Patient Assessment and Nursing Interventions for Severe Pneumonia
Patient assessment
Along with her husband George, 35-year-old Shaun Morely was rushed by ambulance to the Emergency Department (ED) this afternoon due to a severe cough, shortness of breath, fever, and overall weakness. Shaun was only able to speak a few words before he fainted. Four weeks ago, George stated, they both had positive results from a PCR test for the SARS-CoV-2 virus; however, Shaun has had difficulty recovering from his symptoms. George's symptoms have gotten worse over the last two days, but there was not enough room to schedule an appointment with his local physician. Shaun was evaluated and found to be cool and pale. His tongue was cracked and his lips were parched. Auscultation reveals the presence of medium and low tones. From the assessment, it has been found that the pneumonia issue has increased.
Shaun resides in an outside Sydney suburb with her spouse. He works as a barista at a nearby cafe on the weekends and is a social studies major at the moment in college. Shaun abstains from smoking and limits his alcohol use to exceptional events. Though he still takes it every day, he stopped taking it after contracting COVID-19. When he was younger, he had a pneumonia diagnosis but eventually was under control. From the current diagnosis, the issue of pneumonia has been raised for Shaun.
Disease pathophysiology and complications
Bacterial pneumonia is characterized by inflammation of the parenchyma and alveolar gaps. Numerous bacteria cause this illness, and each one interacts intricately with the immune system of the patient. Clinically, individuals may have symptoms including fever, cough, dyspnea, and chest pain in addition to consequences like meningitis, sepsis, and multiple organ failure, as well as necrotizing pneumonia and empyema. Long-term consequences on lung function and quality of life may result from it. By informing patients about long-term consequences, this initiative will increase awareness of the disease's effects on lung function and quality of life (NHLBI, 2022). A diagnosis is typically made based on the severity of the sickness and recent medical history, including surgery, colds, and travel. Your doctor can diagnose pneumonia based only on your physical examination and medical history if these factors are met. The sort of pneumonia you have will determine how it is treated. Although severe infections can be treated in a hospital, pneumonia is typically treated at home. In cases of bacterial pneumonia, antibiotics are employed. Mycoplasma pneumonia also heals quickly, though in certain circumstances it may take longer. For the majority of viral pneumonia, there is no particular treatment.
Numerous infections, such as bacteria, viruses, fungi, and parasites, can result in CAP. This exercise, however, concentrates on the causes of bacterial pneumonia. Based on where they came from, bacteria are divided into two categories: typical organisms and atypical organisms. Although unusual organisms may not exhibit these traits, they can nevertheless be recognized by gram plates or grown on a normal medium. The basement floor is constantly exposed to environmental germs and is not a clean environment. Bacterial pneumonia is caused by bacterial invasion that spreads to the lung parenchyma at the alveolar level (Gamache, 2024). The clinical manifestations of pneumonia are caused by the body's inflammatory reaction to this attack. In the lung, several host defensive mechanisms cooperate to stop the growth of microorganisms. Particularly opsonizing are mechanical barriers like mucus and nasal hair as well as chemical barriers like proteins that come from the alveolar epithelium, like surfactant proteins A and D. Toll-like recognition triggers neutrophil infiltration, which is the initial immunological response. Bacteria are taken up and destroyed by activated alveolar macrophages. However, the number of bacteria will rise if their development outpaces the host's capacity for defence.
Numerous virulent traits of pathogenic bacteria stimulate the host's immune system. Examples include the adhesion protein of M pneumoniae, the polysaccharide capsule of S pneumoniae, and the pili of Legionella pneumophila which are involved in the production of biofilms. Following bacterial invasion, alveolar macrophages trigger inflammatory responses in the host, preventing bacterial spread within the human host. The primary cause of the clinical symptoms associated with bacterial pneumonia is the host's inflammatory response. Cytokines are generated in response to the inflammatory response, which sets off a series of events that result in regulatory signalling. For example, the fever observed in bacterial pneumonia is linked to interleukin-1 (IL-1) and tumour necrosis factor (TNF). Neutrophil chemotaxis and maturation are facilitated by the chemokines interleukin-8 (IL-8) and granulocyte colony-stimulating factor (G-CSF), which lead to leukocytosis (Mayoclinic.org, 2020). An infection with Covid-19 can brought on by bacteria, viruses, or fungi is cancer. One or both of the lungs' air sacs become inflamed. Breathing becomes difficult when the alveoli, which are these sacs, fill with pus or fluid. The breathing issues is caused by bacterial and viral illnesses. Usually, inhaling airborne droplets from coughing or sneezing is how it spreads from person to person. Mild pneumonia is known as walking pneumonia.
Someone who has pneumonia may be unaware of their illness. Rather than pneumonia, its symptoms are more akin to a moderate respiratory illness. On the other hand, walking pneumonia recuperation can be protracted. Covid-19 issues can be interrelated with the pneumonic as in some cases people can also get infected due to the bacteria which can cause their immune system to get weaker. Covid-19 with pneumonia has some common respiratory distress in the airways and lungs might include cough, shortness in breathing and also chest congestion. 12.5% of severity Covid-19 pandemic can be diagnosed with the organising pneumonia (Grief & Loza, 2018).
Identify nursing issues
Breathing problems
The main symptoms of pneumonia can be coughing, sputum production and shortness of breath. If this is left untreated pneumonia might complicate health issues such as hypoxemia, respiratory failure, pleural effusion, lung abscess and bactermia. (Sattar et al., 2024). Therefore, all healthcare professionals must promote drug adherence and guarantee careful follow-up with the treating physician. It's crucial to educate patients about their condition and how to change their behaviour. Additionally, patients must be urged to adopt a healthier lifestyle and engage in outside activities (Martin-Loeches et al., 2023).
Hydration issue
One of the major issues in nursing to help the given care seeker is to encourage clients to consume more fluid. This can help to prevent dehydration but it is not an easy task to achieve. It is crucial to assess the hydration status and keep the electrolytes normal with the help of oral rehydration solutions. Another common issue in the multi-organ failure and exacerbation of prevalent comorbidities. Such potential complications of bacterial pneumonia might include lung fibrosis and destruction of lung parenchyma which can cause more nursing issues (Who. int, 2023). The main focus is on a multi-disciplinary approach which can be used to underscore the importance of collaboration among healthcare professionals in managing bacterial pneumonia. Healthcare experts might also learn about the practical methods by assessing past trends and physical assessment to understand the exposure or risk factors (Chiemelie Ebeledike et al., 2023).
Lack in awareness
The most crucial aspect of bacterial pneumonia management, despite the abundance of published guidelines, is patient education. Before patients are released from the hospital or emergency room, nurses are the final healthcare providers to see them. Furthermore, because the majority of bacterial pneumonia patients are regarded as outpatients, pharmacists interact with bacterial pneumonia patients on an equal basis (Andrew Conway Morris, 2018). Research indicates that providing patients with information about this illness and the value of compliance is critical to positive results. It is important to instruct patients on how to utilize inhalers, change their surroundings, and monitor themselves. Patients should be given access to several evidence-based bacterial pneumonia management programs that are now accessible (Stets et al., 2019). Lastly, nurses are crucial to school-based bacterial pneumonia education initiatives that raise students' self-esteem, knowledge, and self-care practices. The danger of developing bacterial pneumonia and dying from this illness remains high, even with more awareness of it. Patient adherence to medicine is a big problem, even though there are uniform recommendations for controlling the disease.
Nursing interventions
Helping with the awareness
Pneumonia patients can communicate with nurses. In addition to being a chronic condition in the patient's clinical history, bacterial pneumonia can present as a complex condition requiring continuous care and monitoring. By giving patients information on symptoms, indicators, and drugs, nurses can assist patients in managing their disease. Nursing assessments are the initial nursing activity in which the nurse gathers data related to physical, psychological, emotional, and diagnostic aspects of nursing (?Tow & Mei 2018). Being physically active is essential for overall health. For those who have Bacterial pneumonia, safe activities like yoga or walking are often advised. Patients should reduce the amount of time spent sedentary and build tolerance by switching between rest and activity intervals. Instruct patients to consider potential triggers before participating in outdoor activities. Bacterial pneumonia can be aggravated by allergens, tobacco, humidity, and cold temperatures. Children who are unable to engage in more strenuous activities, such as running or soccer, can play, create crafts, or engage in sports like golf or exercising (?Uranga et al., 2016). Since Bacterial pneumonia can aggravate infections and induce exacerbations of Bacterial pneumonia, remind patients that their pneumococcal, flu and other vaccines are current and should be administered on time.
Dealing with hydration issues
If the pneumonia of care seekers as in this case can be serious it might be treated in a care facility with a proper supply of antibiotics and fluids through an intravenous line which is inserted in the vein. It might also be provided with oxygen therapy to increase the quantity of oxygen in the blood. It can help to treat pneumonia which is highly serious and it may need to be put on a ventilator. Care seekers are expected to be treated with more humidified oxygen to help or loosen up the secretions as well. Awareness of conformance Daily adherence to specified long-term treatment regimens is necessary to manage and avoid flare-ups. During an attack, short-term (curative) medicines are used to ease symptoms. Give patients instructions on how to take the following drugs as directed. Encourage environmental controls: To stop recurrent attacks, environmental controls are crucial. The patient's quality of life can be significantly enhanced by avoiding or getting rid of allergies. To minimize contact with allergies, nurses should advise. Promote modifications to activities and lifestyle. To halt the disease's course and lessen the frequency of acute episodes, self-control, weight loss, quitting smoking, and reduced pollution exposure are crucial.
Dealing with breathing issues
Breathing exercises might help to assist in alveolar expansion which can be useful in the expectoration of excessive mucus and also prevent any atelectasis for the collapse of lung tissue. Several basic therapeutic nursing plans can be used to adhere to the infection prevention standards which can be used to elevate the head of the bed up to 30 or 45 degrees. It can help to prevent any type of aspiration and make sure that oral hygiene is provided to the care seekers. Finally, increasing patient mobility with ambulation nearly 3 times a day can also be required (Parul Pahal et al., 2023). The actions might also be impacted by a lack of knowledge related to the illness and its impact on pulmonary function or quality of life. This can help to recognise the potential of long-term consequences for healthcare seekers.
Long-term follow-up education: Patients should know when to call their doctor or seek emergency assistance, and they should have a Bacterial pneumonia action plan (?Pierre-Franoi et al., 2023). Request assistance from the patient in operating the high-flow meter. Make sure the patient is directed to a spirometry expert and talk to them about spirometry and any follow-up examination.
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