Integrated Nursing Case Study Help – Pneumonia

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1. Introduction:

When the lungs get a serious infection, it is called Pneumonia and in this Nursing Case Study Help shows the treatment of Pneumonia is done based on the antibiotic medications. Pneumonia becomes life threatening for some cases when the patient of Pneumonia is in a poor health condition or a person is an old-age person (Hohenthal, Vainionpaa & Meurman, 2009).

Nursing Case Study Help, Dudley Dawes is the patient with more than 70 years of age. He got a femur injury in his right neck during bowling. And for that he had a Right Total Hip Replacement (THR) and he is now in the hospital for recovery. For past 2 days he has a productive cough, fever, night chills, shortness of breath and difficulty in breathing. This Nursing Case Study Help will find the recovery solution of this patient.

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2. Aetiology of Pneumonia:

Aetiology of Pneumonia is associated with the infectious agents that are the common cause of Pneumonia. From the breathing of the infectious agents such as viruses, bacteria and other germs, Nursing Case Study Help Shows the disease of Pneumonia can be occurred. For the healthy people, the small number of infectious viruses, bacteria and other germs cannot create Pneumonia. According to Cunha (2010), generally for the people those have poor health, the germs and bacteria of Pneumonia get trapped in the sputum of the people and then it gradually kills the immune system of the people. For most chronic cases, the germ, bacteria and viruses get multiplied and these multiplied viruses help to create severe infection in the lungs of the patient.

The bacteria, viruses and other germs that cause Pneumonia can be more powerful in the body of those people those are already in a poor health status. For the old and frill people it can be severe some times. For the people those have already diseases in their chest or those people those have low immunity power, Pneumonia attacks them more easily than the young and healthy people (Miyashita, Shimizu & Ouchi, 2009). Low level of immunity power can be generated from in taking the alcohol, other serious diseases and AIDS. Though there is the minimum chance for the healthy and young people to get Pneumonia or life-threatening positions, sometime they also get the serious Pneumonia. 

3. Three Most Common Symptoms of Pneumonia and the Underlying Pathophysiology:

The symptoms of Pneumonia can be developed suddenly within a human body either within very short time of 24-48 hours or it can take more time, sometimes over many days (www.bbc.co.uk, 2014).

The most common three symptoms of Pneumonia are –

  • The patient can have cough with dry and thick mucus. The colour of the mucus can be yellow or, green or, blood-stained or, brownish.
  • The patient can feel difficulty in breathing. The breathing of the patient can be thin and rapid. Sometimes the patient may feel breathless while taking rest also.
  • The patient having Pneumonia may have high fever with night chills. Dudley in this Nursing Case Study Help is having all these symptoms.

Pneumonia is basically the infection in the tissue of the lungs of a human resource management body. Pneumonia is much more serious disease compared to Bronchitis. Tacconelli, De Angelis & Cataldo (2009) stated that the germs of Pneumonia after attacking the human body, it creates irritation in the lung tissues of the human body. From this irritation in the lung tissue, the inflammation occurs. It encourages the fever and it also helps to build up white cells in the blood of the affected body. It generates mucus in the lungs and it causes difficulties in the breathing system of the patient. In this position, the lungs of the body try harder to transfer the oxygen and remove carbon-dioxide from the blood stream and also remove the harmful waste product from the blood. When Pneumonia occurs, then the body cells of the human body cannot get enough oxygen and the portion of carbon-dioxide increases in the affected human body (www.patient.co.uk, 2014).

4. Assessment and Diagnosis of Pneumonia:

The doctors make proper diagnosis for identify the Pneumonia by asking several questions to the patient about the symptoms they are having. When a doctor suspects that the patient is having Pneumonia, then the doctor will first check the chest of the patient to understand the heart rate. The faster heart rate is the symptom of Pneumonia. Then the doctor will check that the patient is having fever or not. The body temperature should be high in the case of Pneumonia. Then the doctor will check that there are any difficulties in the breathing or fast breathing or shallow breathing is present in the patient’s breathing system. Fast and shallow breathing and difficulties in breathing is a very common symptom of Pneumonia (apps.who.int, 2014).

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The doctor will check that the patient is having any chest pain or not and then he will check the oxygen level in the blood cells of the patient. The doctor will also listen to the chest of the patient to check that there is any crackling or bubbling rates that is generated by the movements of the fluid in the air sacs within the lungs of the patient (Ott, Allewelt & Lorenz, 2009). The doctor will search for the sounds created by the rasping of inflamed lungs tissues on the lungs lining. If Pneumonia is present, then a dull sound should be heard when the chest is tapped by the doctor. It helps the doctor to understand that is there any fluid is present in the lungs and if it collapsed any part of the lungs.

5. Alteration in Physiology Associated with Pneumonia:

Pneumonia is caused by the inflammation in the lungs tissue of a human body. This disease can be sometimes hard to identify and it can cause threatening to the life of the patient of Pneumonia. It may be very effective to the older people and the very young people generally those are having a poor health condition (www.nhs.uk, 2014).

Generally the job of the lungs in the human body to filter the germs from the air a human breaths and it helps to prevent the bacterial infections to the lungs. Pneumonia occurs when the bacteria or germs of this disease become successful to reach the lungs of the human body and create infection. From the lungs the infection may spread in the other organs of the human body. The immunity power of a healthy young person helps them to fight against this infection (www.webmd.com, 2014).

As the germ of Pneumonia attacks the human body, then the white blood corpuscles of human body fights back. For the body’s normal reaction to infection, the inflammation starts in the affected part. There are small airs sacs are present at the end of the breathing tubes within the lungs through that the oxygen moves into the blood, the alveoli. Roberts, Macfarlane & George (2009) stated that when these become infected by the germs of Pneumonia, then they become filled up with the fluid. Due to the infection, less oxygen can be distributed in the blood levels and also there is less removal of carbon dioxide. It generates breathing problems with short breath.

6. Goal of Treatment and the Pharmacological and non-pharmacological Treatment Available by Dudley:

Pharmacological Treatment – Within the pharmacological treatment the medicines are included. The doctor prescribes some antibiotics to cope up the effect of Pneumonia. For Dudley, the doctor may prescribe him Penicillin. It is an antibiotic that helps to break the wall of the bacterial cells. It enters into the bacterial cells, and then the bacterial cells start to crumble. Then the water enters into the bacterial cell and the cell wall bursts (Naik, Ricketts & Harrison, 2009). The doctor may prescribe Dudley the penicillin such as Amoxicillin or Ampicillin. The macrolides like Azithromycin or Erythromycin may also be prescribed to Dudley.

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Non-pharmacological Treatment – It is the treatment that can take place without any medications. It is the basic treatment that may be performed at home with some precautions. As from the Nursing Case Study Help it can be understood that the patient Dudley is a heavy smoker those consumes 10 cigarettes per day. But, cigarettes smoking help to increase the level of infection in the lungs that is caused by Pneumonia. The doctor may prescribe Dudley to stop the smoking for next 3 months that will help to decrease the lungs infection (www.ispad.org, 2014).

Dudley is type II diabetes patient and for that reason the medicines will not work normally in his body (Gottlieb, 2009). As Dudley stays alone and does all the house holding jobs, he should avoid the jobs that are related to water. Dudley should take help from his relatives or friends to perform his jobs. Dudley also takes 1-2 glasses of beers per day. Now, he should avoid the ice in his beer glasses for next 3 months.

7. Short-term (Acute) and Long-term (Chronic) Complications of Pneumonia:

Short-term (Acute) Complications – In the short-term or acute complications of Pneumonia occurs when it is not more than 6 weeks old. In this stage, the patient can get cure only by taking the proper medications. In this stage, the complications are-

  • High fever with night chilling that already is a symptom of the patient Dudley in this case studies.
  • The patient can feel difficulty in breathing as the viruses and germs of Pneumonia creates barrier to mobilize oxygen in the blood through the lungs and at the same time it reduces the removal of carbon-dioxide from the blood (Kuikka et al. 2009). Dudley also is facing this problem.
  • Cough that coloured in yellow, brown, green or blood coated can be a symptom of Pneumonia that is also felt by Dudley.
  • It can cause the respiratory system failure and failure to the other organs through septicaemia.

Long-term (Chronic) Complications – Long-term or chronic complications of Pneumonia can be created if the disease is not treated in its early stage. If the Pneumonia become more than 6 weeks old, then it can be difficult to cure. If the pneumonia is not treated in its earlier stages, then the decreased levels of oxygen within the affected body of the patient can be life-threatening (Ott, Allewelt & Lorenz, 2009). When the needed oxygen does not reach the tissues of brain and heart, then the patient may get into coma, failure of the function of heart and often deaths may happen to the patient.

More critical symptoms can be created from the bacterial Pneumonia. Life-threatening Pneumonia can be generated from the viral Pneumonia through severe inflammation in lungs by the secondary bacterial infection.

7.1 Initial Treatment for Dudley:

For the initial treatment, the doctor prescribe antibiotic to Dudley. The penicillin may prescribe to Dudley. It will help to burst the bacterial cells of the pneumonia creating bacteria. The penicillin can be Amoxicillin or Ampicillin. Penicillin will help to destroy the bacteria creating Pneumonia. If the first antibiotic does not work then the doctor will prescribe the next medicine. The doctor will also prescribe macrolides like Erythromycin or Azithromycin to Dudley. It will help to decrease the infection took place due to the entry of the bacteria of Pneumonia.

8. Three Lifestyles Modifications for Dudley to Prevent Complications:

The patient Dudley is a single person those are aged also. He stays alone and performs all the household tasks by his own including cooking and washing. All those works are related to water. The patient should avoid the usage of water for at least next 3 months.  It will help to decrease the creation of common cold that will help to decrease the level of infection of Pneumonia. Dudley should avoid the air conditioner also as the cold comes from the air conditioner can increase the cough and cold of the patient.

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Dudley is a heavy smoker those smokes 10 cigarettes per day that helps to increase the infection in the lungs. So, Dudley should also avoid smoking for the next 3 months or till his infection removes. The patient should also avoid consuming chill beer with ice as it also can increase the cough and cold of Dudley.

9. Conclusion:

Pneumonia is a disease that can be created from the infection in the lungs tissue of the human body. In this Nursing Case Study Help, Dudley has all the symptoms of Pneumonia such as high fever with night chills, productive cough and difficulty in breathing. His respiratory rate is low and the temperature is high. The doctor should prescribe him the required antibiotics. But, he also types II diabetes patient so the antibiotics will be less effective to Dudley.

Some lifestyle should be changed for Dudley. He should avoid the smoking, drinking chill bears, performing the house hold tasks related to water such as cooking, gardening, washing etc. He should also avoid the air conditioner as these can increase his lungs infections due to Pneumonia.