Healthcare: Pneumonia Case Study of a 75-Year-Old Patient

This case study analyzes a 75-year-old patient presenting with community-acquired pneumonia, detailing symptoms like chest pain, breathing difficulties, and septic shock indicators. The analysis includes diagnostic reports such as chest X-rays, full blood counts, and arterial blood gas (ABG) results, revealing acidosis and hypoxia. The study identifies the patient's condition, including potential kidney failure and thrombosis. It outlines crucial nursing interventions to manage cardiovascular symptoms, improve cardiogenic output, and address respiratory distress. The interventions include monitoring cardiovascular symptoms, administering dopamine, and providing external oxygen support. The patient's ABG results show low pH, low PaO2, high PaCO2, and high lactic acid levels, indicating acute acidosis. The case study emphasizes the importance of timely intervention and effective management strategies in severe cases of pneumonia. The study is supported by multiple references.

Running head: PNEUMONIA CASE STUDY
Pneumonia Case Study
Name of Student
Name of University
Author Note

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Criteria 1:
The community acquired pneumonia occurs when a patient is subjected to continuous
pathogenesis without having any access to medical help and the severe symptoms include chest
ache, tachycardia, sputum induced cough and breathing obstruction (Wunderink & Waterer,
2014). The patient in the case study is 75 year old man with medical history suggesting chronic
bronchitis came to the medical emergency unit and the diagnostic reports showed that the patient
is experiencing persistent coughing with sputum generation, chest pain, difficulty in breathing
and speaking (Bullock, S., & Manias, 2013). Chest X ray reports show that there are crackles on
his lower left side of lungs. These symptoms are suggestive of Community acquired Pneumonia.
The patient has high fever, erratic heart rate, low BP, and high respiratory rate. All these
symptoms suggest that the patient is undergoing septic shock. Analysis of the electrolytes, urea
and creatinine shows that all the components of the test Na+ and Cl- due to dehydration. Urea
and creatinine are high as the body is not being able to perform excretion properly, this could be
suggestive of a potential for kidney failure that occurs in severe cases of septic shock. The urine
colour of the patient was observed to be very dark, which further suggests kidney failure
symptoms (Craft et al., 2013). The full blood count report shows that the patient’s white blood
cell and platelet count is very high and his extremities are swollen. This kind of symptom is
common due to inflammation caused by anaphylactic shocks, called thrombosis. The WBC could
also be high due to presence of pathogen in his body.
Criteria 2:
The patient seems to have undergone septic shock which is commonly observed in
patients with severe community acquired pneumonia (AlOtair et al., 2015). Septic shocks can

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induce tremors through the body, raise temperature, alter cardiac output erratically, and cause
severe inflammation which may induce thrombosis of the extremities that ultimately leads to
organ failure, like kidney, lungs and heart (Craft et al., 2013). Intravenous hydration was already
introduced to lower the ionic balance, so the next target is to control the cardiac output to ensure
that the patient does not undergo heart failure.
Nursing Interventions Rationale
Monitoring and
controlling
cardiovascular
symptoms
 Development of hypotension is observed when the endotoxins released
by pathogens circulate in blood and create vascular dilation which
progresses with the diseases and affects cardiac output. Dopamine can be
administered to control Hypotension.
 It is necessary to control cardiac rhythm which is affected by electrolyte
and ionic contents of heart inducing hypotension causing tachycardia
 Shallow breath, difficulty in speaking is caused due to obstruction in
respiratory pathway and should be controlled.
 Anaphylactic shock can also induce cardiogenic shocks, which is why it
is important to monitor the cardiac output (Craft et al., 2013).
 Improving the cardiogenic output can be enhanced by introducing
histamines and vasodilators to stop the septic reaction and introducing
external oxygen supply from oxygen concentrator systems.

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Criteria 3:
Analysis of the Arterial Blood Gas (ABG) of Mr. Farouq, shows that his artery pH is
significantly low; below 7.35-7.45 range of 7.24. The pressure of the oxygen in the arteries or
PaO2 is: 55mmHg which is lower than the threshold range: 80-100mmHg. The arterial Carbon
Dioxide pressure or PaCO2 is: 56mmHg, this is also higher than the allowed threshold in normal
patients, 35-45mmHg (McCance & Huether, 2015). The bicarbonate content or HCO3 result of
Mr. Farouq is observed to be: 24mmol/L, which is the normal threshold for arteries, 22-
32mmol/L. The excess of basic components in the arteries is allowed to be (-2)-(+2) mmol/L
which is normal for Mr. Farouq, -2mmol/L. Finally the lactic acid content of the arterial cavity
of Mr. Farouq is content of the 5.2mmol/L which is very high with respect to the normal range
that is 0.3-0.8mmol/L, this is suggestive of the fact that Mr. Farouq is unable to consume enough
oxygen in his tissues which is creating a hypoxic condition in his artery. This kind of symptoms
occurs when a patient undergoes acute acidosis in their lungs when the excess CO2 is not being
removed. This also affects the pH of the arterial cavity and such case is common in severe
conditions of community acquired pneumonia (Jain et al., 2015). The blocked alveoli sacs of the
lungs fail to maintain balance between CO2/ O2 for which the ionic concentration is misbalanced
and the patient suffers breathing difficulty along with acidosis in arteries like in the case of Mr.
Farouq (Wunderink & Waterer, 2014).

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References:
AlOtair, H., Hussein, M., Elhoseny, M., Alzeer, A. and Khan, M. (2015). Severe pneumonia
requiring ICU admission: Revisited. Journal of Taibah University Medical Sciences,
10(3), pp.293-299.
Bullock, S., & Manias, E. (2013). Fundamentals of pharmacology. Pearson Higher Education
AU.
Craft, J., Gordon, C., Huether, S. E., McCance, K. L., & Brashers, V. L. (2015). Understanding
pathophysiology-ANZ adaptation. Elsevier Health Sciences.
Jain, S., Williams, D. J., Arnold, S. R., Ampofo, K., Bramley, A. M., Reed, C., ... & Zhu, Y.
(2015). Community-acquired pneumonia requiring hospitalization among US
children. New England Journal of Medicine, 372(9), 835-845.
McCance, K. L., &Huether, S. E. (2015). Pathophysiology: The biologic basis for disease in
adults and children: Elsevier Health Sciences.
Wagner, K. D., Hardin-Pearce, M. G., Brenner, Z. R., & Krenzer, M. (2014). High-acuity
nursing.
Wunderink, R. G., & Waterer, G. W. (2014). Community-acquired pneumonia. New England
Journal of Medicine, 370(6), 543-551.

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