Linda Kay Cook and Janet Armstead Wulf are assistant professors at the University of Maryland School of Nursing, Baltimore. Contact author: Linda Kay Cook,
Am J Nurs. 2020 Dec;120(12):34-42. doi: 10.1097/01.NAJ.0000723420.30838.97.
Among the most common causes of U.S. adult hospitalizations, pneumonia accounted for nearly 50,000 deaths in the United States in 2017. This article provides nurses with a thorough update on pneumonia risk factors, signs and symptoms, and diagnostic criteria, as well as inpatient treatment recommendations and recommendations for discharge and prevention, including the nurse's role in patient and family teaching. The article also details key similarities and differences between the new 2019 guideline jointly developed by the American Thoracic Society and the Infectious Diseases Society of America on diagnosis and treatment of adults with community-acquired pneumonia and their earlier 2007 guideline. One crucial difference is the growing recognition that the etiology of pneumonia is changing, necessitating the abandonment of prior categorizations of pneumonia type when determining antibiotic coverage in favor of reliance on local epidemiology and validated risk factors for antimicrobial resistance.
在导致美国成年住院的最常见原因中，肺炎导致 2017 年美国近 5 万人死亡。本文为护士提供了有关肺炎危险因素、体征和症状以及诊断标准的全面更新，还提供了住院治疗建议以及出院和预防建议，包括护士在患者和家属教育中的作用。文章还详细介绍了美国胸科学会和传染病学会联合制定的新的 2019 年成人社区获得性肺炎诊断和治疗指南与之前的 2007 年指南之间的主要异同。一个关键区别是，人们越来越认识到肺炎的病因正在发生变化，因此在确定抗生素覆盖范围时，需要摒弃先前的肺炎类型分类，转而依靠当地的流行病学和经过验证的抗微生物药物耐药风险因素。
