Pneumonia

Pneumonia is an infection of the lung parenchyma causing inflammation and alveolar consolidation with fluid or pus. Community-acquired (CAP) and hospital-acquired (HAP/VAP) types differ in likely pathogens and urgency. CAP often presents with sudden onset fever, productive cough with rust-colored or purulent sputum, pleuritic chest pain, and crackles on auscultation. HAP develops ≥48 hours after hospital admission and carries higher mortality because of drug-resistant organisms. Key assessment findings include tachypnea (often the earliest sign), SpO₂ decline, increased work of breathing, diminished or bronchial breath sounds over consolidated areas, and dullness to percussion. Elevated WBC (>11,000/mm³), positive sputum culture, and chest X-ray showing infiltrates support and confirm the diagnosis. Nursing priorities center on airway management: position the spontaneously breathing client with the affected lung up (good lung down) to optimize V/Q matching, encourage incentive spirometry 10 times per hour while awake, administer prescribed antibiotics within one hour when sepsis criteria are met, monitor oxygen therapy to maintain SpO₂ ≥94%, and ensure adequate hydration (2–3 L/day unless fluid-restricted) to thin secretions.