Nursing Care for Pneumonia Patients

This document provides information on the specific considerations of clinical manifestations of pneumonia, the pathophysiology of altered ventilation and diffusion, the difference between HAP, CAP and Aspiration pneumonia, nursing care required for patients with pneumonia, and the rational for monitoring specific parameters for pneumonia.

NURSING
CASE STUDY

Table of Contents
Question 1 Specific considerations of clinical manifestations of pneumonia.............................1
Question 2 Pathophysiology of altered ventilation and diffusion...............................................2
Question 3 Difference between HAP, CAP and Aspiration pneumonia.....................................3
Question 4 Nursing care required the patient with pneumonia...................................................4
Question 5 Rational for monitoring specific parameters for pneumonia ...................................6
Question 6 Strategies would be use to ensure Mr. Hunter understand implications...................7
Question 7 Reflection..................................................................................................................8
REFERENCES................................................................................................................................9

Question 1 Specific considerations of clinical manifestations of pneumonia
Nurses plays an important function to render help for sick individuals or respond to their
health issues and problems. They are putting their efforts for improving well being of people
through providing various treatments as per causes of disease. The patient is suffering from
several problems such as Breathless, restless, Tacheypnoeic and productive coughs. He is also
facing pleuritic pain on inspiration and all these symptoms are of pneumococcal pneumonia. It's
indications are different as per type of peumonia from which a person get suffered (Holloway
and Galvin, 2016).
(Source: Pneumonia, 2016)
Symptoms
 Inflammation in lung parenchyma and rapidly fever rising which is sign of infection.
 Patients feel pleuritic chest pain while inhaling oxygen or deep breathing and coughing is
observed.
 Heartbeat becomes fast and low concentration of oxygen is observed then body tries to
maintain it which is known as tachypnea.
1
Illustration 1: Pneumonia

 Lung infection results into purulent sputum that are filled with pus.
A well qualified and experienced nurse have to identify the status of patient's health
regarding disease of pneumonia through evaluating various symptoms. It is also important to
carrying out several activities related to pathology to determine exact reason of heal issues so
that it can be treated properly to improve well being of an individual. It is necessary to carrying
out check up of an individual in correct way because treatment is based of these indications to
improve health of person (Alligood, 2017).
Diagnosis of pneumonia
They required to to determine the ineffective airway to clear it which is relevant to
copious tracheobronchial secretions which are produced by lungs due to infection. This is
basically related to respiratory system then they have to provide such treatment so that roles of
respiration can be conducted by body in appropriate manner. It is mandatory to put proper efforts
to reduce the production of deficient fluid relevant to fever or rapid respiratory rate of body of
patient.
Goals of Nurse Priorities of nurse
 It is needed to enhance airway patency
of patient.
 Suggest to take rest for conserving
more energy and healthy diet as it is
helpful to recover (Munhall, 2012).
 It is important to maintain normal
production of fluid in correct volume.
 Understand treatment protocol carefully
to conduct diagnosis.
 Nurse have to put efforts to maintain
functions of respiratory system to
normal condition.
 They requires to take proper
precautions so that complications
should be avoided.
 It is compulsory to render knowledge
about treatment status along with
support recuperative procedure.
Question 2 Pathophysiology of altered ventilation and diffusion
Pathophysiology can be described as that field of medical science which facilitate to
know about symptoms and causes of specific health issue along with suitable procedure of
treatment. Some of information about pneumonia according to which Mr. Hunter's treatment
should be carrying out that is given below:
2

 This disease results into raising from normal flora in people whose resistance altered
which is present in oropharynx.
 Alveolar sacs in lungs get infected and generating exudates which creates problem in
diffusion of oxygen and carbon dioxide.
 WBCs (white blood cells) are also moved into alveoli and occupy that space which is
usually filled by air (Kitson and et. al., 2013).
 Production of mucosal edema, several area if lungs are unable to ventilated And cause
partial occlusion of bronchi. And hypo ventilation results into mismatch of ventalation-
perfusion.
 Sometimes, it is observed that venous blood enter into pulmonary circulation and passes
through ventilated area and travels to left side of heart de oxygenated.
 If blood get mixed then it may results into arterial hypoxaemia.
The disease of pneumonia can be considered as inflammation of lung parenchyma which
is generally cause by several micro organisms such as bacteria, mycobacteria, fungi and viruses.
This health issues has certain types according to which treatments are also varies as per different
kind of symptoms and signs (O'brien, 2017).
Ventilation :- It is all about the movement of air into and out of trachea, bronchi and
lungs.
Diffusion :- This term, refers to movement of particles from an specific area from high to
low concentration. It in includes diffusion capacity that may described as calculation of carbon
monoxide to nitric acid transfer from inspired gas to pulmonary capillary blood. It is relevant of
volume of gas which diffuses through alveolar capillary membrane every minute.
Question 3 Difference between HAP, CAP and Aspiration pneumonia
Pneumonia is classified into several classes such as Community acquired pneumonia
(CAP), Hospital acquired pneumonia (HAP) and Aspiration pneumonia. They all are different in
respect of their causes, symptoms, indications and agents of infection. Diagnosing tricks are also
varies as per their dissimilar nature of these health problems. These are separately described
below:
Community acquired pneumonia
The CAP is takes place in community setting and after 48 hours of hospitalisation. Ther
are several infective agents like streptococcus pneumonia, Legionella, Pseudomonas aeroginosa,
3

and H. Influenzae. It is very into common in those individuals who are younger than 60 years of
age and mostly caused by viruses in infants or children.
Hospital acquired pneumonia
It is also known as nosocomial pneumonia and considers all symptoms to record that
occurs from more than 48 hours of admission in hospital (Halter, 2017). These patients does not
have any sign at time of entry. This disease can be be explained as nosocomial infection and
cause death due to these critical infections in human body. The HAP may involve several agents
like Escherichia coli, Influenza, Klebsiella species, Enterobacter apecies, Serratia marcescens, S.
aureus, and S. Pneumonia. HAP can be easily identified through X-ray of chest with indicant of
unhealthiness as it a new pulmonary infiltrate.
Aspiration pneumonia
This kind of pneumonia can be described as pulmonary consequences that results due to
entry of several substances like endogenous as well as exogenous into lower airway. It is mostly
regarding bacterial infection from aspiration of bacteria which are genarlly reside in upper
airways. This may occur on both setting such as community and hospital. Some of common
pathogens for this disease are refers to S, aureus, H. Influenza and S. pneumonia.
Question 4 Nursing care required the patient with pneumonia
Nursing can be defined as kind of profession in healthcare organisations that provides
support to stop sickness and improving healthcare. It includes taking care of physically and
mentally ill people of every age group and gender to make them well being.
A nurse has role and responsibility to take care of patient suffering from pneumonia in
order to improve health and well being of them (Houser, 2013). In case of any disease, it is
mandatory to renders appropriate treatment with correct medicines or injections but more
importantly they required to check status of body repeatedly to know about impacts of diagnosis
at right time. Sometimes, it is observed that an individual need other type of treatments allergic
reaction by human body for few of medicines. For pneumonia, nurses have to diagnose primarily
the ineffective airway clearance relevant to increased generating of secretions along with
enhanced viscosity.
Evaluation of treatment :- It is an essential aspect to carrying out evaluation of several
activities and procedures that are included into diagnosis of pneumonia. It can involve that
presence of sputum cultures to determine specific organism and sensitivities reflects existence of
4

bacteria along with it's resistivity. Further check up described about to conduct X-ray of chest
due to feeling pain because of infection in alveolar sacs of lungs and that indicates areas of
increased density (lobe, lung segment, one lung or both). Overall, after checking the body major
infected areas and consolidation are identified.
Pharmacologic interventions :- Different Types of medicines are available that are used
for getting rid off pneumonia but it is very essential to take them carefully (Weaver, 2011). It is
mandatory to render high or heavy dose of antibiotics as per requirements. Initial medicines and
further injections are different as per changed status of patient's condition. Initial antibiotics :- There are various kind of medicines that required to take first like
Erythromycin, roxithromycin, clarithyromycin and azithromycin. These are basically
known as macrolides which are helpful in community acquired bacterial pneumonia.
 Other antibiotics :- Various medicines are also useful to in getting rid off this disease
like Penicillin G for strepcococcal pneumonia, nafcillin or oxalin for staphylococcal
pneumonia, aminoglycoside or cephalosporin for Klebsiella. All these antibiotics are to
destroy several types of bacteria which cause disease in human body.
Nursing interventions :- They have to put efforts for administering oxygen as per prescription
of professional doctor along with evaluation about respiratory status. Various kind of elements
should be monitored laboured respirations, cyanosis, clammy skin and cold. Utilisation of
effective equipment like spirometer to improve coughing and deep breathing. They always stay
careful about each and every response of body through recording colour, consistency and amount
of sputum along with monitoring pulse oximetry. Apart from providing an efficient treatment, it
is also important to take care of a balanced diet which is preferred by patient (King and Hinds,
2011). It must include certain nutrients essential for infected person high calorie, protein rich
with small frequent meals. Nurse have to administer antipyretics, bronchodilators, cough
suppressants, mucolytic agents and expectorants that are prescribed.
Documentation of health status :- It is mandatory to determine respiratory rate and
depth, ausculation, chest tightness of pain along with vital indications. Assessment of
hypoxaemia involve like colour of lips and mucus membrane along with oxygen saturation by
pulse oximetry. Response of body after deep breathe and coughing exercise and amount of
sputum should be monitored on regular basis. All of these are helpful in determining several
5

changes after starting treatment can be analysed and take appropriate actions to improve health
of patient.
Question 5 Rational for monitoring specific parameters for pneumonia
Pneumonia may become a critical disease in case of it is not controlled by taking
appropriate steps to diagnose it. And if patient is facing several major issues like heart rate rises
above 100, oxygen saturations fall below 90% and temperature arise beyond 38.5 degree Celsius.
There are various kind of parameters which are required to be considered while diagnosing any
disease. There are different patients suffering from pneumonia can involve into asymptomatic to
seriously symptomatic then it become more compulsory for practitioners to asses severity of
disease and it effects on physical health of people.
The normal heart rate is between 90 to 100 % of blood that is mostly similar in adults as
well as infants. But if its is below 90% or higher than 100% then it will considered as irregularity
which is usually occur due to health issues. Similarly, an normal body temperature is 37 degree
in Celsius and if it is high then this can be refers to fever. It is mandatory that supply of oxygen
must appropriate so that different types of cells become able to play their role properly (Cherry
and Jacob, 201).
Some of treatments which can be provided to person infected by pneumonia are
described below:
 Respiratory support :- In the case of this disease, people are usually face problem of
inhaling oxygen which is very essential for cells and heart. Providing a nebulizer metered
dose inhaler so that an individual become capable to take air properly. Ventilated support
should also rendered to those people who were facing shortness of breathe, only
supplemented oxygen with nasal cannula etc.
 Fluid resuscitation :- One more issue of volume deletion observed in any persons
suffering from pneumonia and cardiac disease bearing people face volume overload
problem. It is mandatory to reduce these health issues through medication.
 Empiric antibiotic therapy :- In many of old age people like above 80 years, then
mortality rate remains approximately 40% even in aggressive treatment. It is usually for
hospitalised patients that should broadly and cover likely causative organisms. It has
significance to use such cautions for elderly or deliberated people.
6

 Corticosteroids :- It is helpful and play an essential role with issue of hypotension from
septic remains controversial. It is necessary to take proper steps to render correct
diagnosis for patients as per different symptoms of disease.
Question 6 Strategies would be use to ensure Mr. Hunter understand implications
There are different types of strategies that are generally used by nurses and other medical
professional as per ethical and legal codes or standards to make effective decision. It includes
several national codes which defines values that are comprehensive and culturally adapted. Some
of them are described below:
Nurses and people  It refers that nurses have to take care of their
patients in proper manner to improve health of
them.
Nurses and Profession  It is mandatory to remain loyal and trust worthy
with their profession.
Nurses and Practice  It is important to to attend regular training for
practices because they are dealing with lives if
people so that possibility of taking risk is nil.
Nurses and Co-workers  This refer that various kind of people are working in
this profession with each other with mutual
understanding.
Nurses, education and Research  Nurses should be well qualified and experienced and
try to work on researches on several diseases so that
appropriate diagnosis can be done to improve health
status of individuals.
The above mentioned standards were build ethically and legally which are necessary to
be followed by nurses and other medical professions. In case of Mr. Hunter, it is mandatory to
wear an oxygen mask permanently to survive. But he is not comfortable to wear that mask and if
it continues then it is not possible to stay healthy and condition become more worst. Now, nurse
have to make sure that they put their efforts to prepare an effective technique as per codes of
7

ethical or legal aspects. Apart from oxygen mask, nurse can utilise other methods of providing
proper oxygen for maintaining health of patient.
Question 7 Reflection
The above discussion is all about disease of pneumonia including its types, causing
agents, treatment and evaluation. Nursing can be defined as kind of profession in healthcare
organisations that provides support to stop sickness and improving healthcare. There are various
kind of aspects which are necessary to learned for improving future treatments.
I have observed and analysed that different types of patients are required to tackle with
differentiated methods. A particular disease is also classified into several sub-classes as per
different causing agents and symptoms. Diagnosis of people are done through various age groups
and gender because antibiotics and other medicines impacts in dissimilar way in individual.
I also agree with the technique of regular evaluating health status of patients according to
check impacts of medication so that it should be changes in case of not achieving improvement.
It is helpful to determine several effects of initial and further treatment so that any negative
impact can be identified easily to take correct steps against it for enhancing health situation of an
individual.
8

REFERENCES
Books and Journals
Holloway, I. and Galvin, K., 2016. Qualitative research in nursing and healthcare. John Wiley
& Sons.
Alligood, M. R., 2017. Nursing Theorists and Their Work-E-Book. Elsevier Health Sciences.
Munhall, P., 2012. Nursing research. Jones & Bartlett Learning.
Kitson, A. and et. al., 2013. What are the core elements of patient‐centred care? A narrative
review and synthesis of the literature from health policy, medicine and nursing. Journal
of advanced nursing, 69(1), pp.4-15.
O'brien, M. E., 2017. Spirituality in nursing. Jones & Bartlett Learning.
Halter, M. J., 2017. Varcarolis' Foundations of Psychiatric-Mental Health Nursing-E-Book: A
Clinical Approach. Elsevier Health Sciences.
Houser, J., 2013. Nursing research: Reading, using and creating evidence. Jones & Bartlett
Publishers.
Weaver, A., 2011. High-fidelity patient simulationin nursing education: an integrative review.
Nursing education perspectives, 32(1), pp.37-40.
King, C. R. and Hinds, P.S., 2011. Quality of life: from nursing and patient perspectives. Jones
& Bartlett Publishers.
Cherry, B. and Jacob, S. R., 2016. Contemporary nursing: Issues, trends, & management.
Elsevier Health Sciences.
Online
Pneumonia. 2016. [Online]. Available through:<https://nurseslabs.com/pneumonia/>
9