Case Analysis of Robert Snider with Middle Lobe Pneumonia

This report provides a detailed analysis of the case of Robert Snider, a patient diagnosed with middle lobe pneumonia. It covers various aspects such as treatment, nursing care, prevention of complications, hydration and nutrition, emotional support, and discharge planning. The report also highlights the importance of oxygenation, general nursing care, prevention of hospital-acquired complications, and the promotion of adequate hydration and nutrition. It concludes with recommendations for education and discharge planning for the patient's well-being.

Written analysis of casebased
scenario

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
Promotion and facilitation of oxygenation..................................................................................3
Provision of general nursing care................................................................................................4
Prevention of possible hospital acquired complications..............................................................4
Promotion of adequate hydration and nutrition...........................................................................5
Provision of emotional and psychological support......................................................................5
Education and discharge planning...............................................................................................6
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Case-based scenario is based on a case which helps in analysing the case from all the aspects
and then suggesting the recommendations for the improvement of the condition of the patient
and improving the outcomes of the patients (Chou and et.al., 2019). This report will shed light on
the case of Robert Snider who is a 68 year old male who is diagnosed with middle lobe
pneumonia. Along with this, the person was also having a medical history in which he was
diagnosed with many other disorders such as hypertension and COPD. Various symptoms were
also seen in the patient due to the disorders and also due to some of his bad habits such as having
20 cigarettes per day.
Promotion and facilitation of oxygenation
As observed in the case, Robert Snider was suffering from pneumonia which is basically
an inflammatory condition of lungs. Robert was having disorder in the middle lobe as he was
also working in the coal mine. The major treatment for pneumonia involves taking rest,
antibiotics, management of the complications, fluids and professional home care. Oxygen
supplementation is the main solution for the patients who are unable to breathe on their own
(Wang and et.al., 2018). Robert was suffering from pneumonia which is why he was feeling pain
in breathing and also the oxygen intake was limited. This was evident from his SaO2 level which
was 88% which was supposed to be almost 94%. Oxygen therapy helps to maintain adequate
saturation levels of oxygen. This must be above 93% which depends upon the oxygen
concentrations and the severity of pneumonia (Wang and et.al., 2020). The humidified oxygen
therapy can also be proved to be useful for assisting the patient with expectoration. This must be
ensured that the oxygen therapy is provided with least degree of discomfort or irritation to the
patients. This must be given till the patient requires an atmosphere of oxygen plus for
maintaining tissue respiration. Some of the patients can even be treated at home through the use
of medications. But Robert was having severe symptoms such as fatigue, restless, shortness of
breath, pale in colour, feeling fearful etc. which is why he was given oxygen therapy. It is also
must for Robert to get plenty of rest, stay hydrated and also taking the medicines become
mandatory. For discomfort and fever, various drugs can be taken such as ibuprofen, aspirin and
acetaminophen. Also, in this disorder, weight of the patient must be managed which can be done
by exercises and workout plans.
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Provision of general nursing care
Pneumonia is basically an infection which leads to inflammation in the air sacs in lungs.
This results in the filling of the air sacs with fluid. Also some of the patients having pneumonia
found that they have pus or fluid filled in the air sacs. This can also result in life threatening
conditions. Therefore, it is must to provide right treatment to those patients. The antibiotics are
able to prevent some types of pneumonia while the other types of pneumonia are treated by
vaccines. Along with this, if the symptoms of the disease are severe then the various other
alternatives are suctioning, inducing coughing, oxygen therapy or deep breathing which helps in
ensuring that the patient is hydrated and mechanical ventilation. Robert also has Chronic
Obstructive Pulmonary disease (COPD) and hypertension (Wang and et.al., 2020). This
evaluated that the patient was already suffering from lung disease which lead to obstruction of
airflow from the lungs. The symptoms of this disease were also difficulty in breathing, mucus
production, cough and wheezing. This disorder is basically due to the exposure to particulate
matter or irritating gases especially from smoking the cigarettes. The major cause of this COPD
is tobacco smoking (Jang and Rhee, 2020). The nurses must provide a balance of activity and
rest which helps in increasing the activity gradually. The antibiotics must be administered as
prescribed. The exercises must also be involved in the nursing care as Robert was also
overweight and in order to improve his condition, he must lose some weight for gaining better
outcomes.
Prevention of possible hospital acquired complications
The pneumonia can be treated in number of ways but the condition of Robert was critical
as his symptoms were severe. The normal heart beat per minute was found to be 120 beats per
minute without doing any exercise and workout. At the rest time, it must be between 60 and 100.
The patient in the hospital must take care of various things as there can be various risks and
complications of showing some carelessness. There can be respiratory infections which can
increase the severity of pneumonia. The person must wash hands properly and also use alcohol
based hand sanitizer. Smoking is strictly prohibited in this case as these damages the natural
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defences of lungs (Taler, 2018). Immune system of the patient must be strong which can help in
fighting with the disease and can respond effectively to the treatment given. In case of giving the
oxygen therapy, there can be risk of oxygen toxicity which means there can be inappropriate or
excessive oxygen which can cause greater damage to the lungs along with other organs and
organ systems. If the oxygen is supplied in higher amounts then this can lead to damaged
membranes, formation of radicals and also damaged cell structures in the lungs (Cillóniz and
et.al., 2019). There can be many fall risks which can be occurred due to the oxygen therapies and
also can cause deteriorated outcomes. During the oxygen therapy, continuous oxygen is supplied
to the person for longer period of time then this can lead to changes in the lungs which is
normally harmful. Oxygen also cause risk of fire so when taking oxygen therapy the patient must
not do smoking but Robert was taking 20 cigarettes per day which is much harmful for his body.
Promotion of adequate hydration and nutrition
For the patients like Robert diagnosed with pneumonia must balance their daily nutrition
and diet and must ensure that their body remains hydrated. Their diet must be rich in protein and
also the intake of food such as seeds, nuts, cold water fishes such as salmon and sardines which
have anti-inflammatory properties, white meat etc. must be there (Watkins and Van Duin, 2019).
This type of food basically helps in repairing the damaged tissues and also helps in building the
new tissues in the body. The patient must ensure that dehydration is not present which can be
removed by consuming electrolytes and liquids such as cool beverages and having homemade
ice popsicles can help in hydrating the body for cooling it down. Good nutrition can help the
body in fighting against the infections (Miravitlles and Anzueto, 2017). The body weight of
Robert must be maintained. The total body calories must be limited by intake of high fiber foods
such as fruits, vegetables, cooked dried peas and beans, pasta, rice and also whole grain cereals.
Herbs must be used for flavouring the food and no salt must be used. This is how, the condition
of the patients like Robert can be improved.
Provision of emotional and psychological support
Robert needed psychological and emotional support as he was alone and no one was there
to assist him. As it was observed in the case that Robert has medical history of hypertension so it
is must to provide emotional support to Robert. Stress lead to hypertension and also hampers the
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efforts of the treatment. This can be managed by counselling, providing behavioural therapies,
changing the mindset and also providing the medication. The practitioners must help the patients
in dealing with the stress by scheduling the practical changes and also modifying the demands of
the person (Vogelmeier and et.al., 2018). There must be personal care giver to the patient who is
suffering emotionally as half of the disease can be cured by the emotional and psychological
support.
Education and discharge planning
After treating the patient suffering from Pneumonia, the patient must be made educated
regarding the knowledge of the medicines and the doses which are to be taken. When the
planning of discharge is done, the patient must be educated this much as he can take care of
himself or some person centred care must be provided to him. This is because, after being
discharged also, proper care of the patient must be taken so that no symptoms occur again.
Education regarding the repeated symptoms must be given and the patient must analyse the
symptoms if occurs again. Therefore, education and proper planning must be done for the well
being of the patient like Robert.
CONCLUSION
The above report concluded about the case scenario of Robert Snider who was suffering
from disease of right lobe pneumonia. The report focussed upon various aspects of the case. It
discussed about the different nursing plans and care for Robert. This was followed by
highlighting the other aspects such as risks of the treatment, provision of the complications,
providing nutrition and hydration, offering psychological and emotional support along with
providing education and discharge planning.
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REFERENCES
Books and Journals
Chou, C. C. & et.al., (2019). Recommendations and guidelines for the treatment of pneumonia in
Taiwan. Journal of Microbiology, Immunology and Infection. 52(1). 172-199.
Cillóniz, C. & et.al., (2019). Ceftobiprole for the treatment of pneumonia. Revista Española de
Quimioterapia. 32(Suppl 3). 17.
Jang, S., & Rhee, J. Y. (2020). Three cases of treatment with nafamostat in elderly patients with
COVID-19 pneumonia who need oxygen therapy. International Journal of Infectious
Diseases. 96. 500-502.
Miravitlles, M., & Anzueto, A. (2017). A new two-step algorithm for the treatment of
COPD. European Respiratory Journal. 49(2).
Taler, S. J. (2018). Initial treatment of hypertension. New England Journal of Medicine. 378(7).
636-644.
Vogelmeier, C. & et.al., (2018). Guideline for the diagnosis and treatment of COPD patients-
issued by the German respiratory society and the German Atemwegsliga in cooperation
with the Austrian Society of Pneumology. Pneumologie (Stuttgart, Germany). 72(4).
253-308.
Wang, Q. & et.al., (2018). Azithromycin-loaded respirable microparticles for targeted
pulmonary delivery for the treatment of pneumonia. Biomaterials. 160. 107-123.
Wang, Y. & et.al., (2020). A retrospective cohort study of methylprednisolone therapy in severe
patients with COVID-19 pneumonia. Signal transduction and targeted therapy. 5(1). 1-
3.
Wang, Z. & et.al., (2020). Clinical characteristics and therapeutic procedure for four cases with
2019 novel coronavirus pneumonia receiving combined Chinese and Western medicine
treatment. Bioscience trends.
Watkins, R. R., & Van Duin, D. (2019). Current trends in the treatment of pneumonia due to
multidrug-resistant Gram-negative bacteria. F1000Research. 8.
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