Pneumonia is an infection of one or both lungs.  It occurs when either bacteria or viruses get stuck in the lungs – the germs multiply and form an infected area.  In order to understand it, things you should know include something about the lungs and what they do. When you breathe in, you pull oxygen into your lungs.  That oxygen travels through breathing tubes and eventually gets into your blood through the alveoli.  Alveoli are tiny air sacs covered in tiny blood vessels called capillaries.  When oxygen-rich air reaches the alveoli, it can be absorbed into the blood and then your red blood cells carry oxygen all over your body.  When an individual has pneumonia, his or her lungs can’t do their job as well as they usually do.  The reason is because this kind of infection creates fluid that blocks the alveoli.  The person can still breathe, but it might be harder to breathe, especially if the pneumonia affects both lungs (often referred to as double pneumonia).

The major symptoms of pneumonia are:

  • Moderate to severe cough– often junky sounding, but not always.
  • Sustained rapid or labored breathing (as opposed to temporary rapid breathing from a high fever).
  • Medium to high fever – usually will be over 102, but not always.
  • Chest pains – not just during coughing, but in between coughing fits as well.
  • Vomiting – not just vomiting from a big coughing fit, but vomiting even in between coughing fits.
  • Blue color around the lips and face – from lack of oxygen.
  • Wheezing – although wheezing is more often a sign of a viral chest cold, it sometimes can mean pneumonia.

To diagnose pneumonia, a doctor will first ask you questions about how you are feeling – including how well you’re breathing – and examine you.  The doctor will listen to your chest with a stethoscope.  If there’s fluid in there – a sign of pneumonia – he or she might be able to hear bubbling or crackling sounds called rales.  If your doctor thinks you could have pneumonia, he or she may order a chest X-ray or begin treatment right away.  On an X-ray, the doctor can often see signs of the pneumonia infection.  Any buildup of fluid or infection often shows up as a cloudy, patchy white area in the usual see-through spaces of the lungs.  In some cases, the X-ray can help the doctor tell if the infection is caused by a virus or bacteria.  If the pneumonia is caused by bacteria, antibiotic medicine will be given.  Antibiotics won’t work on viruses, so if that’s the cause of the pneumonia, only fever reducers and sometimes cough medicine will be suggested.  No matter which germ caused the pneumonia, getting rest and drinking plenty of fluids is always recommended.

Recruits on military bases and college students living in dormitories are at higher-than-average risk for Mycoplasma pneumonia.  These groups are at lower risk, however, for more serious types of pneumonia.  The risk for pneumonia in people who smoke more than a pack of cigarettes a day is three times that of nonsmokers.  Quitting smoking reduces the risk of dying from pneumonia to normal, but the full benefit takes 10 years to be realized.  Toxic fumes, industrial smoke and other air pollutants may also damage cilia function, which is a defense against bacteria in the lungs.  Alcohol or drug abuse is strongly associated with pneumonia.  These substances act as sedatives and can diminish the reflexes that trigger coughing and sneezing.  Alcohol also interferes with the actions of macrophages, the white blood cells that destroy bacteria and other microbes. Intravenous drug abusers are at risk for pneumonia from infections that start at the injection site and spread through the bloodstream to the lungs. If you struggle with addiction, then I encourage you to get the help needed to quit for good.

Between 5 and 10 million people get pneumonia in the United States each year, and more than 1 million people are hospitalized due to the condition.  As a result, pneumonia is the fourth most frequent cause of hospitalizations.  Although the majority of pneumonias respond well to treatment, the infection kills 40,000 – 70,000 people each year.  Men with community-acquired pneumonia tend to fare worse than women.  Men are 30% more likely than women to die from the condition, even if the severity of the illness is the same.  Whether you are a man or a woman, there are several things you should know to keep from getting pneumonia.  The first is to get all of your shots, because one of them can help to prevent a type of pneumonia called pneumococcal pneumonia.  Getting a flu shot can also help guard against getting pneumonia, particularly in persons that have asthma or certain other lung conditions.  Having enough rest is also very important because lack of sleep may make it harder for your immune system to fight infections. Washing your hands is probably the single most important thing you can do to prevent the disease.  Regularly washing with soap and water can keep you from getting colds, the flu and picking up other nasty germs that can cause pneumonia.


  1. Hi, Im a nursing student and currently have an case study assignment on pnuemonia.

    The case study is a 72yr old man, he is diagnosed as having a fractured neck of femur, 2 days later he undergoes surgery- he has an ORIF. he is now 2 days post op and has developed respiratory and oxygenation problems, hes diagnosed as having pneumonia.

    im assuming that he has developed a nosocomial infection, as research shows that hospital acquired pneumonia can occur with 48-72 hours of hospitalisation. But im confused as to how a post op patient may have even contracted the illness, hes been immobile for 4 days, is elderly and had been under general anasesthia and i know these are all risk factors…

    but HOW does immobility affect the respiratory system, i know lung function diminishes with age so that makes sense, and the only thing i can think of for the anasesthia part is that the gag and cough reflex are absent when under GA.. could this allow bacteria into the lungs?

    what would be 2 specfic nursing interventions for this patient?? (not including anitbiotic administration or further obs monitoring/tests)

    any help would be much appreciated! :)

    • Hi – Immobility causes havoc on EVERY system in the body, but specifically regarding the respiratory system: 1) Reduced lung expansion – immobility changes the distribution of ventilation and blood flow through the lungs and patients are unable to take a deep breath, 2) Respiratory muscle weakness – this is caused by limited physical activity and metabolic changes. It results in an increase in the work of breathing which causes a decrease in the ability of the patient to cough, 3) Stasis of secretions – the distribution of mucous in the bronchi increases and it accumulates. With decreased lung expansion and weakened respiratory muscles, secretions stagnate and pool which increases the risk for hypostatic pneumonia, 4) Impaired gas exchange – decreased respiratory muscle tone causes decreased vital capacity and decreased exchange of oxygen and carbon dioxide at the alveolar level. Immobility results in incomplete expansion of the lungs with a resulting collapse of the alveoli themselves. As far as nursing interventions, it is important to change the patient’s position every 2 hour, encourage deep breathing and coughing every 2 hours, encourage the use of incentive spirometry if ordered, maintain a patent airway and encourage fluids to keep secretions liquid. Hope this helps, Stephanie

  2. Hi i have not been well i recently had sinues surgery 1 month ago iam slow healer . but i also have seasonal alergies with a samll dry cough not all the time only when pollen is havy in the air .. i get all over pain possibly my fibromyalia and i have went to see my MD and hesaid i have an infection as penumiona and precribed avelox antiboticonc a day which i get very sick from …..But i feel that my whole back is sore can i be nuscle pain or is it actually a sign of pneumiona iam not couging but feel very tired iam also on Bleeod pressure medication which at this time is normal readings my have mild to severe headaches wth dizzyness… i do not undertand why i was not sent for exrays frist and my MD also knows iam very sensitive to many antibotics and very strong narroctic pills .. please reply to me thank you .Barbara ……..Please send it through my e-mail addy

  3. My husband has just been diagnosed with Pnuemonia for the second time in less than a year. Can anyone say why he keeps getting pnuemonia? This time he is on antibiotics.

  4. Hello…I have a patient that has pnuemonia he is 92 years old and undergone medication at home.One night he was attacked by a severe cough and all the seven signs and symptoms was on him.I always elevate his bed specially when he is coughing and after that I suction him.I just want to ask what else I should do in case he is attacked with severe cough and yes his lips become bluish….aside giving his oxygen..Please I need to know what to do more.I’ll be waiting your reply and really I appreciate it.Thank you very much….

  5. I think it’s so neat to read and write. Writing is very calming to me and I also enjoyed reading your blog. I’m new to blogging but I hope to get as far as you have in sharing what you know.

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