Bacterial pneumonia: Nursing process (ADPIE)

Neli Kaur is an 82-year-old male client who arrives at the Urgent Care Clinic with his home health aide.

Mr. Kaur has a history of cardiac disease, type I diabetes, prostate cancer, and depression.

He was brought to the clinic this afternoon because of a new onset of a productive cough, dyspnea and chest pain.

Mr. Kaur’s aide tells the triage nurse, “Neli had these same symptoms 2 months ago.

I’m worried it’s pneumonia again.”

Pneumonia is an infection in the lung tissue caused by microbes, resulting in inflammation.

The inflammation brings fluid into the lung tissue, and that extra fluid can make it hard to breathe.

Now, there are lots of different pneumonia-causing microbes.

Usually it’s caused by viruses and bacteria, but it can also be caused by fungi and a special class of bacteria called mycobacteria.

In adults, the most common viral cause of pneumonia is influenza, sometimes just called the flu.

In adults, bacterial causes include Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus.

There are also more unusual bacteria like Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila, which don’t have a cell wall and are well known for causing an “atypical or walking pneumonia” because they often cause vague symptoms.

For example, you might manifest with symptoms of a common cold, and these aren’t severe enough to require you to stay home or be hospitalized.

So, you can still be out and about, walking around. In individuals with a normal immune system, fungi are a rare cause of pneumonia and often it’s regional - for example, there’s Coccidioidomycosis in California and the Southwest.

One special fungal culprit is Pneumocystis jiroveci which is a risk for immunocompromised individuals.