Pneumonia Care Plan
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Mrs. Davenport is a 76-year-old female who lives in an assisted living facility who developed a productive cough three days prior to coming to the Emergency Department. Her sputum is thick yellow, and blood tinged. She has a fever and an overall general feeling of fatigue. Mrs. Davenport also complains of pain in her chest that is worse with inspiration. Mrs. Davenport recently stopped smoking and has 35-year pack history.
Vital signs: blood pressure 140/80, heart rate 116, respirations 22 and labored, temperature 101.2 degrees Fahrenheit, and oxygen saturation 85 percent.
Auscultation reveals anterior bilateral diminished breath sounds, posterior rhonchi and inspiratory crackles. Clubbing is noted on the fingertips.
WBC 18,000/mm3; neutrophils 70%, bands 12%, lymphocytes 12%.
COURSE OF ILLNESS:
PA and Lateral chest x-ray reveal bilateral lower infiltrates.
Answer the following questions:
1.Identify problems from the history.
2. Explain the significance of physical findings.
3. Review lab and diagnostic testing. How do the results support the pneumonia diagnosis?
4. What is the difference between hospital acquired and community acquired pneumonia? Which type of pneumonia does your patient have?
5. What organisms are likely to be causing the pneumonia?
6. List the various factors, or conditions which predispose Mrs. Davenport to developing pneumonia?
7. Explain the pathogenesis of pneumococcal pneumonia?
8. Are there any disadvantages to obtaining a sputum culture and examination of sputum?
9. What antimicrobial agents would you expect the physician to prescribe for this patient? What is the duration of treatment? When might the patient convert from IV to oral antibiotics?
10. What are some potential complications of Pneumococcal pneumonia?
11. Is prevention of pneumonia possible?
12. Choose 1 NANDA for Mrs. Davenport and list your top 3 interventions with rationale.