Pneumonia a Case Study

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II. HISTORY OF PRESENT ILLNESS

Three days prior to admission, the patient suffered from fever, cough, and colds. He didn’t receive any medications or even consulted a physician. One day prior to admission, he suffered difficulty of breathing which triggered his parents to bring him to the hospital. They went first in the OPD and he was assessed with (+) head hobbing, (+) nasal flaring, and (+) rales. He was admitted at the PICU ward for further evaluation. Through the diagnosis of the attending physician, it was found that he has bronchopneumonia, severe.

III. PAST HISTORY

The patient completed her immunization except Hepatitis – B Vaccine due to lack of financial resources. The patient did not experience any hospitalization before. He is the third child of the family and was a home delivery by a midwife. He suffered the same signs and symptoms when he was 10 month – old. He was brought at the health center for consultation and was prescribed to take medicines (the parent can not remember the medicine given). He did not complete the medication due to financial insufficiency and relieved from the illness.

IV. FAMILY HISTORY

No familial diseases.

V. DESCRIPTION OF PRESENT ILLNESS

An acute infectious disease of the lungs usually caused by the pneumoccocus resulting in the consolidation of one or more lobes of either or both lungs.

Etiology
• Majority of cases due to Diploccocus pneumoniae
• Occasionally pneumoccocus of Friedlander
• Other organisms
• Viruses

Predisposing Causes
• Fatigue
• Overexposure to inclement weather (extreme heat or cold) • Exposure to polluted air
• Malnutrition

Incubation Period – 2 to 3 days

Signs and Symptoms
• Rhinitis/common cold
• Chest indrawing
• Rusty sputum
• Productive cough
• Fast respiration
• High fever
• Vomiting at times
• Convulsions may occur
• Flushed face
• Dilated pupils
• Severe chill in young children
• Pain over affected lung
• Highly colored urine with reduced chlorides and increased urates

Diagnosis
• Based on history and clinical signs and symptoms
• Dull percussion note on affected side (lung)
• X-ray

Complications
• Emphysema or pleural effusion
• Endocarditis on pericarditis with effusion
• Pneumococcal meningitis
• Otitis media in children
• Hypostatic edema and hyperemia of unaffected lung in the elderly • Jaundice
• Abortion

Management
• Bedrest
• Adequate salt, fluid, calorie and vitamin intake. Water requirement increases because of fever, sweating and increased respiratory rate. Plasma chlorides tend to fall in pneumonia, hence sodium chloride should be given by mouth or by vein if necessary. Adequate urine output is essential for excretions of toxins and for avoidance of serious urinary complications due to medications. Adequate caloric and vitamin (especially Vitamin C) intake are essential since the body reserves are rapidly depleted by the increased rate of metabolism due to the abnormally high body temperature. • Tepid sponge for fever

• Frequent turning from side to side
• Antibiotics based on Care of Acute Respiratory Infection (CARI) of the Department of Health

VI. ANATOMY AND PHYSIOLOGY

➢ anatomy of the lungs
[pic]

Lungs are paired cone shaped organs lying in the thoracic cavity. It extends from the diaphragm to a point about 1.5 to 2.5 cm (0.75 – 1 inch) superior to the clavicle and lie against the ribs interiorly and posteriorly. The brood inferior portion of the lungs, the BASE, is concave and fits never the convex area of the diaphragm. The narrow superior portion of the lung is termed as APEX. The surface of the lung lying against the ribs, the COSTAL SURFACE is rounded to match...
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