Diagnostic tests / Interprofessional Care / Pneumonia
Diagnostic tests
- History and physical examination
- Chest x-ray
- Gram stain of sputum
- Sputum culture and sensitivity test
- Pulse oximetry or ABGs (if indicated)
- Blood cultures
- Thoracentesis
- Bronchoscopy with washings
- Biologic markers to guide clinical decisions:
- C-reactive protein (CRP)
- Procalcitonin
Interprofessional Care
- Pneumococcal vaccine
- To prevent Streptococcus pneumoniae
- Prompt treatment with antibiotics is essential
- Response generally occurs within 48-72 hr
- Drop in temperature
- Improved breathing
- Decreased chest discomfort
- Repeat chest x-ray in 6-8 weeks
- Supportive care
- Oxygen for hypoxemia
- Analgesics for chest pain
- Antipyretics
- Individualize rest and activity
- No definitive treatment for majority of viral pneumonias
- Antivirals for influenza pneumonia
Drug therapy
- Start with empiric therapy
- Based on likely infecting organism and risk factors for MDR organisms
- Varies with local patterns of antibiotic resistance
- Should see improvement in 3-5 days
- Start with IV and then switch to oral therapy as soon as patient stable
Nutritional therapy
- Adequate hydration
- Prevent dehydration
- Thin and loosen secretions
- Adjust for older adults, patients with heart failure, those with preexisting respiratory conditions
- High calorie, small, frequent meals