It is imperative to be aware when elderly has been diagnosed with pneumonia, depending on severity it is essential to treat and prevent it. Pneumonia is inflammation in lung result by infection, bacteria, fungi, and virus, and described as lungs with fluid or pus causing cough with phlegm. There are two categories of pneumonia for elderly that will be discussed, community-associated pneumonia (CAP), and healthcare associated pneumonia (HAP). Why older people are susceptible and high risk to pneumonia and what are signs and symptoms that they should look after. Proper assessment to treat pneumonia and how to prevent it is necessary, since there is also confirmation that it lasting impact to elderly. Now, pneumonia in elderly people is the one of the leading cause of hospitalization depending on severity either mild or serious it …show more content…
can be life threatening. There are three kinds of acquired Pneumonia in elderly, first, the community-associated pneumonia (CAP), occurs outside of hospital or health care facilities that can be caused by either bacteria, fungi and viruses, second, the healthcare associated pneumonia (HAP), occurs inpatient during hospitals stay and, who live in long term care facilities that can more serious because of the bacteria or virus causing it may be more resistant since patients are already sick. Third, we have Aspiration Pneumonia that can occurs when patient inhale food, drink and other substances in the lungs. (Lawrence, P., 2017) & (Towairq, A. at al., 2018) Elderly people are more susceptible to pneumonia for several reasons. Signs and symptoms of pneumonia to look for, its as simple as similar to cold or flu but longer. Cough with phlegm, chest pain when breathing and coughing, confusion, fever, excessive sweating, chills or shiver, nausea, vomiting, diarrhea, headache, drowsiness, and shortness of breath. (“Pneumonia,” 2018). They are more likely to develop since most of them have multiple medical conditions and when symptoms arise unlike younger people they can differentiate if its more than just a cold, while older one may take longer before seeing a doctor as well as the case of elderly that is inpatient. Risk factors for elderly are due to many reasons such as age, smoking, alcoholism, hospitalization, other health care problems and weak immune system. Malnutrition and use of solid fuel heating (e.g., coal or wood burning stoves), and patients who takes acid suppressive medications are more likely to develop pneumonia. Patients with dysphagia related to stroke, dementia and poor oral hygiene are at risk, which weakens the lungs and can cause inflammation that bacteria can grow in for aspiration pneumonia. Other risk factors for aspiration pneumonia include dehydration, sputum suctioning and dementia. (Lawrence, P., 2017). Hip Fracture is also a big risk to get a pneumonia, if they are not having physical activities it can lead to complication that include pneumonia. (“Hip Fracture,” 2018). According to joint research by University of Michigan Health System in Ann Harbor, and the University of Washington School of Medicine in Washington that there are lasting effect of pneumonia in older adults health than having heart attack, based on the study if they are treated with pneumonia even once in a nine year time period even if not hospitalized are more than twice likely to progress new cognitive impairment and develop depression. (Lawrence, P., 2017). Iwashyna’s (2013) American Journal Medicine Pneumonia is clearly not only an acute life-threatening event, but also a profoundly life-altering event. The potential substantially substantial chronic care needs and diminished quality of life for survivors are comparable to effects of heart disease, yet we invent far fewer resources to pneumonia prevention. It is frequent diagnosis of pneumonia to patient aging 65 years of age and older with healthcare problem and weakened immune system.
However, once diagnosed doctors assess and provide treatment depending on severity and remember even with treatment with high risk groups may experience more complications and can lead to death that’s why it is crucial to see a doctor immediately. Doctors may proceed to following test one pneumonia was suspected, some blood test, chest x-rays, pulse oximetry (measures oxygen level in your blood), and sputum(sample fluid from lungs after deep cough) test. Meanwhile, other complications like bacteria in bloodstreams; bacteria from lungs will spread the infection to other organs to potentially cause organ failure and difficulty breathing especially if having other chronic medical condition. Pneumonia may also fluid build up into the lungs and if the fluid becomes infected its required to be removed either by surgery of drained using a chest tube. Moreover, a pus in the lungs called abscess that form in cavity of the lungs that usually can be treated by antibiotic but sometimes surgery or drainage is also
needed. Treating it involves curing and preventing complications. Antibiotics, cough medicine, fever reducers and other non antibiotic therapies must have a strict adherence of prescribed medication for best outcome either outpatient or inpatient (“Pneumonia.” 2018). Furthermore assessing patient status, frequent monitor of vital signs, maintains supplemental oxygen is necessary. Provide supportive care especially HAP patients, frequent repositioning to avoid skin breakdown, fall risk, assist prescribed tracheal intubation and mechanical ventilation, assist food and water consumption. Good tips such as get plenty of rest, stay hydrated, and taking medicine as prescribed will help patients recover quickly. Above all help prevent pneumonia, get vaccinated the most preventative way for elderly, so consider receiving vaccinations for influenza and pneumococcal. (Towairq, A., 2018). Practice good hygiene to protect from infections, be sure to wash hands regularly as well as good oral hygiene, including brushing teeth after each meal or cleaning dentures daily even the for patients in mechanical ventilation. Do not smoke or be around smoke, smoking just damages lung’s natural defenses against respiratory system. Get enough sleep, exercise daily, and eat a healthy diet. (Lawrence, P., 2017).
Below will be looking into the progression of the disease and effects it will have on bill and his family, also will look into the pathophisology of COPD, nursing considerations, treatment management and the community services available to Bill so he can return home safely.
Ventilator Associated Pneumonia (VAP) is a very common hospital acquired infection, especially in pediatric intensive care units, ranking as the second most common (Foglia, Meier, & Elward, 2007). It is defined as pneumonia that develops 48 hours or more after mechanical ventilation begins. A VAP is diagnosed when new or increase infiltrate shows on chest radiograph and two or more of the following, a fever of >38.3C, leukocytosis of >12x10 9 /mL, and purulent tracheobronchial secretions (Koenig & Truwit, 2006). VAP occurs when the lower respiratory tract that is sterile is introduced microorganisms are introduced to the lower respiratory tract and parenchyma of the lung by aspiration of secretions, migration of aerodigestive tract, or by contaminated equipment or medications (Amanullah & Posner, 2013). VAP occurs in approximately 22.7% of patients who are receiving mechanical ventilation in PICUs (Tablan, Anderson, Besser, Bridges, & Hajjeh, 2004). The outcomes of VAP are not beneficial for the patient or healthcare organization. VAP adds to increase healthcare cost per episode of between $30,000 and $40,000 (Foglia et al., 2007) (Craven & Hjalmarson, 2010). This infection is also associated with increase length of stay, morbidity and high crude mortality rates of 20-50% (Foglia et al., 2007)(Craven & Hjalmarson, 2010). Currently, the PICU has implemented all of the parts of the VARI bundle except the daily discussion of readiness to extubate. The VARI bundle currently includes, head of the bed greater then or equal to 30 degrees, use oral antiseptic (chlorhexidine) each morning, mouth care every 2 hours, etc. In the PICU at children’s, the rates for VAP have decreased since the implementation of safety ro...
Ventilator-associated pneumonia (VAP) remains to be a common and potentially serious complication of ventilator care often confronted within an intensive care unit (ICU). Ventilated and intubated patients present ICU physicians, nurses, and respiratory therapists with the unique challenge to integrate evidence-informed practices surrounding the delivery of high quality care that will decrease its occurrence and frequency. Mechanical intubation negates effective cough reflexes and hampers mucociliary clearance of secretions, which cause leakage and microaspiration of virulent bacteria into the lungs. VAP is the most frequent cause of nosocomial infections and occurs within 48 hours of intubation. VAP is a major health care burden with its increased morbidity, mortality, longer ventilator days and hospital stay, and escalating health care cost.
Based on the subjective symptoms, it appears this patient has bronchitis, a type of chronic obstructive pulmonary disease, which is a respiratory disorder. The care plan will focus on intervention to prevent the disease from re-occurring and causing chronic bronchitis. Further assessment will be needed to obtain a baseline, so when the care plan is implemented, then it can be evaluated to measure positive outcome and where alteration will be need in the plan for a great outcome in the patient’s health.
The Cumulative Index to Nursing and Allied Health Literature (CINAHL) was used to find peer-reviewed articles, using query terms such as: aspiration pneumonia, ventilator, and prevention. In addition, the TWUniversal search engine was utilized to find peer-reviewed articles, with the key words: aspiration pneumonia, ventilator, and enteral.
Most patients may begin with symptoms of a runny nose, cold or sinusitis that continue to persist longer than normal upper respiratory infections and fail to respond to therapeutic measures. Even though, not all patients experience all of the symptoms, the severity of the disease is different for each patient. Other symptoms can include: arthritic joint pain, blood in urine, cough (with or without presence of blood), fever, inflammation of the ear with hearing problems, inflammation of the eye with vision problems, lack of energy, loss of appetite, nasal membrane ulcerations and crusting, night sweats, numbness of limbs, pleuritis (inflammation of the lining of the lung), rash and/or skin sores, saddle-nose deformity, weakness, fatigue, and weight
My disease is Streptococcal pneumonia or pneumonia is caused by the pathogen Streptococcus pneumoniae. Streptococcus pneumoniae is present in human’s normal flora, which normally doesn’t cause any problems or diseases. Sometimes though when the numbers get too low it can cause diseases or upper respiratory tract problems or infections (Todar, 2008-2012). Pneumonia caused by this pathogen has four stages. The first one is where the lungs fill with fluid. The second stage causes neutrophils and red blood cells to come to the area which are attracted by the pathogen. The third stage has the neutrophils stuffed into the alveoli in the lungs causing little bacteria to be left over. The fourth stage of this disease the remaining residue in the lungs are take out by the macrophages. Aside from these steps pneumonia follows, if the disease should persist further, it can get into the blood causing a systemic reaction resulting in the whole body being affected (Ballough). Some signs and symptoms of this disease are, “fever, malaise, cough, pleuritic chest pain, purulent or blood-tinged sputum” (Henry, 2013). Streptococcal pneumonia is spread through person-to-person contact through aerosol droplets affecting the respiratory tract causing it to get into the human body (Henry, 2013).
later brings up green and yellow mucus. The cough may persist to 4 to 6
...ering to medication antibiotics which fight off infections, bronchodialators used to decrease dyspnea relieve broncho spasms , and pulmonary rehabilitation help betters their condition. The nurse expects the patient to be able to perform suitable activities without complication, avoid irritants that can worsen the disease (contaminated air) and reduce pulmonary infection by abiding to medications.
Hospital-acquired infections (HAI) are preventable and pose a threat to hospitals and patients; increasing the cost, nominally and physically, for both. Pneumonia makes up approximately 15% of all HAI and is the leading cause of nosocomial deaths. Pneumonia is most frequently caused by bacterial microorganisms reaching the lungs by way of aspiration, inhalation or the hematogenous spread of a primary infection. There are two categories of Hospital-Acquired Pneumonia (HAP); Health-Care Associated Pneumonia (HCAP) and Ventilator-associated pneumonia (VAP).
Streptococcus pneumoniae is a Gram-positive and fast-growing bacteria which inhabit upper respiratory tract in humans. Moreover, it is an aerotolerant anaerobe and usually causes respiratory diseases including pneumonia, otitis media, meningitis, peritonitis, paranasal sinusitis, septic arthritis, and osteomyelitis (Todar, 2003). According to Tettelin et al., more than 3 million of children die from meningitis or pneumonia worldwide (2001). S.pneumoniae has an enzyme known as autolysin that is responsible for disintegration and disruption of epithelial cells. Furthermore, S.pneumoniae has many essential virulence factors like capsule which is made up of polysaccharides that avoids complement C3b opsonization of cells by phagocytes. Many vaccines contain different capsular antigens which were isolated from various strains (Todar, 2003). There are plenty of S.pneumoniae strains that developed resistance to most popular antibiotics like macrolides, fluoroquinolones, and penicillin since 1990 (Tettelin et al., 2001). Antibiotic resistance was developed by the gene mutation and selection processes that, as a consequence, lead to the formation of penicillin-binding proteins, etc. (Todar, 2003).
Klesbiella pneumonia is omnipresent in nature meaning it has two common habitats, one being the environment, where they are found in water, sewage, soil and on plants and the other being the mucosal surfaces of mammals such as humans, horses, or pigs, where they colonize. [2] In humans, however Klebsiella is present in the nasopharynx and in the intestinal tract where it resides living off of growing and decaying matter. [2]. The detection rate of Klebsiella bacteria in stool samples ranges from 5 to 38%, while rates in the nasopharynx can range from 1 to 6%.[8][9] Because gram-negative bacteria growth conditions are limited on the human skin Klebsiella are rarely found there and are considered as transient members of the human flora.[1] These carrier rates change drastically in the hospital environment, where colonization rates increase in direct
My patient is male, age 49 and was admitted because of pneumonia. Pneumonia is an infection that inflames the air sacs in one or both lungs (Ross - Kerr, 2014).
Pneumonia can also become a hospital acquired infection. Ventilator-associated pneumonia is a type of lung infection that occurs in a person who has been on a ventilator.... ... middle of paper ... ...
Nursing Diagnosis I for Patient R.M. is ineffective airway clearance related to retained secretions. This is evidenced by a weak unproductive cough and by both objective and subjective data. Objective data includes diagnosis of pneumonia, functional decline, and dyspnea. Subjective data include the patient’s complaints of feeling short of breath, even with assistance with basic ADLs. This is a crucial nursing diagnosis as pneumonia is a serious condition that is the eighth leading cause of death in the United States and the number one cause of death from infectious diseases (Lemon, & Burke, 2011). It is vital to keep the airway clear of the mucus that may be produced from the inflammatory response of pneumonia. This care plan is increasingly important because of R.M.'s state of functional decline; he is unable to perform ADL and to elicit a strong cough by himself due to his slouched posture. Respiratory infections and in this case, pneumonia, will further impair the airway (Lemon, & Burke, 2011). Because of the combination of pneumonia and R.M's other diagnoses of lifelong asthma, it is imperative that the nursing care plan of ineffective airway clearance be carried out. The first goal of this care plan was to have the patient breathe deeply and cough to remove secretions. It is important that the nurse help the patient deep breathe in an upright position; this is the best position for chest expansion, which promotes expansion and ventilation of all lung fields (Sparks and Taylor, 2011). It is also important the nurse teach the patient an easily performed cough technique and help mobilize the patient with ADL's. This helps the patient learn to cough and clear their airways without fatigue (Sparks a...