Nursing Care Plan - Neonatal Pneumonia

Neonatal pneumonia is a pulmonary infection presenting with a clinical picture of respiratory distress, associated with chest radiological findings suggesting pneumonia and persisting for at least 48 hours. Infections may be transmitted via the placenta, by aspiration, or acquired postnatally. Neonatal pneumonia can be subdivided into 4 categories (with some overlap between them):

Congenital pneumonia (transplacentally acquired), e.g. rubella, cytomegalovirus, toxoplasma, listeria, herpes simplex, Treponema pallidum.
Intrauterine pneumonia (aspiration of infected amniotic fluid)
Early-onset pneumonia (due to an ascending infection “vertically”)
Late-onset pneumonia (due to organisms acquired nascomially (”horizontally”) or in the community.

Early-onset pneumonia presents at birth or soon afterwards. Associated maternal risk factors are:

spontaneous onset of preterm labour
prolonged rupture of membranes (>18
maternal fever (> 37.5°C)
chorioamnionitis
offensive liquor

Microbes involved are group B betahaemolytic streptococcus (GBS), pneumococcus and coliforms.

Late-onset pneumonia occurs at least 48 hours after delivery and later. Presents more insidiously and may develop abdominal distension and feeding intolerance. Microbes involved are streptococci, staphylococci, E.coli, Klebsiella. Viral and chlamydial infections are also associated with pneumonia. Chlamydial pneumonia usually presents between 4 and 11 weeks of age (and earlier) with tachypnoea, apnoea, nasal congestion, paroxysmal and staccato cough and crepitations.

Source: Department of Paediatrics and Child Health, University of Stellenbosch

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