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  1. Caring for a Patient with Community Acquired Pneumonia

    QUESTION

    An essay about Caring for a Patient with Community Acquired Pneumonia

 

Subject Nursing Pages 6 Style APA

Answer

Caring for a Patient with Community Acquired Pneumonia

Concept Map

 

 

 

 

                                                           

 

 

 

 

 

 

 

                                                                                                              

 

 

 

 

 

 

 

Clinical Manifestations

The very first symptom that the patient is presented with is dyspnoea. The lungs always need an open airway that allows breathing in and breathing out to occur unobstructed. An open airway serves as an optimal means through which the lungs are replenished with oxygen all the time. Any form of swelling and inflammation, mucus and obstruction makes the breathing process more difficult by making it harder to move air through the airways thus making it harder to breathe (Vaughn et al. 2019; Mandell & Niederman, 2019)). This may consequently lead to shortness of breath difficulty in breathing and increased fatigue for the patient.

It is also true that pneumonia patients often present with intense chest pain, especially that of the lower part of the chest. The patient indeed demonstrates this chest pain. The pain may feel sharper as the patient breathes in and out. It is important to understand the reason why this pain comes about if it is to be understood and managed at all. Often when the infection proliferates into the lungs, the thin lining between the lungs and the ribcage which is called pleura, may be infected and therefore inflamed (Mandell & Niederman, 2019). It is because of this inflammation, which is called pleurisy, that the lungs may fail to smoothly move as the breathing process goes on. The failure to move and function as usual is the one that therefore causes the intense pain that the patient eventually is presented with.

In addition to these symptoms, there is also usually the possibility of fever as a consequence of pneumonia. Fevers are demonstrated by the high temperature recordings that the patient is presented with (Vaughn et al. 2019). The inflammation of the air sacs with fluid or pus eventually contributes to the heightened fever. Diagnosing one with pneumonia includes looking at the possibility of cough and the nature of this cough. With regards to this case, the assessment reveals a moist cough. This is in line with the symptom that most pneumonia patients show. The moist cough is from the fluid and pus that often fills the lung air sacs and that have to be expelled for the normal respiratory process to be resumed.

For the pneumonia patient, there tends to be fatigue, confusion and often even sleepless episodes as a consequence. In this case, the HOPC reveals a lethargic aspect, myalgia, asthenia and anorexia. As already indicated, one of the ways in which pneumonia makes an announcement is through the laboured breathing. The respiratory muscles are worn down by incessant overworking of the accessary muscles, inspiratory muscles and the muscles between the lungs and the rib cage. Because of the ceaseless functioning of these muscles, the patient tends to be worn out and tired most of the time. In this case, the patient has been unwell for a number of days before seeking medical help. In this regard then, the patient must have undergone prolonged breathing difficulties. It is this that combines to cause feelings of lethargy, drowsiness and anorexia (Mecham et al 2017). The increased heart rate and the higher blood pressure is also testament to the increased difficulty in breathing and the heightened physical activity and strain that the respiratory system has to be subjected to.

Nursing Management Strategies

Once the tests and the diagnosis have all but confirmed the presence of pneumonia, what remains is the proper treatment of the infection. To manage pneumonia, the symptoms are to be handled in order of their priority.  For this patient, the priority lies in clearing the airway so that the breathing is back to normal. In this case, this would first involve fever and pain relievers that would make the breathing process less painful. For this, drugs like aspirin, ibuprofen and acetaminophen are recommended (Ramirez et al. 2017). These drugs would function to relieve the patient of the pain and thus make the breathing process simpler. The drugs would also go a long way in helping relieve the chest pain that the patient is also presented with.

The second in the list of this priority would be to reduce the intensity of the cough. It may be surprising that the word chosen here is “reduce” rather than “stop”. This word choice is strategic. Cough medicine would have to be administered on the patient so that the patient can calm their cough. The main aim of reducing rather than stopping the cough would be so that the slight cough helps loosen and move fluid from the lungs (Amalakuhan et al. 2017). The cough suppressant used ought to be one that helps reduce the intensity of the cough thus helping the patient have some rest and thus become less fatigued.

The main goal of clearing the airway is to have the patient breathing back on track. Sometimes, the interventions used do not work well, and the patient has to undergo oxygen supplementation to help the patient easily breathe on their own (Grief & Loza, 2018). Notably, this can be done either through nasal cannula or mechanical ventilation. In patients with acute conditions and who can be said to be in life-threatening conditions, the use of a mechanical ventilator would be the ideal choice. In this regard, there are the non-invasive ventilation and the invasive ventilation. The patient in this case can have non-invasive ventilation done for them in which case they would be tightly fitted with a face or nasal mask or have the invasive one whereby a tube would be entered into the windpipe through the nose or mouth via the front of the throat (Ramirez et al. 2017).

The pain and fever that the patient feels also has to be controlled. While the controlling of the cough helps alleviate some pain that comes with pneumonia, it does not do it all. For the patient, the pain may still persist. This is where the prescribed antibiotics come in. Once the test has revealed the type of bacteria causing the pneumonia, the relevant antibiotics would be prescribed to reduce the potency of the infection (Ramirez et al. 2017). The antibiotics can be changed when the condition of the patient does not improve. Other pain relievers too can be used by the patient. It has to be observed that besides the paracetamol that the patient has been taking, others that could be used by the nurses include aspirin, ibuprofen and acetaminophen.

 

 

References

Amalakuhan, B., Echevarria, K. L., & Restrepo, M. I. (2017). Managing community acquired pneumonia in the elderly–the next generation of pharmacotherapy on the horizon. Expert opinion on pharmacotherapy, 18(11), 1039-1048.

Grief, S. N., & Loza, J. K. (2018). Guidelines for the Evaluation and Treatment of Pneumonia. Primary Care: Clinics in Office Practice, 45(3), 485-503.

Mandell, L. A., & Niederman, M. S. (2019). Aspiration pneumonia. New England Journal of Medicine, 380(7), 651-663.

Mecham, I. D., Vines, C., & Dean, N. C. (2017). Community‐acquired pneumonia management and outcomes in the era of health information technology. Respirology, 22(8), 1529-1535.

Ramirez, J. A., Wiemken, T. L., Peyrani, P., Arnold, F. W., Kelley, R., Mattingly, W. A., … & University of Louisville Pneumonia Study Group. (2017). Adults hospitalized with pneumonia in the United States: incidence, epidemiology, and mortality. Clinical Infectious Diseases, 65(11), 1806-1812.

Vaughn, V. M., Flanders, S. A., Snyder, A., Conlon, A., Rogers, M. A., Malani, A. N., … & Gandhi, T. N. (2019). Excess antibiotic treatment duration and adverse events in patients hospitalized with pneumonia: a multihospital cohort study. Annals of internal medicine, 171(3), 153-163.

 

 

 

 

 

 

 

 

 

 

Appendix

Appendix A:

Communication Plan for an Inpatient Unit to Evaluate the Impact of Transformational Leadership Style Compared to Other Leader Styles such as Bureaucratic and Laissez-Faire Leadership in Nurse Engagement, Retention, and Team Member Satisfaction Over the Course of One Year

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