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Pneumonia in older adults case study
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When a nurse is taking care of a patient with a pulmonary embolism or pulmonary edema, there is a very good chance that they are assisting an elderly patient. It is difficult however to determine the severity of these problems in some cases. If a patient is experiencing a pulmonary embolism, and are elderly, then they may not present with common symptoms (Sen et al., 2010). Elderly patients will tend to present with an increased heart rate, while chest pain may not be present (Sen et al., 2010). There may also be a case where in an elderly patient, they may present with delusions or confusion (Soysal & Isik, 2014). This type of presentation may not appear in a younger patient. Depending on the situation, there is the potential for thrombolytic …show more content…
It is found that in the persons of the age of 80, one of the most common causes of death is cardiogenic pulmonary edema (Bonomo et al., 2008). This disease in the elderly is presented with dyspnea and chest pain, as well as decreased stats. It is common for certain symptoms to overlap with other diseases, therefore careful consideration needs to be done to insure accurate diagnosis. An initial sign that there is something wrong with pulmonary function is the presence of decreased ease of respiration, which will be viewed by strained inspirations (Bonomo et al., 2008). There may be obvious signs of edema elsewhere that may signal to get imaging for pulmonary edema (Bonomo et al., 2008). It is important to note that the presence of pulmonary edema may yield the presence of a pleural effusion due to the relatedness of these two diseases (Bonomo et al., 2008). Pulmonary edema will have generally a rapid, acute onset with rapid painful breathing (Bonomo et al., 2008). In this case quick diagnosis and management of pain while providing supplemental oxygen is key. As a nurse it is important to inform the patient as well as family if allowed, to provide for optimal
The risk factors that Jessica presented with are a history that is positive for smoking, bronchitis and living in a large urban area with decreased air quality. The symptoms that suggest a pulmonary disorder include a productive cough with discolored sputum, elevated respiratory rate, use of the accessory respiratory muscles during quite breathing, exertional dyspnea, tachycardia and pedal edema. The discolored sputum is indicative of a respiratory infection. The changes in respiratory rate, use of respiratory muscles and exertional dyspnea indicate a pulmonary disorder since there is an increased amount of work required for normal breathing. Tachycardia may arise due to the lack of oxygenated blood available to the tissue stimulating an increase in heart rate. The pedal edema most probably results from decreased systemic blood flow.
Additionally, some of the general diagnostic and pulmonary function tests are distinct in emphysema in comparison to chronic bronchitis. In the case of R.S. the arterial blood gas (ABG) values are the following: pH=7.32, PaCO2= 60mm Hg, PaO2= 50 mm Hg, HCO3- = 80mEq/L. R.S.’s laboratory findings are indicative of chronic bronchitis, where the pH and PaO2 are decreased, whereas PaCO2 and HCO3- are increased, when compare to normal indices. Based on the arterial blood gas evaluation, the physician can deduce that the increased carbon dioxide is due to the airway obstruction displayed by the hypoventilation. Furthermore the excessive mucus production in chronic bronchitis hinders proper oxygenation leading to the hypoxia. On the other hand, in emphysema the arterial blood gas values would include a low to normal PaCO2 and only a slight decrease in PaO2 which tend to occur in the later disease stages.
Mrs. Jones, An elderly woman, presented severely short of breath. She required two rest periods in order to ambulate across the room, but refused the use of a wheel chair. She was alert and oriented, but was unable to speak in full sentences. Her skin was pale and dry. Her vital signs were as follows: Temperature 97.3°F, pulse 83, respirations 27, blood pressure 142/86, O2 saturation was 84% on room air. Auscultation of the lungs revealed crackles in the lower lobes and expiratory wheezing. Use of accessory muscles was present. She was put on 2 liters of oxygen via nasal canal. With the oxygen, her O2 saturation increased to 90%. With exertion her O2 saturation dropped to the 80's. Mrs. Jones began coughing and she produced large amounts of milky sputum.
Licensed practical nurses (LPN 's) fill an important role in modern health care practices. Their primary job duty is to provide routine care, observe patients’ health, assist doctors and registered nurses, and communicate instructions to patients regarding medication, home-based care, and preventative lifestyle changes (Hill). A Licensed Practical Nurse has various of roles that they have to manage on a day to day basis, such as being an advocate for their patients, an educator, being a counselor, a consultant, researcher, collaborator, and even a manager depending on what kind of work exactly that you do and where. It is the nursing process and critical thinking that separate the LPN from the unlicensed assistive personnel. Judgments are based
Hinkle, Janice, and Kerry Cheever. “Management of Patients with Chronic Pulmonary Disease." Textbook of Medical-Surgical Nursing, 13th Ed. Philadelphia: Lisa McAllister, 2013. 619-630. Print.
...llen S. “Dysphagia and Aspiration Pneumonia in Older Adults.” Journal of the American Academy of Nurse Practitioners 22 (2010) 17-22 *
The pleurisy is an inflammation of the pleura, which is the double layer of lining of the lungs. The most common symptom of pleurisy is an acute chest pain during respiration. The chest pain is accompanied by a high fever, cough with phlegm or blood, or difficulty breathing, you should consult a doctor immediately. The pleurisy can affect people of any age, but seniors who are over 65 are most at risk.
Once upon a time, my best friend, Bryan Martinez, often heard his mother’s medical conversations with friends. One day at school, our teacher confronted Mrs. Martinez and told her that she was able tell that Bryan was a son from a nurse. Apparently there was an incident at school where a little boy was acting out and Bryan told our teacher that the little boy was agitated, and to give him some medication to calm him down. As demonstrated by Bryan, nursing is ongoing profession that promotes the health and well-being of individuals.
“The ultimate value of life depends upon awareness and the power of contemplation rather than upon mere survival” (Aristotle, n.d.)
Nursing is a great career choice that can be very rewarding and has many benefits that come with the job. One downside to nursing is the scheduling because it runs on a shift system, it can lead to many problems. Nurses often have to work long hours, that can last sometimes more than twelve hours at a time. Working this long can lead to problems on the job, as well as health problems and trouble sleeping.
The following essay is a reflective paper on an event that I encountered as a student nurse during my first clinical placement in my first year of study. The event took place in a long term facility. This reflection is about the patient whom I will call Mrs. D. to protect her confidentiality. Throughout this essay I will be using LEARN model of reflection. I have decided to reflect on the event described in this essay since I believe that it highlights the need for nurses to have effective vital signs ‘assessment skills especially when treating older patients with complex medical diagnoses.
A 89 year old female with past medical history of hypertension presented with shortness of breath for four days. She recently had ERCP with sphincterotomy and stent placement
Two ideologies that exist in ethics and apply to decision-making are utilitarian and deontological viewpoints. Ethical theories provide a systematic approach to decision-making toward the applications of standard principles. “In utilitarian ethics, outcomes justify the means or ways to achieve it” (Mandal, Ponnambath, & Parija, 2016, p. 5). Decisions made considering utility are based benefitting the greatest number of people. In utilitarianism, outcomes determine the moral nature of interventions. Some people are to experience harm, but the overall outcome is good for most individuals. Applying utilitarianism personally or professionally seems relevant when considering its ideology maximizes happiness and minimizes suffering. Utilitarianism
Saying that you are a registered nurse is a broad statement. Registered nursing is a job that has many aspects. Registered nurses work in many different settings and they carry out many different routines. As a registered nurse you could be exposed to many different opportunities. My goal is to be a registered nurse but, I need to learn a lot. Becoming a being a registered nurse requires a lot of hard work and effort but, if I focus on my goal I will be able to achieve it.
My concept of nursing revolves around simply one word: compassion. By being sensitive to others’ needs and recognizing their situational plight, nursing provides the essential compassion required for patient care. Throughout all the specialties in healthcare, “the nurse” is recognized as the ultimate caregiver above all others due to the inordinate supply of compassion that is incumbent upon the profession. From a patient’s perspective, compassion can be perceived in various forms; such as when a nurse warms a stethoscope before applying it to bare skin, or when a friendly smile and soothing words can ease a patient’s trepidation. It is these acts of compassion that embody the concept of nursing.