2.18. PNA = pneumonia

Pneumonia, like jam, comes in many flavors--all of them bad. Mucus coughed up can be creamy yellow (Staphylococcal pneumonia), green (Pseudomonas), rusty (Pneumococcal), currant jelly (Klebsiella), or pink and frothy (not just pneumonia, but pulmonary edema.) A sputum culture can be done to identify the offending organism.

One can get this infection of the lungs out in the world (community-acquired pneumonia) or from a hospital (nosocomial pneumonia). There's also "walking pneumonia" (Mycoplasma pneumoniae), and ventilator-acquired or aspiration pneumonia.
That doesn't mean one must pick one of these poisons. Flu shots are better than nothing (pneumonia often follows a flu), and anyone older than 65 without contraindications might consider the pneumococcal vaccine (sepsis from S. pneumoniae was the main thing that did my mom in at the age of 63--maybe they should lower the recommended age).

Patients present with fever, chills, flushed face, sweating, shortness of breath, chest pain, sputum production, and coughing. Older adults may just have confusion as their primary symptom (due to reduced oxygen to the brain).

Position the patient to maximize breathing (raise head of bed) and administer oxygen. Provide nutrition, rest, and fluids for hydration and to thin secretions. Physicians usually order antibiotics to prevent spread of the infection (to the blood = sepsis, or) to other parts of the body (meninges = meningitis, ventricles = ventriculitis, etc.)

Along the butterfly-effect line (or wave) of thinking, if one gets a flu shot one's less likely to get pneumonia. If one still gets the flu, or even some flavor of pneumonia, it won't be the one that turns into pneumococcal meningitis if Pneumovax had been administered. And one would live.

It's a good thing we student nurses had to give one another our flu shots last September, since we've all had multiple pneumonia patients since then. It's been a bad flu season, followed by a bad allergy season, hopefully turning into a nice, healthy summer (to be spent teaching Engl 1A--thank you, Donna, Meg & Vince!)


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