2-45. PNEUMONIA
a. Pneumonia is inflammation of the lungs accompanied by consolidation (lung
becomes firm as air spaces are filled with exudate). This condition is most commonly
caused by infectious agents such as viruses, bacteria, or fungi. Inhalation of caustic
gases may cause chemical pneumonia.
b. Pneumonia may be referred to as lobar pneumonia if the majority of a lobe is
involved. The term bronchopneumonia is used when the inflammation begins in the
bronchi and extends to adjacent lung tissue.
c. Signs and symptoms include fever, chills, chest pain, rapid and difficult
breathing, and rapid pulse accompanied by a painful cough and purulent sputum. The
organisms are spread by droplets or by contact with material contaminated with
respiratory secretions.
d. Treatment depends upon the causative agent. Antibiotic therapy is initiated
when the agent has been identified. Increased fluid intake and humidification are
encouraged to liquefy secretions and aid in their expectoration. Percussion and
should be used to relieve the pleuritic pain, but care should be taken to avoid
suppressing the cough reflex.
2-46. PULMONARY EMBOLISM
a. Pulmonary embolism is the presence of one or more thrombin that has moved
from their site of origin, into the pulmonary vascular bed, to obstruct one or more of the
pulmonary arteries. These thrombin originate somewhere in the venous system or the
right side of the heart. They become dislodged and are carried to the lung, interrupting
the blood supply to lung tissue and causing infarction of lung tissue.
b. Signs and symptoms range from nonexistant to pleuritic pain, cough,
hemoptysis, tachycardia, dyspnea, and anxiety. The symptoms present will depend
upon the size of the thrombus and the location of the occlusion.
c. Treatment for pulmonary embolism involves immediate measures to stabilize
the patient. Massive pulmonary embolism is a life threatening medical emergency.
Oxygen is administered to relieve respiratory distress. An IV is started to provide a
life-line for administration of emergency medications. If the embolism is severe enough,
the patient may require an indwelling urinary catheter, endotracheal intubation,
mechanical ventilation, and ECG monitoring. The second aspect of treatment involves
anticoagulant therapy to prevent recurrence or extension of the embolism. This therapy
is potentially dangerous and must be strictly controlled by the physician.
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