XII.

PATHOPHYSIOLOGY

Modifiable Risk Factors: No history of pneumococcal vaccination No history of having received influenza vaccine Asthma Direct contact with infected person Alcohol Abuse Cigarette Smoking Chronic llnesses !C"D# emph$ema# DM% &ong term use if immunosuppressant drugs Non-modifiable Risk Factors: Contaminated Air

)ortal of ',it: Mouth and Nose 'tiologic Agent: Streptococcus pneumoniae "iral# (acterial# Fungal# )roto*oa Reser-oir: ./MAN

Mode of +ransmission: Airborne# droplet nuclie

)ortal of 'ntr$: Mouth and Nose

'ntr$ to the upper airwa$

nhaled to the lower airwa$ (acteria multiplies in al-eolar spaces

Hyperthermia S1S2: ncreased temperature 3454 6C !N73859-345: 6C% ncreased RR: ;8 bpm !N7:;-39 breaths per minute% ncreased .R <3= bpm !N7<>>-<3> beats per minute% Lab Test: CBC ncreased ?(C !N7 9-<>2<>@:1&%

Stimulation of defense mechanisms

Release of damaging to,ins b$ bacteria

Antigen-antigen bod$ combines with endoto,ins released b$ microorganisms

Mucociliar$ clearance Cough refle, )hagoc$tosis b$ al-eolar macrophages

Release of biochemical mediators b$ al-eolar mast cells .$perresponsi-eness of airwa$s

C$tokine 0 mediated inflammation !Neutrophils migrate to al-eoli%

Further damage to bronchial mucous membranes and al-eolocapillar$ membranes ncreased capillar$ permeabilit$ Al-eolar edema

',udate Formation
Impaired gas exchange S/SX: D RR: ;8 cpm!N7:;-39cpm% D .R: <3= bpm !N7<>><3>bpm% D$spnea ?eak appearance

Stimulation of goblet cells ncrease mucous production

CANB'S+ AN: Al-eoli and Respirator$ brionchioles fill with serous e,udates# blood cells# fibrins# bacteria CANSA& DA+ AN of lung tissue R'D .')A+ CA+ AN: e,udates coagulates resulting to red appearance of tissue with li-er tissue consistenc$
S/SX: Dullness upon percusion Rales upon auscultation

Rich medium for proliferation of bacteria

&ocal capillar$ leak

)artial occlusion of the al-eoli

CXR: Streak$ ha*ed infiltrates at both lungs M): )neumonia# bilateral

Ineffective Airway Clearance S/SX: ?hee*es on auscultation )roducti-e cough +hick purulent sputum ncreased RR: ;8bpm !N7:;-39 breaths per minute%

Spread infection to other areas of the lungs

Reduced surfactant

Stiffens the lung Reduced compliance Decreased -ital capacit$ ?ork of breathing
Ineffective breathing pattern S/SX: D RR: ;8 bpm !N7:;-39bpm% D$spnea /se of accessor$ muscle Nasal flaring

&eukoc$tes !Neutrophils and Macrophages% dominate and eliminate inEurious agents and dead cells BRAF .')A+ CA+ AN: fibrin deposition on pleural surfacesG phagoc$tes in al-eoli R'SA&/+ AN AF NF'C+ AN: ingestion of degenerated neutrophils# fibrin# bacteria b$ macrophages and remo-al b$ l$mphatic -essels Restoration of both structure and function of the lungs

Legend: Disease Process Signs and Symptoms

RED Blue

Mo-es into the bloodstream

Atelectasis !al-eolar collapse

Diagnostics Complications Factors

nfection spreads to other organs of the bod$ reduces the abilit$ of the lungs to o,$genate

h$po-entilation -entilation perfusion mismatch

Septicemia

Septic Shock h$po,emia h$po,ia

h$percapnia Respirator$ acidosis HussmaulIs respiration Respirator$ alkalosis Respirator$ failure Respirator$ arrest

DEAT H