There are different kinds of pneumonia, there is aspiration pneumonia, which occurs when you inhale foreign particles into your lungs. There is also opportunistic (viral or bacterial) pneumonia which often happens to people with weak immune systems. Those at risk for developing pneumonia are older adults, immobility, dysphagia, and people taking immunosuppresant such as chemotherapy and corticosteroids. There are many preventatives that health care workers do every day to help limit the spread infection and reduce the risk of pneumonia.
Some of these preventatives are to wash hands frequently, before and after patient care, encourage coughing and deep breathing exercises, get the patient out of bed and allow the patient to do as much for themselves as possible to allow proper expansion of the lungs so the aspiration risk is lower. If the patient is bed bound then it is helpful for the nurse and respiratory therapist to collaborate together and introduce an incentive spirometer to the patient. The respiratory therapist often will show the patient how to use it and then the nurse will make sure the patient is in fact using it, explaining the benefits.
Driver (2012) wrote an article on preventatives for pneumonia and stated that you actually need to prevent pneumonia early in life by healthy habits such as not smoking or heavy drinking, maintaining a healthy weight and exercise (pg. 106). Driver (2012) also goes on to recommend pneumonia vaccines. “Although vaccines are not available against every pathogen that may cause pneumonia, they are available for two of the most significant associated groups: Streptococcus Pnuemoniae and influenza” (pg. 106).
Mazur (2011) had conducted a study to research the benefits to the pneumonia vaccine and seasonal influenza vaccine and if getting the vaccines lead to lower hospitalizations. The study was with patients, 65 and older that were hospitalized with pneumonia. There were 238 individuals that were vaccinated and 195 unvaccinated. “No differences were found with respect to combined antibiotic therapy between groups. Similar percentages of vaccinated and unvaccinated individuals required ICU admission” (pg. 711).
Mazur (2011) goes onto say “Nevertheless, this observation should not discourage healthcare providers from vaccinating elderly persons because of the benefits of the pneumococcal and influenza vaccines in reducing the burden of both diseases in this age group” (pg. 1716). Reviewing this nursing literature would benefit this clinical experience because it would educate the nurse on what causes pneumonia, how to determine a patients risk for getting it, and how to prevent it.
Nursing care for a patient with pneumonia would be to monitor oxygen levels, administer oxygen as needed, per physician and maintain vitals within normal limits. You would also want to monitor for any dyspnea or shortness of breath and auscultate lung sounds. If the patient is immobile make sure to turn or reposition them at least every two hours. A chest x-ray will also be ordered and the nurse will be responsible to get a sputum collection from the patient, if possible, to have a culture done.
In a recent clinical experience I had a patient come to the hospital from a local nursing home admitted with pneumonia. This patient was at risk for pneumonia because of her immobility, alert and oriented to only herself, and she was older adult. I believe it is important for continued education and proper teaching on pneumonia prevention. Pneumonia vaccines are an important role and although it is not assured the vaccine will work wholly it is a great prevention method.