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Neumonía. Cuidados de Enfermería (Diagnósticos, NIC y NOC)

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Neumonía. Cuidados de enfermería: Diagnósticos, NIC y NOC.

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Neumonía. Cuidados de Enfermería (Diagnósticos, NIC y NOC)

  1. 1. Cuidados de Enfermería Adalberto Pizarro Enfermero MN 50305
  2. 2. LA NEUMONIA ES LA INFLAMACIÓN DEL PARÉNQUIMA PULMONAR O PROCESO INFLAMATORIO DE LOS ESPACIOS ALVEOLARES PRODUCIDO POR UNA INVASIÓN DE MICROORGANISMOS QUE PRODUCE INFECCION Y GENERA COLAPSO ALVEOLAR DEBIDO A PRODUCCIÓN DE EXUDADO. Adalberto Pizarro Enfermero MN 50305
  3. 3. Epidemiología de las patologías Respiratorias: Las enfermedades respiratorias constituyen una de las principales causas de muerte en la población, solo superadas por las enfermedades cardiovasculares y neoplásicas y traumatismos u otras causas, siendo la 4° causa de muerte en nuestro país con un 9,3 % del total de las defunciones. Adalberto Pizarro Enfermero MN 50305
  4. 4. **En función del agente casual: -neumocóccica, -estafilocócica, -klebsiella, -legionella **Por la localización anatómica macroscópica: Lobular Multifocal bronconeumonia Intersticial **En función del ámbito de adquisición: -Adquiridas en la comunidad:Las más típicas son la neumonía neumocóccica, por Mycoplasma y la neumonía por Chlamydia. -Neumonías hospitalarias o nosocomiales: Presentan mayor mortalidad, debido a que en el hospital se da la conjunción de una población con alteración de los mecanismos de defensas, junto a la existencia de unos gérmenes muy resistentes a los antibióticos, lo que crea dificultades en el tratamiento de la infección. Adalberto Pizarro Enfermero MN 50305
  5. 5. Adalberto Pizarro Enfermero MN 50305
  6. 6. Neumonía Adquirida en la Comunidad: Epidemiología:  Representa 3%- 5% de las consultas en atención primaria y consultorios.  Es la principal causa de muerte por enfermedad infecciosa.  Es la 6° causa de muerte por causa específica.  Tasa de mortalidad 21,2 x 100mil habitantes  20% de los pacientes con Neumonía se hospitaliza.  > 70 años entre 50-70% muere Adalberto Pizarro Enfermero MN 50305
  7. 7. Adalberto Pizarro Enfermero MN 50305
  8. 8. Los criterios absolutos de exclusión para manejo ambulatorio, en personas de 65 años y más, serán: • Inmunosupresión. • Tuberculosis activa, Alcohólicos. • Insuficiencientes renales. • EPOC. • Con asistencia ventilatoria. • Rehospitalizacion dentro de 30 días desde el alta. • Neumonías no comunitarias, neumonías con fracaso terapéutico previo. • Antecedentes de reacción adversa severa a antibióticos considerados en la presenta guía clínica. Adalberto Pizarro Enfermero MN 50305
  9. 9. LOS GERMENES MAS HABITUALES EN NAC SON: S. PNEUMONIAE H. INFLUENZAE (streptococus) BACILOS G (-) S. AUREUS M. PNEUMONIAE C. PNEUMONIAE (mycoplasma) VIRUS INFLUENZA A y B Adalberto Pizarro Enfermero MN 50305
  10. 10. • LOS GERMENES SEGÚN POBLACION SON: ANCIANOS H. INFLUENZAE EPOC H. INFLUENZA, NEUMOCOCO DM NEUMOCOCO PCTE. ASILO BACILO G(-) ANAEROBIO ESTRICTO HO NEUMOCOCO, G(-), LEGIONELLA BRONQUIECTASIAS PSEUDOMONAS Adalberto Pizarro Enfermero MN 50305
  11. 11. 1°: Colonización V. Aéreas superiores 2°: Microaspiraciones contenido Bucofaríngeo 3°: Alteración de los mecanismos de defensa Virus influenza Staphilococo. Tabaquismo Neumococo Durante el sueño Compromiso de conciencia Disminución movilidad ciliar Diabetes Alcoholismo Neoplasias Alcoholismo ACV /TEC Alteraciones Deglución Inmunosupresión Adalberto Pizarro Enfermero MN 50305
  12. 12. Adalberto Pizarro Enfermero MN 50305
  13. 13. • EDADES EXTREMAS • MAL ESTADO NUTRICIONAL • ALCOHOLISMO, DROGAS • COMPROMISO DE CONCIENCIA • EPOC • PACIENTE INMUNOINCOMPETENTE • ANTIBIOTICOTERAPIA • USO DE SEDANTES OPIACEOS • TERAPIAS VENTILATORIAS INVASIVAS Adalberto Pizarro Enfermero MN 50305
  14. 14. Adalberto Pizarro Enfermero MN 50305
  15. 15. Adalberto Pizarro Enfermero MN 50305
  16. 16. - Cuadro Clínico (factores riesgo) - Rx Tórax Derrame, focos de condensación. - GSA Hipoxemia, acidosis respiratoria - Hemograma Leucocitosis - Cultivos Secreción, sangre. Adalberto Pizarro Enfermero MN 50305
  17. 17. Adalberto Pizarro Enfermero MN 50305
  18. 18. - Reposo en cama semi-fowler - Antibiótico establecido, según criterio - Oxigenoterapia - Apoyo ventilatorio no invasivo - Apoyo ventilatorio invasivo. - KNT respiratoria. - Hidratación oral, parenteral. Adalberto Pizarro Enfermero MN 50305
  19. 19. Adalberto Pizarro Enfermero MN 50305
  20. 20. Adalberto Pizarro Enfermero MN 50305
  21. 21. Adalberto Pizarro Enfermero MN 50305
  22. 22. Adalberto Pizarro Enfermero MN 50305
  23. 23. • Gestionar KNT respiratoria Adalberto Pizarro Enfermero MN 50305
  24. 24. Adalberto Pizarro Enfermero MN 50305
  25. 25. Limpieza ineficaz de la vía aérea r/c fatiga, obstrucción 2° a proceso inflamatorio-infeccioso m/p ruidos adventicios, tos, disnea. NIC: SIMILARES A LOS ANTERIORES: • POSICION • BRONCODILATACION • FLUIDIFICACION • ASPIRACION • EJERCITACION POR KNT • EJERCITACION POR PACIENTE (TRIFLOW)NOC: PACIENTE LOGRARÁ EXPECTORAR SECRECIONES , AL CABO DE DOS HORAS A L INICIO DE LA FLUIDIFICACIÓN para mejorar el interecambio gaseoso……Y EN EL MISMO MOMENTO EN QUE SE REALICE KNT RESPIRATORIA, Adalberto Pizarro Enfermero MN 50305
  26. 26. Adalberto Pizarro Enfermero MN 50305
  27. 27. Adalberto Pizarro Enfermero MN 50305
  28. 28. Adalberto Pizarro Enfermero MN 50305
  29. 29. Adalberto Pizarro Enfermero MN 50305
  30. 30. Adalberto Pizarro Enfermero MN 50305

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