during a hospital stay and especially from breathing support machines. It attacks the bodies of those who are sick. It is severe since the hosts have weak immune systems, and the bacteria are more complicated than those found in the CAP.
Aspiration pneumonia – this infection is brought about when substances such as food, saliva, or vomit enter the lungs.
Atypical pneumonia – microorganisms such as mycoplasma pneumoniae, chlamydophila pneumoniae, and legionella pneumophila bring about this type of pneumonia. (NIH, n.d.)
Viruses require efficient modes of transmission, cellular infiltration, and adherence to bring about an infection. A number of viruses have particular preferences for some of the body tissues. The viruses spread by the wall of the main contaminated cell and secondary viremia or creation of syncytia between the lung cells. The pneumonia may result in complications and sometimes death. The disease is severe with pregnant mothers and patients previously suffered from heart or lung related conditions. Viruses are repeatedly formed at the surface of the cell, or the genome may be incorporated into the patient’s genome cell.
Bacterial infections have a complicated pathogenesis which is understood by checking on the parasite life cycle. Some protozoa and infections need transmission of a disease, epidemiology. Pneumonia caused by bacteria can take place independently or occur after an attack by cold or flu. Patients recuperating from viral infections, surgeries, cancer, respiratory ailments, and those infected with HIV/AIDS are at high risk of contracting this bacterial infection (Case Study, n.d.).
Approximately 151 million cases arise in the most developed countries, such as China with 21 million, Pakistan with 10 million, and India with 43 million. The disease is also to blame for the deaths that amount to 20% of children under five years (Rudan et al., 2008). According to Case Study (n.d.), an estimation of 4.5 million reports of CAP takes place yearly in America. Rate of recurrence of approximation of pneumonia in America varies from 4-7 incidents for every 1000 hospitalizations.
The disease is rampant in the wintry weather months and cold temperatures. Episodes are higher in males than in females; and older age increases the rate of infection. For old people, the occurrence of the disease rises from 94 cases at the age of 44 to 280 incidences per 100,000 individuals aged above 65 years (Case study, n.d.).
Signs and Symptoms
Pneumonias signs and symptoms range from less complicated to severe. General symptoms include nausea, high fever, shortness in breathing, colds, shaking chills, muscle aches, diarrhea, cough filled with phlegm, severe abdominal pains, persistent flu, and chest pains. Some of the symptoms differ in particular populations. Distinctive signs and symptoms for children aged below five years are cough, rapid breathing, and fever. Severe symptoms that may require medical emergency are heavy breathing, dementia, bluish skin, weight loss, and rapid heartbeat (Pathophysiology of pneumonia, n.d.).
Risk factors adding to the prevalence of pneumonia are poor nutrition, air pollution, insufficient breastfeeding, and low birth weight. Loeb (2009) argues that the leading cause of deaths in kids aged below five years is the childhood pneumonia. The cases reported for the age cluster are reported to be 0.29 episodes per kid every year globally.
According to a study carried out by Loeb et al. (2009), problems such as congestive heart failure, renal disease, chronic obstructive pulmonary disease, poor functional status as well as dysphagia are the main causes of hospitalization of patients with pneumonia. Ecological issues linked to hospitalization are regular exposure to poisonous gasses, chemicals, and vapors from various paints and solvents.
In 2001, the World Health Organization founded a sovereign group of technical specialists known as the Child Health Epidemiology Reference Group (CHERG). The CHERG objective was to analytically assess and improve data compilation, techniques of assumptions triggering the approximations of the distribution of the major reasons of death for the previous year (Loeb et al., 2009).
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Complications of Pneumonia
People suffering from severe alcoholism, lung cancer, cystic fibrosis, and diabetes mellitus are at a high risk of getting bacterial pneumonia that is brought about by klebsiella pneumoniae. Other possible complications of pneumonia include respiratory breakdown, multiple organ failure, destruction of lung tissue, accumulation of pus in the lungs, bronchiectasis as well as reliance on equipment such as air conditioners for ventilation (Case Study, n.d.).
Diagnosis for pneumonia is for people suffering from less complicated pneumonia. A number of factors act either independently or in addition to others to add to the number of death rates among the patients. These are coexisting illness, body immune deficiency state, old age, respiratory failure, sepsis features, and aggressive bacteria.