Question

1. What is pneumonia?
2. What nursing interventions would you initiate for a patient with pneumonia?
3. How would this impact their daily living?
4. List some focus points for patient teaching.
5. List 5 things for this patient that you would want to know in morning report.

Answer 1

PNEUMONIA

WHAT IS PNEUMONIA ?

Pneuminia is an inflammatory process in lung parenchyma ususlly associated with a marked increase in interstitial and alveolar fluid.

NURSING INTERVENTIONS

1. Assessment of the patient

• History collection, eg: contact with other clients experiencing similar manifestations
• Respiratory assessment every 4 hours eg: determination of the rate and character of respiration,auscultation of breath sounds, assessment of skin and nailbeds to determine severity of hypoxia
• Transcutaneous oxygen level analysis or ABG analysis

2.Maintain oxygen saturation above 92%

• Monitor oral mucus membrane
• Assess the nares for signs of drying from oxygen use
• Assess the skin underneath the oxygen tubing for the signs of pressure ulcer

3. Maintain clear airway

• Increase fluid intake
• teach effective coughing and breathing techniques
• Encourage clint to use their spirometer every 2 hours while awake
• Administer bronchodialator medications if prescribed
• Suctioning of airway if indicated

4. Maintain adequate breathing pattern

• Positioning of the client, eg: raise the head-end of bed to 45 degree
• Teach the client to splint chestwall with a pillow during coughing and the use of incentive spirometry
• Administer prescribed cough suppresents and analgesics

IMPACT ON DAILY LIVING

Patient have decreases oxygen level to meet their metabolic needs and there is decreased activity level

• Assess the client's baseline activity level and response to activity
• Assess the changes in respiratory and pulse rate, marked dyspnoea, fatigue , pallor or cyanosis and dysrhythmias
• Schedule activities after treatment or medication

Psychological support

• Patient have many doubts and may leads to poor mental status. Their daily activities may worsen as a result of repeated nursing activities. Provide psychological support and a quiet environment to reduce and promote rest. Gradually increase activities on the basis of tolerance

PATIENT TEACHING

1. Moisten the mouth and lips before meals
2. Avoid smoking,temperature extremes,and stress
3. pursed-lip and diaphragmatic breathing
4. nutritional requirements
5. Activities that are tiring should be interspersed with rest
6. Use of incentive spirometry
7. Use of pillow as a splint during coughing

MORNING REPORTS

1. Temperature,pulse,respiration and blood pressure
2. ABG values
3. Complete blood count and Sputum examination reports
4. Oxygen demand of patient
5. Physician's orders