“ “

CASE STUDY :
Pediatric Community
Acquired Pneumonia
(PECAP)
It then has to decide the means it will use to
achieve those ends, draw up a plan and devise
a strategy.
Also known as a targets.
By setting aims and objectives, companies give
themselves a sense of purpose and direction.

OBJECTIVES
 Define the meaning of pediatric community acquired
pneumonia (PCAP), signs and symptoms and its
environmental factors 
 Review and discuss the data gathered of nursing
history, risk factors and laboratory result
 Discuss the anatomy and pathophysiology of pedi8atric
community acquired pneumonia 
 Formulate an effective nursing care plan for the patient
with a indicate of disease process 
 Identify and enumerate the various drugs prescribed,
side effects, nursing responsibilities and their action. 
 Construct an appropriate health teaching plan in relation
to a client's present situation
 It is important because they provide a
first impression, establish credibility with
your audience, and prepare the audience
for the content of the case study.

INTRODUCTION
 Pediatric Community-acquired
pneumonia is a potentially serious infection
in children and often results in
hospitalization.
 Pneumonia is a number of infectious agents
including viruses, bacteria and fungi.
 Environmental Risk Factors include :
indoor air pollution caused by cooking and
heating with biomass fuel (such as woods
and dung), living in crowded homes and
parental smoking
 Signs and Symptoms : vary depending on
 Uses for nursing documentation and the broader patient
record, nurses have a ritual of using a paper-based report
sheet that is not part of the medical record during handoffs.
 Nurses often use these unique, personal notes to store
information that is communicated by the patient’s care
nurse from the prior shift.  
 The paper-based report sheet appears to be used as a
key information source to support knowing the patient. 

PATIENT’S PROFILE
 NAME Patient X

AGE 1 year old and 3 months

SEX Female

STATUS Child

RELIGION Roman Catholic

NATIONALITY Filipino

ADDRESS Sitio Puyo, Sta. Clara Batangas City

ADMISSION DATE August 19, 2019 1:00am

CHIEF COMPLAINT Fever

ADMISSION DIAGNOSIS Pediatric Community Acquired Pneumonia

(PCAP)
  is the study of how often diseases occur in
different groups of people and why. 
 Epidemiological information is used to plan and
evaluate strategies to prevent illness and as a
guide to the management of patients in whom
disease has already developed.

EPIDIEMOLOGY
 The patient is 1 year old and 3 months
and was born healthy, weighing 7.4 kg.
According to the mother they have a
history of difficulty in breathing. The
patient experience fever so that the
mother went to Golden Gate Batangas
Hospital Incorporated to undergo
examination and the result is Pediatric
Community-Acquired Pneumonia.
 PHYSICAL ASSESSMENT of a patient serves
many purposes:
1. Screening of general well-being. The findings
will serve as baseline information for future
assessments.
2. Validation of the complaints that brought the
patient to seek health care.
3. Monitoring of current health problems.
4. Formulation of diagnoses and treatments.

PHYSICAL
ASSESSMENT
INTEGUMENTARY ASSESSMENT OBSERVATION
Skin Normal
Color Reddish
Moisture Sweating
Temperature Cold
Terture Smooth
Turgor Normally
Vascularity Reddish
Edema None
Hair Color Grey
Nails Normal
Color Transparent
Length Approximately 160-degree
Cleanliness Clean
HEAD & NECK  Symmetry
Head Rounded/symmetrical
Neck No Abnomality of superficial lymph nodes
EYES AND VISION  

Eyebrows Symmetrical aligned

Eyelids Normal
Pupil Respond to light
Irises Clearly visible
EARS AND HEARING Responsive symmetrical
Equal movement No edema or tenderness
 Nose No discharges/symmetrical
Mouth Lips uniformly pink
Teeth and gums Normal
Gums is pink

Tongue Tongue is pink

Uvula is positioned

THROAT/NECK No palpable lymph nodes

Neck can move freely 

AXILLA Skin is smooth

Symmetrical
No tenderness
No masses or nodules
 CHEST AND RESPIRATORY Skin is intact
No lesion
No tenderness
No masses

Rhythm of breathing Tachypnea

Wheezes
CARDIOVASCULAR ASSESSMENT OBSERVATION
Anatomic landmarks of the heart
Aortic Palpable
Pulmonic Palpable
Tricuspid Palpable
Palpable
Mitral
Palpable
Apical
Palpable
Epigastric
 ABDOMEN  
Inspection Uniform skin color in the abdomen
Rounded
Palpation No lesion
No tenderness

EXTREMITIES  
Muscles Symmetrical size
Has a firm grip, can crawl
Uniform in skin color
Bone Develop
Joints Joints move normally

REPRODUCTIVE NOT ASSESSED

 SOUNDS PRODUCED BY PERCUSSION

Sound Intensity Pitch Duration Quality Example

Tympany Loud High Moderate Drum like Large
pneumothorax

Resonance Moderate to Low Long hollow Normal lung

loud
Hyper- Very loud Very Longer than Booming Emphysematous
resonance low resonance lung

Dullness Soft to High Moderate Thud like Liver

moderate
Flatness Soft High Short Flat Muscle
Whereas anatomy is about
structure, physiology is about function.
Human physiology is the scientific study of the
chemistry and physics of the structures of the
body and the ways in which they work together
to support the functions of life.

ANATOMY and
PHYSIOLOGY
 THE

RESPIRATO
RY
SYSTEM
 AVEOLI
SHOWING
CAPILLARY
NETWORK
INSPIRATION AND EXPIRATION
 GASEOUS EXCHANGE
Some lab tests are used to help diagnose, screen,
or monitor a specific disease or condition.
Other tests provide more general information
about your organs and body systems. 
Lab tests play an important role in your health
care.
But they don't provide a complete picture of your
health.

LABORATORY
 TEST REFERENCE RESULT INTERPRETATIO RATIONALE
N
Red Blood 4-610^12/L 4.46 Normal -it ranges from 4-610^12/L therefore normal
Cell -to see if you have another health issue or to explain symptoms like weakness,
fever, bruising, or feeling tired
WBC 5-10x10^9/L 11.80 Above Normal -it ranges from 5-10x10^9/L therefore abnormal
-to detect hidden infections within your body
Hematocrit 0.37 – 0.45 0.37 Normal -it ranges from 0.37 – 0.45 therefore normal
-to measure how much of your blood is made up of red blood cells; and determine
if the result indicate a blood disorder, dehydration, or other medical conditions

Hemoglobi 120 – 150g/dl 118 Below Normal -it ranges from 120 – 150g/dl therefore below normal
n -to screen for a variety of disorders, such as anemia

MCV 86 – 110fL 82.5 Below Normal -it ranges from 86 – 110fL therefore below normal
-to help classify the cause of anemia based on red cell morphology

MCH 26 – 38 pg 26.5 Normal -it ranges from 26 – 38 pg therefore normal

-to help classify the cause of anemia based on red cell morphology
MCHC 310 – 370 g/L 321 Normal -it ranges from 310 – 370 g/L therefore normal
-to evaluate the severity and cause of anemia
Segmenter 38.3 – 73% 57 Normal -it ranges from therefore normal
s
Lymphocyt 18.0 – 48.3% 37 Normal -it ranges from 38.3 – 73% therefore normal
es -to determine if a body is dealing with an infection or other inflammatory condition
Basophils 4.40 – 12.7% 6 Normal -it ranges from 4.40 – 12.7% therefore normal
-to determine if there is a sign of an allergic reaction or another condition
Platelet 150 – 450 x 358 Normal -it ranges from 150 – 450 x 10^9/L therefore normal
Count 10^9/L -to monitor or diagnose diseases, or to look for the cause of too much bleeding or
clotting.
Pathophysiology is a medical discipline that
focuses on the function and symptoms of diseased
organs, generally for purposes of diagnosis and
patient care. 
Pathophysiology differs slightly from pathology,
which studies all aspects of disease, not just
organic function.

PATHOPHYSIOLOGY
 Pediatric Community
Acquired Pneumonia
(PCAP)

Risk Factors

NERVOUS SYSTEM HEART OR LUNG

PREMATURE
PROBLEMS DISEASE PRESENT AT
BIRTH
BIRTH
Some premature babies are born
Respiratory distress with pneumonia; pneumonia Usually caused by a
syndrome (RDS). occurs later because the breathing bacteria or virus. Some
Babies born before 34 tube provides a passageway for babies get pneumonia
weeks pf pregnancy infection to enter immature lung. while they are still in
often develop this the womb. Some may
serious breathing also develop
problem. Symptoms pneumonia several
weeks after delivery.
Fever, sweating and shaking
chills.
Very fast breathing

Cough and stuffy nose

.
 RISK FACTORS
■ Being younger than 6 months of age
■ Being born prematurely
■ Birth defects, such as cleft palate
■ Nervous system problems, such as seizures or cerebral palsy
■ Heart or lung disease present at birth
■ Weak immune system (this can occur due to cancer treatment or
disease such as HIV/AIDS)
■ Recent surgery or trauma
■ Environmental risk factors such as; smoke , outdoor air pollution,
indoor pollution, passive smoking, and overcrowding
■ Low birth weight, malnutrition, measles, breastfeeding and vitamin
A deficiency
Is a general term for using medication to
treat disease. 
Drugs interact with receptors or enzymes in
cells to promote healthy functioning and
reduce or cure illness

DRUG
GENERIC BRAN DOSAGE CLASSIFICATI INDICATIO CONTRA- MECHANIS SIDE NURSING
NAME D ON N INDICATIO M OF EFFECTS CONSIDER
NAME N ACTION -ATIONS

Parace- Tylenol Paracetamol Analgesic Temporary - Antipyretic -head ache -Do not
tamol drops 1ml q4 reductions of Contraindica reduces fever exceed the
Tablet Antipyretic - chest pain
fever, relief ted with by acting recommende
•325mg of minor allergy to directly on the d dosage.
-hepatic
•500mg
aches and acetaminoph hypothalamic toxicity and
Caplet - Reduce
•325mg pains caused en. heat failure
dosage with
•500mg by common regulating jaundice
-Use hepatic
•650mg cold nd center to
Capsule cautiously -acute renal inpainment.
influenza, cause
•325mg with impared failure renal
headache, vasodilation - Avoid using
•500mg hepalic tubular
sore throat, and sweating multiple
Tablet function, neurosis-
toothache, which helps preparations
chewable chronic Hypersensit
•80mg back ache, dissipate containing
alcoholism. ivity
Liquid oral menstrual heat. acetaminoph
160mg/5ml cramps. en carefully
  check all the
OTC
products.
GENERIC BRAN DOSAGE CLASSIFICATI INDICATIO CONTRA- MECHANIS SIDE NURSING
NAME D ON N INDICATIO M OF EFFECTS CONSIDER
NAME N ACTION -ATIONS

monowel Cefoxitin Monowel 250 Cefoxitin for Lower Hypersensitivi Cefoxitin is a -Injection -Ask for drug
mg q8 injection is a semi- respiratory ty to bacterial cell side allergies
regular synthetic, tract infection cephalosporin wall synthesis. reaction(swe
1g -Assess for
broad - spectrum including g and related lling,redness
Cefoxitin has infection. -IV
2g cephaantibiotic pneumonia antibiotics. ,pain)
activity in the change sites
sealed under and lung
10g presence of -skin rash every 48-72
nitrogen for abcess.
some hr to prevent
intravenous -vaginal
1g/50ml betalactamase phlebitis
administration. itching or
s, both
2g/50ml discharge Monitor site
It is derived from penicillinses
frequently for
cephamycin C, and -loss of
thrombophleb
which is produced cephalosporina appetite
itis
by streptomyces ses of Gram
lactamdyrans. negative and - nausea
(pain,
gram positive redness,
- vomiting
bacteria. swelling)
-stomach
pain Advise
patient to
- diarrhea or report sign of
headache super
infection and
allergy
GENERIC BRAN DOSAGE CLASSIFICATI INDICATIO CONTRA- MECHANIS SIDE NURSING
NAME D ON N INDICATIO M OF EFFECTS CONSIDER
NAME N ACTION -ATIONS
salbutamol Albuterol Salbutamol neb Used to treat Typically used to Albuterol or It is essentially headache Asess lungs
q4 wheezing and treat levalbuterol relaxing the sounds, pulse
shortness of breath bronchopspasm hypersensitivity smooth muscles anxiety and blood
Oral caused by breathing due to cause congenital long of the airways. pressure before
dry mouth
problems such as allergic asthma QT syndrome, administration
2,4 mg tablets It activates beta Z
asthma. It is quick or exercise Use of oral tachycardia and during peak
relief medication. It induced,as well syrup in adrenergic of medication.
(3-4 PRN)
works in the airway by as chronic children. receptors in the palpation Note amount,
Inhaler opening breathing obstructive lungs which color and
begins a cascade arrytmia
passages and relaxing pulmonary character of
200-400mg 4 of action that
muscles. disease. It is also flushing of skin sputum
times a day results in
one of the most produced.
common bronchodilation. behavior
IV infusion
medicines used Observe for
3-20mcg/min in rescue paradoxical
inhales. bronchospasm
Subcutaneous (wheezing) if
condition
500mcg q4 occurs, with
hold medication
and notify
physician or
other health
care
professional
immediately.

Inform the
mother not to
smoke near the
child and to
avoid
respiratory
irritants.
 NURSING CARE PLAN
(NCP)
 Patient’s Name: Baby J
 Medical Diagnosis: Pediatric Community
Acquired Pneumonia (PCAP)
 Nursing Diagnosis: Impaired gas exchanged
related to collection of secretions affecting
oxygen exchange across alveolar membrane.
ASSESSMENT DIAGNOSIS PLANNING IMPLEMENTA RATIONALE EVAULATIO
TION N

>S: <Impaired gas < After 8 < Assess <Manifestation of <After 8

“Nahihirapanh exchange hours of respiratory respiratory distress hours of
umingaang nursing rate, depth is dependent on nursing
indicative of the
baby interventions, and ease interventions,
degree of lung
kodahilsaubo” the patient   involvement. the patient
as verbalized will achieve <Elevate head   will achieve
by the mother. timely of the bed and < Promotes timely
  resolution of change expectoration, resolution of
>O: current position clearing or current
  infection frequently infection infection
*Dyspnea without     without
< reduces
*Tachycardia complications. <Limit visitors likelihood of
complications
* V/S taken as as indicated exposure to other
follows:   infectious
T: 36.5 ®C <Institute pathogens
PR: 160 bpm isolation  
RR: 31 bpm precaution <To prevent
BP: 90/60 spread and protect
patient from other
infectious process
 HEALTH TEACHING/
RECOMMENDATION
■ Breath warm and moist air.
■ Take deep breaths.
■ Drink liquid as directed.
■ Gently tap your chest.
■ Get plenty of rest. Rest help your body
heal.
■ Wash hands often with soap and water.
■ Clean environment.
■ Avoid people who have a cold or flu.
■ Ask about vaccines.