Hospital Acquired Pneumonia: Nursing Considerations and Interventions

CASE STUDY ON HOSPITAL ACQUIRED PNEUMONIA
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Hospital acquired pneumonia
INTRODUCTION
Hospital acquired pneumonia is an acute infection of the lower respiratory system and it is often
acquired 48 hours after a patient is admitted at the hospital. The key signs and symptoms include
dyspnea, productive cough and fever (Kalil et al., 2016, p. 2) .It is also associated with chest
pains and diminished resonance. In this assignment, there is a case study who presented with the
condition. She was 78 years old and the notable sign and symptom on assessment was the
difficulties in breathing. In this assignment, the nursing considerations, the important health
issues in the case study and the nursing interventions for the problem will be highlighted.
NURSING CONSIDERATION
To prevent further infections, the nurses should ensure appropriate disinfection or sterilization of
respiratory therapy devices using absolute alcohol .The nurse should also ensure that the patient
reduce aspirations and finally prevent cross contamination through the hands of the healthcare
workers.
IMPORTANT HEALTH ISSUES
In this case study, there were two important health issues identified .Since the patient said that
she cannot breathe well, the two likely health problems include ineffective airway clearance and
impaired gas change. There is need for necessary nursing interventions therefore to achieve the
desired outcome for the two problems.

NURSING INTERVENTIONS
Ineffective airway clearance is the inability by the patient to clear secretions and obstructions
from the respiratory tract so that the airway is clear. This health problem is shown by dyspnea or
cyanosis (Kesinger et al., 2015, p. 398). The desired objective in this problem is to enable the
patient exhibit a patent airway with clear sounds of breathing. Another goal is to clear dyspnea
and cyanosis.
The nurse should assess the depth of the respirations as well as the chest movements. The nurse
should also auscultate the lung fields while noting the areas with decreased airflow as well as
crackles or wheezes(Lacy et al., 2015, p. 98) .The rationale for this nursing intervention to
establish if there is fluid accumulations so that they can be removed by use of medications. This
is because reduced airflow is as a result of areas that have consolidated fluids. This can also be
accompanied by bronchial breath sounds, crackles or rhonchi and wheezes especially on
inspiration.
Elevating the head of the bed and changing the position of the patient frequently is another
important nursing intervention (Pugh, Grant, Cooke, & Dempsey, 2015, p. 2).The rationale for
this nursing intervention is to lower the diaphragm and this will allow expansion of the chest that
will lead to aeration of the lungs and this will mobilize the expectoration of the accumulated
secretions.
The nurse should also administer medications such as mucolytic, expectorants and the
bronchodilators. The rationale for this intervention is to reduce the bronchospasm and mobilize
the secretions (Sandrock & Shorr, 2015, p. 3). Analgesics can also be used to improve the cough