This document presents a case study of bronchopneumonia in an infant. It includes an introduction describing pneumonia, objectives of the case study, the patient's profile, history of present illness, physical assessment findings, relevant anatomy and physiology, pathophysiology, diagnostic laboratory results including urinalysis, hematology, and blood chemistry. A chest x-ray report notes findings consistent with bilateral pneumonia. The case study aims to evaluate nursing care for the infant patient diagnosed with bronchopneumonia.

1. Bicol University
College of Nursing
Legazpi City
A Case Study of
BRONCHOPNEUMONIA
IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS IN
NCM 102
Submitted by:
Group 4
Malacad, Dane Carmela
Monsalve, Kerensa
Ortega, Daryl
Nuyda, Aljo
Pagdagdagan, Lyderlee
Poguilla, Trexy
Publico, Jesse Rey
Puentebella, Michelle May
BSN II-A
Submitted to:
Heintje T. Llana, RN
Instructor

2. INTRODUCTION
Pneumonia is an inflammation of the lungs caused by an infection. It is also called Pneumonitis or
Bronchopneumonia. Pneumonia can be a serious threat to our health. Although pneumonia is a
special concern for the older adults and those with chronic illnesses.
It can also strike young and healthy people as well. It is a common illness that affects thousands
of people each year in the Philippines, thus, it remains an important cause of morbidity and mortality
in the country. There are many kinds of pneumonia that range in seriousness from mild to life-
threatening.
In infectious pneumonia, bacteria, viruses, fungi or other organisms attack the lungs, leading to
inflammation that makes it hard for an individual to breathe. Pneumonia can affect one or both
lungs. In young and healthy individual, early treatment with antibiotics can cure bacterial pneumonia.
The drugs used to fight pneumonia are determined by the germ causing pneumonia and the
doctors findings. It is best to do everything we can to prevent pneumonia, but if one get sick,
recognizing and treating the disease early offers the best chance for a full recovery.
A case with a diagnosis of Pneumonia may catch one’s attention, though the disease is just like
an ordinary cough and fever, it can lead to death especially when there is no immediate intervention
done. Since the case is an infant, an appropriate care has to be done to promote faster recovery for
the patient.
Treating patients with pneumonia is necessary to prevent its spread to others and make them as
another victim of this illness. Bronchopneumonia is an illness of the lungs which is caused by
different organism like bacteria, viruses, and fungi and characterized by acute inflammation of the
walls of the bronchioles.
It is also known as pneumonia. Streptococcus pneumoniae (pneumococcus) and Mycoplasma
pneumoniae both are the common bacterium which causes bronchopneumonia in the adults and
children. Acute inflammation of the walls of the smaller bronchial tubes, with varying amounts of
pulmonary consolidation due to spread of the inflammation into peribronchiolar alveoli and the
alveolar ducts; may become confluent or may be hemorrhagic.
In Philippines, the case of pneumonia is one of leading cause of mortality and morbidity among
Filipinos, 75-85% of the population acquired the disease and the one affected the disease are those
who are in low income status and the below poverty line individual. (www.DOH.org/pneumonia)

3. DEFINITION OF TERMS
Bradypnea - slower than normal rate (<10 breaths/minute), with normal dept and regular
rhythm
Dyspnea – distressful sensation of uncomfortable breathing that may be caused by certain heart
conditions
Empyema – inflammatory fluid and debris in the pleural space. It results from an untreated
pleural-space infection that progress from free-flowing pleural fluid to a complex collection in
the pleural space.
Hypoxemia – decrease in arterial oxygen tension in the blood
Mycoplasma pneumonia – another type of Community Acquired Pneumonia (CAP), occurs most
often in children and young adults and is spread by infected respiratory droplets through
person-to-person contact
Pleural effusion – abnormal accumulation of fluid in the pleural space
Pleural cavity – the area between the parietal and visceral pleurae a potential space
Substernal Retraction – indrawing beneath the breastbone, commonly manifested to infant
and neonate with respiratory distress
Thoracentesis – insertion of a needle into the space to remove fluid that has accumulated and
decrease pressure on the lung tissue; may also be used diagnostically to identify potential causes
of a pleural effusion
Thoracostomy - done to drain fluid, blood, or air from the space around the lungs

4. OBJECTIVES
General:
After 30 minutes of case presentation, the student nurse will be able to present the summary
of the different aspect of the client’s case in order to promote further consciousness and awareness
of the condition for the promotion of health and prevention of further complications as equally
significant to the client’s wellness.
Specific:
After a week of accomplishing this case study, the student nurses will be able to:
 accomplish assessment to gather pertinent data about the client as deemed relevant to the
case
 name the major health problem of the client
 defined the technical terms found in the course of study to facilitate better understanding
 present the anatomy and physiology
 discuss the pathophysiology of the client’s disease condition
 present laboratory studies conducted therein
 present other ideal laboratory studies and their implication to support the diagnosis of the
disease
 determine the appropriate nursing diagnosis for the client’s case
 create a plan of care appropriate for the client’s condition
 commit to effectively execute or implement nursing care plan for the client, including all
nursing interventions suited
 evaluate the efficiency of the nursing care provided according to the nursing care plan

5. PATIENT’S PROFILE
Name: Baby Jesse
Address: #156 Basud, Polangui, Albay
Age: 6 months old
Birth date: February 18, 2011
Birthplace: Dr. Isip Hospital
Gender: Male
Religion: Roman Catholic
Nationality: Filipino
Father’s name : Felly Baguio Rone
Mother’s name: Neiva Dumanjug Rone
Date of Admission: December 30, 2010
Time of Admission: 6:25 AM
Chief Complaint: on and off cough associated with fever
Admitting Diagnosis: Bronchopneumonia
Admitting Physician: Dr. Alimyon Isip, MD
PERSONAL HISTORY:
DEMOGRAPHIC DATA
Baby Jesse is a 6 months old infant; male, 1st child of Mr. and Mrs. Rone, are living in #156
Basud, Polangui, Albay. He was born last 18th of February in Dr. Isip Hospital and was delivered via
normal spontaneous delivery .Mrs. Rone and Baby Jesse stayed in the hospital for three (3) days,
then was discharge. After 4 days, Mr. and Mrs. Rone returned, exclaiming that baby Jesse is
manifesting on and off cough associated with fever and was immediately checked by the physician
on duty and diagnose of Bronchipneumonia.
Informant: Mrs. Rone, mother of the patient

6. SOCIOECONOMIC AND CULTURAL FACTORS
Family is living a typical life in Polangui. Mr. Rone is a security guard of a certain bank in their
area earning atleast Php5000 a month, a graduate of HS and reached the 2 nd year level of his course
criminology, and Mrs. Rone is a housewife, has finished HS and did not continue college due to
financial constraint in their family. Parents of Mrs. Rone seldom help them in their financial needs.
Mr. and Mrs. Rone are both Roman Catholic and is closed to God and has several health beliefs and
practices that were learned from their parents. A belief of the “hilot” is one health belief they are still
giving their credence.
FAMILY – HEALTH ILLNESS:
HEREDITARY DISEASE IN THE FAMILY
According to Mr and Mrs. Rone, the family does not have any hereditary disease. Any of both
sides of the family die because of aging and accident
EXISTING DISEASES IN THE FAMILY
Mr. Rone’s mother is still alive and in good health condition and his father died because of
old age. Mrs. Rone’s father does not have any disease at present and her mother already died
because of old age also.
HISTORY OF PRESENT ILLNESS:
When Mrs. Rone finally went home he noticed that Baby Jesse was in good condition, evident with
a normal brown skin. 3 days prior to admission, Baby Jesse experienced on and off cough and
associated with fever, with intercostals retraction, rapid and shallow breathing.

7. PHYSICAL ASSESSMENT
• A 4-month old baby boy
• Weigh 6.8 kilograms
• Cyanosis noted upon coughing
• Rapid shallow breathing noted
• Expressed his self through crying
• Skin is warm to touch
• Irritability noted due to his condition
Neurological
The patient can able to expressed his self through crying.
Eye/Vision
Our patient, have pale conjunctiva due to fever. Eyelashes present curving outward. No
lesions noted on the eyelid. Pupil equal, round, reactive to light and accommodation.
Ears/Hearing
Our patient doesn’t have hearing problem, no discharges, symmetrical, no swelling and
tenderness. Can respond normal voice tone. Intact with no lesions.
Nose
Our patient doesn’t have nasal problem, any discharges, any swelling and tenderness noted
upon inspection and uniform in color.
Mouth/Tongue/Teeth/ Speech
The patient had a pallor lips, reddened gums, without teeth. Thin whitish coating noted in
the tongue, it moves freely without lesions.
Throat/Neck
Neck is symmetrical with head, can turned head from right to left gradually, but with
resistance, no palpable lymph nodes.
Respiratory System
Patient use accessory muscle in order to breathe normally, presence of wheezing sound is
heard upon auscultation and in normal hearing, with respiratory rate of 60-42 cpm., and
nebulization was given.
Circulatory/Cardiovascular
Patient has a heart rate of 156-140 beats per minute. No edema and swelling noted. Good
capillary refill less than 2sec.
Gastrointestinal
Flat abdominal contour, no tenderness or distention. Thorax had dullness of sound due to
decrease confluent and pleural effusion.

8. Genitourinary
Patient had excessive urination, with minimum of 800cc per diaper
Musculoskeletal
The patient had normal upper and lower extremities, symmetrical and no tenderness
Integumentary
The patient's skin was warm to touch, he experience on and off fever, with good skin
turgor. Negative of rashes, sores, and lesions.

9. ANATOMY AND PHYSIOLOGY
A respiratory system functions to allow gas exchange. The gases that are exchanged, the
anatomy or structure of the exchange system and the precise physiological uses of the exchanged
gases vary depending on the organism.
The respiratory system can be conveniently subdivided into an upper respiratory tract (or
conducting zone) and lower respiratory tract (respiratory zone), trachea and lungs. The conducting
zone starts with the nares (nostrils) of the nose, which open into the nasopharynx (nasal cavity).
The primary functions of the nasal passages are to: 1) filter, 2) warm, 3) moisten,
and 4) provide resonance in speech. The nasopharnyx opens into the oropharynx (behind the oral
cavity).
The respiratory is an intricate arrangement of spaces and passageways that conduct air from
outside the body into the lungs and finally into the blood as well as expelling waste gasses. This
system is responsible for the mechanical process of breathing, with average adult breathing about 12
to 20 times per minute.
When engaged in strenuous acuities, the rate and depth of breathing increases in order to
handle the increased concentrations of carbon dioxide in the blood. Breathing is typically an
involuntary process but can be consciously stimulated of in holding your breath.

10. Nostrils/Nasal Cavities
During inhalation, air enters the nostrils and passes into the nasal cavities where foreign bodies are
removed, the air is heated and moisturized before it is brought further into the body. It is part of the
body that houses our sense of smell.
Sinuses
The sinuses are small cavities that are lined with mocuos membrane within the bones of the skull.
Pharynx
The pharynx, or throat carries foods and liquids into the digestive tract and also carries air into the
respiratory tract
Larynx
The larynx or voice box is located between the pharynx and trachea. It is the location of the Adam’s
apple, which in reality is the thyroid gland and houses the vocal cords.
Trachea
The trachea or windpipe is tube that extends from the lower edge of the larynx to the upper part of
the chest and conducts air between the larynx nd the lungs.
Lungs
The lungs are the organ in which the exchange of gasses takes place. The lungs are made up of
extremely thin and silicate tissues. At the lungs, the bronchi subdides, becoming progressively
smaller as they branch through the lung tissue, until they reach the tiny air sacks of the lungs called
the alveoli. It is the alveoli that gasses enter and leave the blood stream.
Bronchi
The trachea divides into two part called bronchi, which enters the lungs.
Bronchioles
The bronchi sudide creating a network of smaller branches, with the smallest one being the
bronchioles. There are more than one million bronchioles in each lung.
Alveoli
The alveoli are tiny air sacks that are enveloped n the network of capillariesit is here that the air we
breathe is diffused into the blood, and waste gasses are returned for elimination.

11. PATHOPHYSIOLOGY
Predisposing factors Precipitating factors
•Age (very young) •Daily Activities
•Gender •Environment
Exposure (living)
•Diet
Pathological Entry (inhalation)
of organism: Bacteria or Viruses
Occurrence of localized
Mucus Manifested by
•Diminished Bacteria invades alveolar cell
production
in the lungs
•Formation of
Hyaline membrane Sign and Symptoms
Bronchopneumonia
•Fever
•Cough
Airway Pulmonary Edema •Chest pain
•Rapid, shallow breathing
Obstructio •Shortness of breath
•Headache
•Loss of appetite
•Fatigue
Chest Thoracostomy
Tube
A. If disorderDaily If disorder is Treated,
B. Environment
urs:
C. Diet
• Normal breathing pattern
• Normal respiratory rate
•Empyema • Breath sounds
•Lung Abscess
•Pleurisy
•Pericarditis

12. DIAGNOSTIC AND LABORATORY PROCEDURES
URINALYSIS
Color: pale yellow
Transparency: clear
Sp. Gravity: 1.010
pH: 6.0
Microscopic findings
RBC: 0-1/hpf
Pus cells 0-1/hpf
Epithelial cells: rare
Crystals: Amorphous Urates (PD 4) – rare/hpf
Bacteria: rare
HEMATOLOGY
TEST NORMAL VALUES RESULT
Hematocrit 35.0-50.0% 33.0
Hemoglobin 12.0-16.5 g/dl 11.0
White cell count 5,000-10,000mm³ 3,600
Platelet count 150,000-400,000/mm³ 275,000
Segmenters 55-65% 42
Lymphocytes 25-35% 58
Blood Type “B” RH
type(+)

13. BLOOD CHEMISTRY
TEST NORMAL RESULT
VALUES
Sodium 136-145 mEq/L 132.7 mEq/L
Potassium 3.5-5 mEq/L 3.23 mEq/L
RADIOGRAPHIC REPORT
Chest X-ray:
– There are inhomogeneous parasites in both lower lung fields.
– The cilia and pulmonary vascular markings are within normal limits.
– The trachea is midline
– The heart is not enlarged.
– The hemi diaphragms and costophrenic angles are intact.
– The rest of the osseous and soft tissue structures are unremarkable.
Impression: PNEUMONIA, BILATERAL FOLLOW UP CHEST X-RAY IS SUGGESTED.

14. DISCHARGE TEACHING PLAN
The medication of the patient is very important to continue depending on the duration that the
doctor ordered for the total recovery of the patient.
Patient with Bronchopneumonia needs to have deep breathing exercise for lung expansion and
clearing for progressive normal breathing pattern and have adequate rest periods.
The client must relax in order to recover his present condition and instructed significant
others for minimal exposure to an open environment such as dusty and smoky area, which
airborne microorganisms are present that can be a high risk factor that may cause severity of her
condition.
It is also important to maintain proper hygiene to prevent further infection. Significant
others of the patient instructed that the baby should be bathe everyday.
Regular consultation to the physician can be factor for recovery to assess and monitor his
condition
The diet of the patient is also a factor for fast recovery. Encouraged to eat nutritious
foods intended for respiratory problem patient, the family of the patient plays a big role for the
fast recovery