Pneumonia is inflammation of the lungs resulting in consolidation
Obstruction in gas exchange on the alveolar level
Aspiration most common cause
2nd most frequent cause is droplet inhalation
Least likely cause is blood borne
Protein rich fluid move into the alveoli- complicated by production of the organism- result is decreased alveolar surface area-resulting in elevation of pco2 and a decrease in po2
Inspection-tachypnea and central cyanosis
Percussion-dullness
Palpitation-tactile fremitus
Auscultation-crackles, rhonchi, wheezing, or egophony
Diagnosis-labs, chest xray
Ct not recommended unless anthrax is suspected
Bronch-immunocompromised individuals and patients who have not responded to treatment
Xrays
Focal- bacteria
Interstitual-viral
Rapid progression/ multifocal- legionella, pneumococci, staphylococci
Medialstinal widening without infiltrates- inhalation anthrax
Tamiflu within 48 hours to be effective
HAP-received care in a health care institution for at least 2 days in the last 90 days prior to infection
VAP- pneumonia within 48 hours of intubation
HAP more difficult to treat compared to CAP
COPD- include emphysema, chronic bronchitis, and small airway disease
Emphysema-structural change via destruction and enlargement of alveoli
Chronic bronchitis- chronic cough and mucous production
Small airway disease-generalized narrowing of bronchioles, may include asthma
COPD-4th leading cause of death in United States
Risk factors- smoking, outdoor air pollution, occupational dust and chemicals
Candium exposure can cause COPD
Alpha 1 antitrypsin deficiency- hereditary
COPD cause air trapping- mucous obstructs airway. Air then gets trapped in causing increased Co2 eventually leading to VQ mismatch
Indicators-cough, sputum production, dyspnea
Yellow or green sputum- bacteria
Look for barrel chest,
