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Pneumonia is an inflammatory condition of the lung primary affecting the alveoli. The inflammatory response causes the alveoli to fill with fluid or pus. It can be caused by viral and bacterial infections or in rare cases fungal infections. There are various different types of pneumonia, and has different classifications, including how it was acquired:
~ Community acquired
~ Hospital acquired
~ Ventilator acquired (subcategory of HAP)
It can also be classified by which area of the lung is affected or by what is causing the infection.
Examples of common microbes that can result in pneumonia:
Bacterial - Bacterial pneumonia is usually limited to a smaller section on lobes instead of globally. Streptococcus pneumoniae, Staph aureus, Haemophilis influenze, Chlamydophila pneumoniae, Legionella pneumophila
Viral - Pneumonia Respiratory syncytial virus (RSV) Influenza virus Parainfluenza virus Adenovirus Measles virus Coronaviruses
Fungal - Coccidioides

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2. Is it obstructive or restrictive? Why?

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2. Is it obstructive or restrictive? Why?

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Restrictive respiratory condition. There is an increase in the amount of secretions in the lungs, which reduces the compliance of the alveoli

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3. How does the condition effect lung compliance and/or airway resistance?

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3. How does the condition effect lung compliance and/or airway resistance?

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Pneumonia will decrease lung compliance by reducing total lung capacity. Fluid or pus in alveoli will restrict the lung to expand (stiff lungs).

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4. Explain the role of V/Q mismatch in this condition. 

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4. Explain the role of V/Q mismatch in this condition. 

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- inflammation of alveoli with pus/fluid causes:
- poor ventilation (V) & normal perfusion (Q)
- decrease V/Q ratio> shunt.

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5. How is oxygenation and ventilation affected? Eg. consider O2 content, O2 delivery, alveolar ventilation 

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5. How is oxygenation and ventilation affected? Eg. consider O2 content, O2 delivery, alveolar ventilation 

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P (A-a) gradient will increase > diffusion across the membrane is impaired due to accumulation of pus or fluid resulting in a thickened membrane. This causes a reduction in oxygenation.
Increase of membrane size due to increased perfusions

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Stage 1: Congestion usually occur within 24hrs

During the congestion phase, the lungs become very heavy and congested due to infectious fluid that has accumulated in the air sacs. During this stage, your older loved one may experience early pneumonia symptoms such as:

Coughing

A feeling of heaviness in the chest

Loss of appetite

Fatigue

Rapid breathing

Stage 2: Red hepatization day 1-2

Red blood cells and immune cells that enter the fluid-filled lungs to combat the infection give the lungs a red appearance. Although the body is beginning to fight the infection during this stage, your loved one may experience worsening symptoms such as:

Increasingly productive cough

Shortness of breath

Muscle aches

Headache

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Extreme fatigue

Fever

Chills

Sweating

Blue lips or fingernails due to low levels of oxygen in the blood

Some older adults may experience confusion or delirium during this stage. If your senior loved one experiences severe symptoms such as difficulty breathing, high fever, or blue lips or fingernails, you should seek emergency treatment or dial 9-1-1.

Stage 3: Gray hepatization 2-3 days

Red blood cells will disintegrate during this stage, giving the lungs a grayish color. However, immune cells remain, and symptoms will likely persist.

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-fevers/chills
-dry/ productive cough
-consolidation CXR
-Dyspnoea
-crackles on chest auscultation
- positive cultures (sputum or blood)
- increased white cell count / inflammatory marker elevation

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PH (7.35-7.45), PCO2 (35-45mmHg), HCO3- (22-26mmHg) can be in normal range but PaO2 will be lower than 80mmHg, SaO2 lower than 90%.
However, this can be compensated by increased RR and also cause respiratory alkalosis (pH >7.45, pCO2<35, paO2<80, HCO3; 22-26)

But as the disease progress, it can develop into T2RF (high secretion, accumulation of CO2, reduced compensation) which will result respiratory acidosis (pH<7.35 PCO2>45 PO2<80, SaO2<90, HCO3;22-26)

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6. What type of respiratory failure would this condition lead to?

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6. What type of respiratory failure would this condition lead to?

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likely Type 1 respiratory failure due to decrease Pao2, the pneumonia condition can progress into type 2 respiratory failure due to extent the damage of alveoli sac, will lead to hypoventilation and increase co2

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Stage 4: Resolution
If you have reached the resolution phase, enzymes and other immune cells have been able to mount a defense against the infection and dissolve fibrous growths that restricted gas exchange. Immune cells called macrophages clear dead tissue debris, and your alveoli function begins to recover.