Definition of Pneumonia (pneumonia)

Pneumonia is an inflammation of the lung parenchyma that occurs in childhood and often
occurs in infancy. This disease arises as a primary disease and can also be due to disease
complications. Meanwhile, according to Elizabeth J. Corwin, Pneumonia is an infection of
the lower respiratory tract. This disease is an acute infection of lung tissue by
microorganisms.
In addition, according to wikipedia.com pneumonia is a lung disease in which the pulmonary
alveoli (alveoli) responsible for absorbing oxygen from the atmosphere to be "inflamed" and
filled with fluid

Types of Pneumonia
Pneumonia is divided into different types based on the cause, anatomic, and based on the
origin of the disease is obtained. As follows :
1. Based on the cause:
a. Lipid pneumonia
b. pneumonia Chemicals
c. Pneumonia due to extrinsic allergic alveolitis
d. Pneumonia due to drugs
e. Pneumonia due to radiation
f. Pneumonia with no clear cause
(Fundamentals of lung pathology, 2006)
2. Based on Anatomic:
a. lobar pneumonia
Is pneumonia that occurs in all or a large part of the lobe of the lung and if both lobes
affected could be regarded as lobar pneumonia.
b. Interstitial pneumonia
A pneumonia that can occur in the alveolar walls.

c. bronchopneumonia
Is pneumonia that occurs at the end of the end bronkhiolus that can be clogged by mukopuren
exudate to form patches of consolidation in the lobe.
(A. Aziz Alimul Hidayat: 2006)
3. Based on the origin of the disease:
a. Pneumonia community or community acquired pneumonia
Ie community-acquired pneumonia.
b. Nosocomial pneumonia or hospitality acquired pneumonia
That illness was obtained while the patient is in a hospital or health care.

Etiology
At the present time there is a change patterns of microorganisms that cause ISNBA (Acute
Lower respiratory tract infection) due to changes in the patient's condition and immune
disorders such as chronic diseases, environmental pollution, and the use of antibiotics to
cause
changes in the characteristics of germs. The etiology of pneumonia vary depending on the
various types of pneumonia, and this has an impact on the drugs that will be provided. The
most common microorganisms are bacteria, which type is different between countries,
between one area to another in a State, or bacteria originating from the hospital environment
or from the outside environment. Therefore, please note well the pattern of germs
somewhere.
Pneumonia caused by infection, among others:
1. bacteria
The causative agent of pneumonia is divided into organisms gram-positive or gram-negative
such as: Steptococcus pneumoniae (pneumococcus), Streptococcus piogenes, Staphylococcus
aureus, Klebsiela pneumoniae, Legionella, Hemophilus influenzae.

2. Virus
Influenzae virus, parainfluenza virus, respiratory, syncytial adenovirus, chicken-pox (chicken
pox), Rhinovirus, Cytomegalovirus, herves simplex virus, respiratory sinial Virus,
Hantavirus.
3. Fungi
Aspergillus, Fikomisetes, Blastomises dermatitidis, Histoplasma kapsulatum.
(Http://medicastore.com/med/subkategori_pyk.Php,2007)
Besides caused by infection, pneumonia can also be caused by other materials / non-
infectious:
1. Lipid Pneumonia: Caused due to aspiration of mineral oil
2. Pneumonia Chemical: Inhalation of organic materials and inorganic or chemical vapors
such as beryllium
3. extrinsic allergic alveolitis: Inhalation of dust materials containing allergens such as
thermophilic actinomycetes spores contained in the dregs of dust in the sugar mill
4. Pneumonia due to drugs: Nitofurantoin, busulfan, methotrexate
5. Pneumonia due to radiation
6. Pneumonia with no obvious cause.
(Fundamentals Sciences Lung Diseases, 2006)
In infants and children the most frequent causes are:
1. sinsisial respiratory virus
2. adenovirus
3. parainfluenza virus
4. The influenza virus
As for how the micro-organisms to the lungs can be through:
1. Inhalation (inhalation) microorganisms from contaminated air
2. The flow of blood from the infection in other organs
3. Migration (transfer) directly from infectious organisms near the lungs.

Risk factor
Risk factors for pneumonia, such as: upper respiratory tract infection (ISPA), advanced age,
alcoholism, smoking, nutritional deficiencies, Age under 2 months, Gender male,
Malnutrition, low birth weight, not breastfed adequate, air pollution, density dwelling,
inadequate immunization, infant Membedong, the efficiency of vitamin A and chronic
disease chronic.
In addition to the above risk factors, the factors below also affect the risk of pneumonia:
1. Individuals who have HIV;
2. Individuals who are exposed to an aerosol of a long stagnant water;
3. Individuals who have aspiration of gastric contents;
4. Because the water vomiting caused by drowning;
5. The aspirated material.
pathophysiology
Pneumonia can be caused by inhaling airborne germs, or bacteria in the throat sucked into the
lungs. Spreading can also go through the blood from cuts elsewhere, for example in the skin.
If through the airways, agents (germs) that entry will be opposed by a variety of the human
immune system. For example, with coughing, or resistance by cells in the mucous lining of
the throat, until the movement of tiny hairs (cilia) to remove mucus (phlegm) is out.

Clinical manifestations / Signs and Symptoms

Symptoms of pneumonia are usually preceded by acute upper respiratory tract infections for
several days. Besides got a fever, chills, increased body temperature can reach 40 degrees
Celsius, shortness of breath, chest pain, and cough with thick sputum, sometimes can be rust-
red (for Streptococcus pneumoniae), pink (for staphylococcus aureus), or greenish with smell
typical (for pseudomonas aeruginosa). In some patients also found other symptoms such as
abdominal pain, lack of appetite, and headache.
Signs and symptoms include:
1. nonproductive cough
2. Mucus (nasal discharge)
3. The breathing is weak
4. Retraction of intercostal
5. The use of accessory muscles of breath
6. Fever
7. Krekels
8. Cyanosis
9. leukocytosis
10. The photo shows the infiltration widened Thorax
11. Cough
12. Headache
13. The stiffness and muscle pain
14. Shortness of breath
15. Chills
16. Sweating
17. Tired.
Other symptoms that may be found are:
1. Skin moist
2. Nausea and vomiting
3. Joint stiffness.

complication
Complications of pneumonia are as follows:
1. Emphysema
2. Failed breath
3. Pericarditis
4. Meningitis
5. hypotension
6. Delirium
7. Metabolic acidosis
8. Dehydration

Medical Management
Management of nursing in clients with pneumonia are as follows:
1. Maintain body temperature within normal limits by giving compress.
2. Exercise effective form and fisiotheraphy lungs.
3. Provision of oxygenation (oxygen 1-2 liters / minute).
4. Maintaining fluid needs (IVFD dektrose 10%: 0.9% NaCl).
5. Providing nutrition, if the light need not be given antibiotics, but if severe disease may be
hospitalized, it is necessary antibiotic treatment based on age, general condition, possible
causes, such as the administration of Ampicillin and chloramphenicol.
6. The medical management by providing treatment

Prevention
According to professor Cissy, the key to prevention of pneumonia that is important according
to him is the provision of breast milk (ASI) exclusively, immunization, and the fulfillment of
nutritional needs of children, because breast milk contains nutrients, antioxidants, hormones
and antibodies are important for proper body, develops and builds the immune system.
According to Professor Sri fortune, to prevent childhood deaths from pneumonia in 2 ways
namely preventing the development of infection and complications of pneumonia with other
diseases such as measles and pertussis, he further explained pneumonia deaths could be
reduced by implementing prevention and treatment efforts. In addition to the above two
ways, he also said that the most effective way to prevent pneumococcal infection through
administration of pneumococcal conjugate vaccine (PCV-7) to the infant. This Award in
infants aged 4 months 6 months serrta repeated again at 12-15 months of age in order to
protect children from pneumococcal infection.
According to UNICEF reports more than 1 million children could be saved if interventions
for prevention and treatment of pneumonia applied universally. About 600 thousand
children's lives each year could also be saved through antibiotic treatment which will cost
about 600 million US dollars.
Of the various opinions on the above it can be concluded that pneumonia can be prevented by
the following means:
1. Providing exclusive breastfeeding
2. Prevent the development of infection
3. Preventing pneumonia complications with other diseases
4. Using antibiotic treatment