Pneumonia: Management and Complications (Pediatric Nursing)

00:01 So, how do we treat pneumonia? Well, it depends on the child's age, and their clinical and epidemiologic factors.

00:08 First, infants and pre-school aged children with a normal, uncomplicated bacterial pneumonia should be treated with Amoxicillin.

00:16 Amoxicillin's great for this.

00:18 It provides great coverage, it's inexpensive, and has a low side effect profile.

00:23 Kids tolerate this very well.

00:25 In older children, with uncomplicated bacterial pneumonia, so this is >5 year olds, you should start them on a macrolide treatment.

00:34 Community-acquired pneumonia - antibiotics should be initiated immediately.

00:39 There should not be a delay in treating the patient because remember, these patients are treated outpatient.

00:44 They're not receiving IV antibiotics.

00:47 So when they start their oral antibiotics, it's going to take them about 24 hours until the antibiotics actually start working, and so, you don't want to delay this care.

00:56 Now, if your patient has a viral pneumonia, they're going to be treated with supportive care.

01:01 We're going to encourage rest, hydration.

01:04 They may need some supplemental oxygen support and anti-pyretics to manage fever as needed.

01:10 Remember, antibiotics are not indicated with a viral infection.

01:15 Now, most pneumococcal infections are mild.

01:17 However, some can be deadly or result in long-term complications such as hearing loss.

01:23 Another complication is bacteremia.

01:25 This is a type of invasive pneumococcal disease that infects the blood.

01:29 About 1 out of every 100 children younger than 5 with this bloodstream infection will die from it.

01:35 Now, this is a little bit different from sepsis, which is when bacteremia or another infection triggers a massive, body-wide response.

01:43 This will initiate a fever, weakness, a rapid heart rate, rapid breathing rate, and ultimately, a decreased blood pressure.

01:52 This is a life-threatening and overwhelming response to a trigger that can result in end or in failure, ultimately killing the patient.

02:01 Now, meningitis.

02:03 This is another complication of pneumonia, and it is the most severe and evasive.

02:07 Of children younger than 5 who get pneumococcal meningitis, about 1 out of 15 will die from this infection.

02:13 Others may have long-term problems such as hearing loss or developmental delay.

02:19 And empyema.

02:20 This is an infection that develops in the space between the membranes that surround the lungs and the chest cavity.

02:26 Sometimes, this will need to be drained.

02:29 Pericarditis.

02:31 This is an inflammation that develops around the heart.

02:36 Atelectasis is a complete or partial collapse of the entire lung or the area, the whole lobe, of the lung, and this can also happen in the setting of pneumonia.

02:46 A pulmonary abscess can develop and this is a collection of pus in the lungs.

02:51 Now, less serious would be a sinus infection.

02:53 These are usually mild, and it's a pretty common complication, as the bacteria can translocate.

02:59 Now, remember, the most common cause of pneumonia is <i>Strep pneumoniae</i>, and the most common cause of sinus infections is also <i>Strep pneumoniae</i>.

03:07 Ear infections.

03:08 These are mild complications, but some children can develop recurring infections requiring further intervention.