Question

Question: Identify 3 specific nursing interventions that are relevant for a patient with community acquired pneumonia and state how and when the intervention is implemented, why the intervention is implemented and expected outcomes of the intervention.

Answer 1

Community acquired pneumonia is the pneumonia that is acquired outside the hospital. Most causative organisms for community acquired pneumonia are streptococcus pneumonia, staphylococcus and heamophilus organism

Mode of transmission: infection is transmitted by droplet methods

Main Symptoms of community acquired pneumonia

1. Cough is present as a result of accumulation of secretion

2. Fever and chills is present as a result of infection

3. Shortness of breath is present as a result of building secretions

The patient is admitted   to the hospital based on three approaches

1. identify the ability to treat the patient in community settings and based on condition and co morbidity

2. pneumonia port , severity index is calculated and decision is taken regarding treatment of the hospital

3. judgments is taken clinically to treat the patient

Medical management: the patient is commenced on antibiotic therapy mainly doxycycline and antipyretic in first line treatment. In second line treatment, patient is started on amoxicillin and clavulanate to treat patient. The patient begins to show improvement in his condition after initiation of therapy.

Low risk patient can be treated in outpatient basis and primary health center and moderate and severe community acquired pneumonia can be treated in hospital. In community, community nurse performs role as a educator and monitoring and refer the patient when the condition of the becomes serious.

Three main nursing intervention to treat the patient with community acquired pneumonia

1. educate the patient to assume semi fowler position and perform deep breathing and coughing exercises to reduce breathing difficulty and to improve airway patency

2. educate patient to consume more water and small and frequent high nutritious foods in order to reduce temperature and promote hydration and meet energy needs

3. educate to consume medication as per order and cover mouth and nose while speaking and sneezing in order to reduce spread of infection to others in his family

This intervention is implemented in the community in initial stages of community acquired pneumonia. Because the patient shows symptoms in community setting and gets medication from community service. Patient may be transferred to hospital if the symptoms are not relieved and associated with co morbidity condition and severity

Expected outcomes:

1. the patient will be relieved from breathing difficulty

2. the patient will maintain adequate fluid volume and meet energy needs

3. the patient will be get prevented from getting complications

Once the patient is hospitalized, the community nursing intervention is different from the hospital nursing intervention

In hospital, nursing intervention

1. provide semi fowler position to lower diaphragm

2. advice deep breathing exercise and deep breathing exercise in order to improve airway clearance and reduce breathing difficulty

3. administer oxygen therapy, intravenous fluids and antibiotic therapy as per order

Expected outcomes

1. the patient will be relieved from breathing difficulty

2. his airway pattern will be improved

3. he will be prevented from getting complications