3.5 : Pneumonia V: Nursing management and Prevention

Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.

The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.

Enhance airway patency

Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed. Encouraging ambulation and assisting with proper positioning in a chair are vital interventions. Additionally, patients should be encouraged to take deep breaths and cough after each position change.

Using a high-humidity face mask can help deliver warm, humidified air to the tracheobronchial tree, thereby liquefying secretions and alleviating irritation.

Patients with altered consciousness should be positioned to prevent aspiration. Regular repositioning, at least every 2 hours, is necessary to promote adequate lung expansion and prevent the pooling of secretions.

Administering and adjusting oxygen therapy as prescribed or per protocols is crucial. Monitoring its effectiveness through clinical signs, symptoms, patient comfort, and oxygenation values by pulse oximetry or analyzing arterial blood gas is essential.

Keeping the patient's head-of-bed elevated to at least 30 degrees during meals is recommended, especially for those with difficulty swallowing. Assisting patients with eating, drinking, and medication administration can prevent aspiration.

Promoting rest

Encouraging rest and avoiding overexertion is important for debilitated patients. Comfortable positioning, such as the semi-Fowler position, and frequent changes in position aid in secretion clearance, pulmonary ventilation, and perfusion. Outpatients should be educated to avoid excessive activity during the initial phases of treatment.

Maintaining nutrition and fluid intake

Promoting fluid intake is crucial due to increased respiratory rate and insensible fluid loss. Encouraging increased fluid intake, with a minimum of 2 liters per day, is recommended unless contraindicated. Special attention must be paid to patients with preexisting conditions like heart failure, with hydration administered slowly and carefully monitored.

Maintaining nutrition involves providing small, frequent meals when appropriate.

Health promotion

Lastly, health promotion is essential. Educating individuals on good health habits, such as frequent handwashing, proper nutrition, adequate rest, regular exercise, and coughing or sneezing into the elbow, is essential for reducing the risk of pneumonia. Avoiding exposure to cigarette smoke and avoiding individuals with upper respiratory infections is highly recommended. If symptoms persist for more than a week, seek medical attention. Additionally, at-risk individuals, such as the chronically ill and older adults, should consider obtaining influenza and pneumococcal vaccines.

By implementing these strategies, nurses can effectively manage pneumonia, optimize patient outcomes, and promote respiratory health.