LESSON PLAN ON PNEUMONIA

SUBJECT: MEDICAL SURGICAL NURSING I

TOPIC: PNEUMONIA

GROUP: 2ND YEAR GNM STUDENTS

PLACE: SHREE SWAMINARAYAN NURSING COLLEGE, CHIKHLI. (2nd YEAR GNM CLASS)

DATE AND TIME: 25/02/22, 03:00 PM TO 04:00 PM

METHOD OF TEACHING: LECTURE CUM DISCUSSION

DURATION: 1HR

[Link]: WHITE BOARD, CHARTS, FLASH CARDS, DEMONSTRATION, PPT.

NAME OF THE SPEAKER: [Link] PATEL

GENERAL OBJECTIVES:
After the completion of the class, The students will gain in depth knowledge on pneumonia and they will gain knowledge regarding management of
pneumonia

SPECIFIC OBJECTIVE:
After the class, students will be able,
To Introduce pneumonia
To Define pneumonia
To Discussed types of pneumonia
To Enumerate cause of pneumonia
To Explain pathophysiology of pneumonia
To Discussed clinical menifestration
To Enumerate diagnostic evaluation
To Discussed management of pneumonia
To Explain prevention of pneumonia
SR TIME SPECIFIC CONTENT ACTIVITES [Link] EVALUATION
NO. OBJECTIVES TEACHERS STUDENTS
1. 2 min To Introduce PNEUMONIA lacture cum listen and -
pneumonia discussion participated
Pneumonia is an inflammatory illness of the lung.
Frequently, it is described as lung parenchyma/alveolar
inflammation “and” abnormal alveolar fillimg with fluid what is pneumonia?
2. 3 min To Define (consolidation and exudation)}. Pneumonia is a general
pneumonia term that refers to an infection of the lungs, whitch can be
caused by a variety of microorganisms, including viruses,
bacteria, fungi, and parasites.
PPT
The infection causes your lungs air sacs, called alveoll, to
become inflamed. The air sacs may fill up with fluid orr
whiteboard
pus, causing symptoms such asa cough (with phlegm),
fever, chills, and trouble breathing.

3. 8 min To Discussed TYPES OF PNEUMONIA which are the typ-e

types of of pneumonia ?
pneumonia
PNEUMONIA
PPT

whiteboard
Communi Health
Hospital-
Infective ty- Care- Fungal Aspiration
Acquired Acquired Associated

[Link] Pneumonia: Inflammation and infection of

the lungs and bronchial tubes that occurs when a bacteria
(bacterial pneumonia) or virus (viral pneumonia) gets into
the lungs and starts to reproduce. The most common
cause of bacterial pneumonia in adults is a bacteria called
 streptococcus pneumonias or Pneumococcus.
SR TIME SPECIFIC CONTENT ACTIVITES [Link] EVALUATION
NO. OBJECTIVES TEACHERS STUDENTS
[Link]-Acquired Pneumonia: Community- lacture cum listen and flash cards -
Aquired pneumonia (CAP) occurs out-sides of hospitals discussion participated
and other health care settings. Most people get CAP by
breathing in germs (especially while sleeping) that live in
the mouth, nose, or throat. CAP is the most common type
of pneumonia. Most cases occur during the winter.

[Link]-Acquired Pneumonia: Some people catch

Pneumonia during a hospital stay for another illness. This
is called hospital-acquired pneumonia (HAP). Patients are
at higher risk for getting HAP if on a mechanical
ventilator. HAP tends to be more serious than CAP.

[Link] Care-Associated Pneumonia: Patients also

may get pneumonia in other health care setting, such as
nursing homes, dialysis centers, and outpatient clinics.
This is called health care-associated pneumonia.

[Link] pneumonia: Candida and Aspergillus are two

types of fungi that can causes pneumonia Pneumocyitis
carinil is a fungus that typically causes pneumonia in
patients with with AIDS.

[Link] Pneumonia: This type of pneumonia occurs

when person accidentally inhalo food, drink, vomit, or
saliva from mouth into lunges. This usually happens when
something disturbs normal gag reflex, such as a brain
injury. Swallowing problems, or excessive use of alcohol
or drugs. Aspiration can cause pus to form in a cavity in
the lug. This is called a lung abscess.

[Link] Pneumonia: Several types of bacteria-

 Legionella pneumophila, mycoplasnsms pneumonia, and
Chlamydrophila pneumonise –cause this type of CAP.
Atypical pneumonia is passed from person to person.

SR TIME SPECIFIC CONTENT ACTIVITES [Link] EVALUATION

NO. OBJECTIVES TEACHERS STUDENTS
4. 7 min To Enumerate CAUSES OF PNEUMONIA lacture cum listen and what are the causes
cause of Pneumonia can be due to a variety of bacteria and viruses, discussion participated of pneumonia ?
pneumonia less commonly due to fungi and rarely due to other
microorganisms or parasites. Likely causes are associated
with the age of the person, the season, the person’s health
status, and /or where the infection was contracted.
RISK FACTORS
 Age: 65 or older what are the risk
 Cligarette smoking factors of
 Chronic illness, such as heart or lung disease, PPT pneumonia ?
liver ciorrhosis, or diabetes mellitus
whiteboard
 Stoke (aspiration pneumonia due to difilcult
swallowing)
 Weakened immune system caused by AIDS
or chemotherapy treatment
 Recent viral respiratory infection (common
cold, laryngitis, influenza)
 Chronic exposure to certain chemicals
 Cerebral palsy
 Impaired consciousness
 Recent surgery or trauma
 Malnutrition
 Pregnancy
 Infants and very young children
 Alcohol or drug abuse
 Hospitalization in an intensive care unit
5. 8 min To Explain PATHOPHYSIOLOGY OF PNEUMONIA what is
pathophysiolo Pneumonia is an acute infection of the lungs, occurring pathophysiology of
gy of when an infectious agent enters and multiplies in the pneumonia ?
pneumonia lungs of a susceptible person. When the microorganisms
multiply, they release toxins that induce inflammation in
the lung tissue, causing damage to mucous and alveolar
SR TIME SPECIFIC CONTENT ACTIVITES [Link] EVALUATION
NO. OBJECTIVES TEACHERS STUDENTS
membranes. This leads to the development of edema and lacture cum listen and -
exudate, which fills the alveoli and reduces the surface discussion participated
area available for exchange of carbon dioxide and
oxygen. Some bacteria also cause necrosis of lune tissue.
Pneumonia may be confined to one lobe, or it may be
scattered throughout the lungs. If it affects only one lobe, PPT
it is called lobar pneumonia. Generalized pneumonia is
much more seriousand is called bronchopneumonia. whiteboard
Bronchopneumonia occurs more often as a nosocomial
(hospital acquired) infection in hospitalized patients.
Pathyophysiology of pneumonia is characterized by four
stages. The first stage of the disease occurs within 24
hours of infection and it is distinguished by vascular
congestion and alveolar derma. The lungs are also
invaded by bacteria and few neutrophils. Typical
symptorms include cough, fever, and sputum production,
usually developing over days and sometimes
accompanied by pleurisy.
The second stage of the disease is called “red
hepatization”. In this stage lungs are similar to the
consistency of liver, with the presence of many
erythrocytes, neutrophils, desquamated epithelial cells,
and fibrin within the alveoli.
The third stage is the “gray hepatization” in the lung is
gray-blown to yellow because of fibrinopurulent
exudates, disintegration ofred cells, and hemosiderian.
The fourth, and the final, stage is called “resolution” and
 it is characterized by breakdown of the substances
causing inflammation. In this stage, white blood cells are
fighting off invading micro-organisms, and the remains
are usually coughed up. This stage is characterized by
restoration of the pulmonary architecture.

SR TIME SPECIFIC CONTENT ACTIVITES [Link] EVALUATION

NO. OBJECTIVES TEACHERS STUDENTS
6. 6 min To discussed CLINICAL MANIFESTATIONS lacture cum listen and which are the
clinical Symptoms of pneumonia vary, depending on the age of discussion participated clinical
manifestation the child and the cause of the pneumonia. Common manifestation of
of pneumonia symptoms include: pneumonia ?
PPT
bacterial viral pneumonia atypical
whiteboard
pneumonia pneumonia
nasal congestion nasal congestion nasal congestion
and sore throat and sore throat and sore throat
fever fever fever ,often low
grade
shaking chills chills chills
dyspnea , shortness dyspnea, shortness dyspnea, shortness
of breath of breath of breath
cough that dry cough coughing; may be
produces violent at times;
green,yellow, or produce white
rust-coloured mucus
mucus
chest pain headache possible nausea or
vomiting
perfuse sweating muscle pain weakness
bluish color of bluish color of
nails or lips : nails or lips :
cyanosis , cyanosis ,
hypoxemia hypoxemia
confused mental weakness
status
SR TIME SPECIFIC CONTENT ACTIVITES [Link] EVALUATION
NO. OBJECTIVES TEACHERS STUDENTS
7. 6 min To enumerate DIAGNOSTIC EVLUATIONS lacture cum listen and which are
diagnostic The doctor will ask about symptoms and medical discussion participated diagnostic
evaluation of history. A physical exam wil be done. Diagnosis is based evaluation for
pneumonia on symptoms and listening to chest. Tests may be include: pneumonia ?
 Chest x-ray PPT
 CT scan
 Blood test whiteboard
 Bronchoscopy – Direct examination of airways
 Sputum culture – Testing mucus coughed up
from deep in the lungs
 Pulse oximetry – Measurers the amount of
oxygen in the blood
 Pleural fluid culture – If there is fluid in thespace
surrounfing the lungs
 Arterial blood gas – Measure oxygen, carbon
dioxide, and acid in the blood

8. 14 To discussed MANAGEMENT lacture cum listen and what is the

min management Most cases of pneumonia can be treated without discussion participated management of
of pneumonia hospitalization. Typically, oral antibiotics, rest, fluids, and pneumonia ?
home care are sufficient for complete resolution.
However, people with pneumonia who are having trouble PPT
breathing, people with other medical problems, and the
elderly may need more advanced treatment. If the whiteboard
symptoms get worse, the pneumonia does not improve
 with home treatment, or complications occur, the person
will often have to be hospitalized.
NON PHARMACOLOGIC INTERVENTIONS :
 Turning, coughing, deep breathing to remove
secretions
 perform postural drainage and chest
physiotherapy

SR TIME SPECIFIC CONTENT ACTIVITES [Link] EVALUATION

NO. OBJECTIVES TEACHERS STUDENTS
 supplemental oxygen via nasal cannula or mask lacture cum listen and -
and warm moist inhalation discussion participated
 increased fluid intake (2 – 3 liters per day) to thin
and loosen secretions
PHARMACOLOGIC INTERVENTIONS :
antibiotic are used to treat bacterial [Link]
contrast, antibiotics are not useful for viral pneumonia,
although they sometimes are used to treat or prevent
bacterial infections that can occur in lungs damaged by a
viral pneumonia.
patients with mild pneumonia who are otherwise healthy
are usually treated with oral macrolide antibiotics
(azithromycin, clarithromycin, or or erythromycin ).
patient with other seroius illlness, such as heart dieases,
chronic obstructive pulmonary disease, or emphysema,
kidney diseases, or diabetes are often given one of the
following: fluoroquinolone ( levofloxacin,
levaquin ),sparfloxacin (zagam), or gemifloxacin
( factive), moxifloxacin ( avelox ) and high – dose
amoxicillin or amoxicillin-clavulanate, plus a macrolide
antibiotic (azithromycin, clarithromycin, or
erythromycin).
viral pneumonia caused by influenza A may be treated
with rimantadine or amantadine, while viral pneumonia
caused by influenza A or B may be treated with
 oseltamivir or zanamivir.
control fever with aspirin, nonsteroidal anti-inflammatory
drugs (NSAIDs, such as ibuprofen or naproxen), or
acetaminophen. do not give aspirin to children.
some physicians advice taking exectorants, for example
guaifenesin ( breonesin, glycotuss, glytuss, hytuss,
naldecon senior EX , robitussin), to loosen sputum.
codeine or other stronger pain relievers may be
prescribed, for severe [Link], it have to be noted

SR TIME SPECIFIC CONTENT ACTIVITES [Link] EVALUATION

NO. OBJECTIVES TEACHERS STUDENTS
that codeine and other narcotics suppress coughing, so
they should be used with care in pneumonia and often
require monitoring.
expectorants, bronchodilators, and analgesics may be
given for comfort and symptom [Link]
medication may be used for the associated cough.
antihistamines may provide benefit with reduced sneezing
and rhinorrhea.
nasal decongestants may also be used to treat symptoms
and improve sleep; however, excessive use may cause
rebound nasal [Link] mist treatments or
metered dose inhalers may be used to delivers
bronchodilators.
NURSING MANAGEMENT
NURSING DIAGNOSIS :
1. Imparied gas exchanges relate to decreased ventilation
2. Ineffective airway clearance related to excessive
tracheobronchial secretions
3. Ineffective breathing pattern related to chest pain and
hypoxia.
4. Activity intolerance related to impaired respiratory
function
5. Risk for deficient fluid volume related to fever and
 dyspnea Demonstration
6. Deficient knowledge about the treatment regimen and
preventive health measures Charts
NURSING INTERVENTION :
[Link] assessments every 4 hours of respiratory rate,
temperature, and signs of airway effectiveness.
[Link] scheduled chest physiotherapy. removing the
secretion of the airway, preventing obstruction
[Link] her to take several deep [Link]

SR TIME SPECIFIC CONTENT ACTIVITES [Link] EVALUATION

NO. OBJECTIVES TEACHERS STUDENTS
breathing promotes oxygenation before controlled -
[Link] her to take a deep breath, hold for 2
seconds,and cough two or three times in
[Link] coughing is accomplished by
closure of the glottis and the explosive expulsion of air
from the lungs by the work of abdominal and chest
muscles.
[Link] use of incentive spirometry, as appropriate.
Breathing exercises help maximize ventilation
[Link] systemic fluid hydration, as appropriate.
Adequate fluid intake enhances liquefaction pf pulmonary
secretions and facilitates expectoration of mucus.
[Link] [Link] lung tissue oxygen supply
[Link] antibiotics and antipyretics; assess the
effectiveness and side effects (rash, diarrhea)
[Link] a gradual [Link] airway clearance
[Link] the results of the pulse oximeter when installed,
every 2-4 hours. periodically evaluate the success of
therapy/health team action.
[Link] respiratory therapy (e.g., nebulizer) as
needed.A varitey of respiratory therapy treatments may be
used to open constricted airways and liquefy secretions.
9. 6 min To explain PREVENTION lacture cum listen and what are prevantion
prevention of [Link] vaccinated discussion participated for pneumonia ?
pneumonia [Link] hands
[Link]’t smoke
[Link] rest and a diet rich in fruits, vegetables and PPT
whole grains
[Link] exercise whiteboard
[Link] treatment for GERD
 BIBLIOGRAPHY

 BT Basavanthappa,”Text book of nursing foundation ”published by Jaypee brothers medical

publishers (p) LTD .
 Javed ansari and davinder kaur,” Medical surgical nursing I “ published by pee vee [Link] no :359
 Kochuthresiamma thomas,” Medical surgical nursing”Volume I published by Jaypee brothers medical
publishers (p) LTD .page no:130
 potter and perry,s,” Text book of fundamental of nursing published by elsevier .
 I clement,”Basic concepts of NURSING PROCEDURES” 3rd Edition , published by Jaypee brothers
medical publishers (p) LTD . page no : 272