Question

What are the health needs for the follow case scenario?  

HH is a 68 yo M who has been admitted to the medical ward with community-acquired pneumonia for the past 3 days. His PMH is significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3) and azithromycin 500 mg IV qday (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a diet at this time with complaints of nausea and vomiting.

Ht: 5’8” Wt: 89 kg

Allergies: Penicillin (rash)

Answer 1

Community acquired pneumonia is defined as lower respiratory tract infection of lung parenchyma with onset in community or during the first 2 days of hospitalization

Mr.HH ,68 Years is diagnosed with community acquierd pneumonia,who has significant history of COPD,hypertension,hyperlipidemia and diabetes and is on antibiotics .

On assessment ,patients general condition is improved ,he can able ti breath normally without any difficulties,but can not tolerate with oral diet,because of nausea and vomiting.

health needs;

1.Nutrition - If oral intake can not be maintained intravenous administration of fluids and electrolytes necessary.if oral intake tolerated small and fequent meals are better tolerated

Diet plan should be according to the health status(BMI) of  patient. here patient is diabetic and hyperlipidemic.

weight loss often occurs in patents with pneumonia because of increased metabolic need and,difficulty in eating due to nausea/vomiting or pleuritic pain.

2. Drug therapy - The main problems with the use of antibiotics in pneumonia are the development of multi drug resistant organisms and patient's hypersensitivity or allergic reaction to certain antibiotics .Mr.HH is allergic to penicillin.

When using empiric therapy it is important to recognize the non responding patient.Therapy may require modification based on the patients sputum culture response or clinical response

3.Pneumococcal vaccine-pneumococcal vaccine is indicated primarily for the individual considered at risk ,1) who has chronic illness,such as lung and heart disease such as diabetic mellitus,2) recovering from severe illness 3) 65 years or older or4)IS In long term care facility

mr. HH has known casw of COPD,diabetes ,hypertention ,and pneumococcal vaccine is indicated.

Health promotion

Teaching the patient to practice good health habits- such as

• proper diet and hygiene
• adequate rest
• regular exercise
• Avoid exposure to upper respiratory tract infection