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Pneumonia Journal Article
Kellie Hale
Mohave Community College
NUR 122
Mrs. Port
9/8/2016
“In 2012, 1.1 million people were hospitalized in the US for treatment of pneumonia. The average hospital stay for these patients was 5.2 days. There were close to 50,000 deaths due to pneumonia and 95% of them were over the age of 65 (“Pneumonia”, 2016). Pneumonia is an serious condition and the pathogens that lead to pneumonia continue to spread throughout the hospitals and communities. Antibiotic resistance is a huge problem today so prevention and early treatment is very important.
Pneumonia is lung inflammation caused by bacterial or viral infection, in which the air sac may fill up with fluid or pus. The strong internal defenses present in healthy individuals usually protect the body and lungs from these invading bacteria. But when a patient is immunocompromised they lack adequate functioning of these defense mechanisms making them more susceptible for acquiring pneumonia. Some people, such as organ transplant patients, patients taking immunosuppressant drugs, patients with NG tubes, are at increased risk. Other risk factors for pneumonia include smoking, excessive alcohol intake, inability to swallow due to stroke/neuromuscular disease, age over 65, malnourishment, hypoxia, and chronic lung diseases (“Pneumonia”, 2016).
There are several different ways that pneumonia is classified such as hospital acquired pneumonia, ventilator-associated pneumonia, and community acquired pneumonia. Hospital acquired pneumonia, HAP, is an infection that was not present at the time of admission but develops 48 hours or more afterwards. Some of the most common bacteria in this class are Pseudomonas aeruginosa, Staphylococcus aure...
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...tered if needed. The nurse will assess pulse oximetry readings, respiratory rate, and pain level. Pain will be treated with prescribed pain meds, fluids and electrolytes will be given as needed, and other meds such as bronchodilators, antibiotics, and/or antivirals will likely be prescribed. Pneumonia is very common illness but it can be fatal if not treated, so education regarding prevention and treatment is very important. Pneumococcal and influenza vaccines are available for prevention. Healthy eating and exercise are great ways to stay healthy and build a strong immune system. Proper fluid intake is very important, at least 6 to 8 glasses a day. Hand washing is the most effective way to stop the spread of infection.
References
Pneumonia. (n.d.). Retrieved September 8, 2016, from http://nursing.advanceweb.com/Continuing-Education/CE-Articles/Pneumonia.aspx
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...
However, increasing antibiotic resistance patterns among intensive care unit pathogens, cultivated by empiric-broad spectrum antibiotic regimens, characterizes the variable concerns. Recent literature point that antibiotic use before the development of VAP is associated with increased risk for potentially resistant gran-negative infections and Methcillin-resistant Staphylococcus auereus (MRSA)
...estions if not 100% sure of something or use a double checking system. When a nurse is administrating medication, they should use the ten rights of medication administration (right patient, right drug, right route, right time, right dose, right documentation, right action, right form, right response, and right to refuse). Nurses should always keep good hand hygiene and always wear appropriate clothing to prevent from the spread of disease. Good communication with patients and healthcare team members is also key to success. Keeping on the eye on the patient within an appropriate time is important. If the patient ever seems to be looking different than their usual self vitals should be taken immediately. Encouraging patients to ask questions if they are unaware of something can prevent errors as well. Nurses should make sure the patient is on the same page as they are.
With additional bodily fluid and less cilia to dispose it, patients build up an endless hack that raises sputum, a blend of bodily fluid and cell debris. Stagnant bodily fluid in the respiratory tract gives a development medium to microorganisms. This can prompt disease and bronchial aggravation, with side effects that incorporate dyspnea, hypoxia, cyanosis, slight fever, chills, and assaults of hacking (Saladin, 2010). In addition, bronchitis can cause shortness of breath, wheezing, chest pain, and tickle of the
Bacterial resistance to antibiotics has presented many problems in our society, including an increased chance of fatality due to infections that could have otherwise been treated with success. Antibiotics are used to treat bacterial infections, but overexposure to these drugs give the bacteria more opportunities to mutate, forming resistant strains. Through natural selection, those few mutated bacteria are able to survive treatments of antibiotics and then pass on their genes to other bacterial cells through lateral gene transfer (Zhaxybayeva, 2011). Once resistance builds in one patient, it is possible for the strain to be transmitted to others through improper hygiene and failure to isolate patients in hospitals.
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).
Craven , D., & Hjalmarson, K. (2010). Ventilator-associated tracheobronchitis and pneumonia: thinking outside the box. Clinical Infectious Diseases: An Official Publication Of The Infectious Diseases Society Of America , 1, p.S59-66. Retrieved from http://ehis.ebscohost.com/eds/detail?sid=44b983f2-9b91-407c-a053-fd8507d9a657@sessionmgr4002&vid=9&hid=116&bdata=JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ==
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).
In patients infected with K. pneumonia, inflammatory mechanisms can cause tissue damage that is related with a release of “alarm proteins” (Achouiti, 2012). These alarm proteins are known as the Damage Associated Molecular Patters (DAMPs) and are seen in neutrophils where they potentially affect up to 45 percent of the cytoplasmic protein (Achouiti, 2012). This is harmful because it inhibits the body’s ability to fight the infection, as neutrophils are the body’s natural immunity defense.
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).
We can infer that the pneumonia presented a sudden onset in hitherto healthy infants (otherwise neonatal staff would have no reason to suspect PVL+ strains).
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...