Editing Medical-Surgical Nursing (section)

=== Pneumonia ===

Pneumonia is infection and inflammation of lung parenchyma with consolidation. Findings include fever, chills, productive cough, pleuritic chest pain, tachypnea, crackles, bronchial breath sounds over consolidated areas, dullness to percussion, increased tactile fremitus, and hypoxemia.

Nursing interventions: obtain sputum cultures before starting antibiotics when possible, give antibiotics promptly, encourage fluids, provide incentive spirometry and coughing and deep breathing, position with the good lung down when one lung is affected to optimize perfusion to the better lung, and mobilize the patient early.

Nursing application: in older adults the presenting sign of pneumonia is frequently new confusion, a fall, or decreased appetite rather than fever and cough. Treat new confusion in an older adult as a red flag requiring investigation.