Question

Barbara Smith, a 77-year-old female client with a history of chronic obstructive pulmonary disease (COPD) and lung cancer, still smokes occasionally and is admitted to the hospital with bilateral pneumonia in the lower lobes. She stated that she watches her two grandchildren ages 5 and 7 years in her home before and after school. She stated that both had recently had some sort of upper respiratory infection with fever, coughing, and sneezing. She attends a large church regularly that has a meet and greets time when everyone shakes hands with each other. She reported that several church members have been sick with the flu recently. The nurse is concerned when reviewing the electronic medical record that the client has no records of receiving immunizations for pneumococcal pneumonia or influenza. All other immunizations are up-to-date.

1. Ms. Smith has pneumonia. What in this case study makes her at risk for pneumonia? List and explain at least 4 risks specific to this case.

2. What are the nursing interventions used to treat a client with pneumonia? Please include at least 4 nursing interventions. DO NOT DISCUSS MEDICATIONS.

a. For each nursing intervention listed, explain why it is appropriate for Ms. Smith.

3. What is the guideline Ms. Smith should follow regarding getting immunized for flu and pneumonia?

a. Should she be vaccinated? Provide a rationale for your answer.

4. What lifestyle changes should Ms. Smith make to reduce her risk for pneumonia and to manage her COPD? Provide at least 3 lifestyle changes. Also, provide a rationale for the suggested

Answer 1

1.risk factors

. Chronic obstructive pulmonary disease

Patients with COPD have an already weakened airway and immune system.

COPD patient will have Chronic bronchitis ,presence of bacteria in airway and persistent mucus production , which leads to inflammation, resulting in pneumonia.

. Smoking

It increases the risk 3 times.

Morover it is a prominent risk factor in patients with copd.

. Older age

They have an immune system works less well.

While exposing the bacteria the catch pneumonia very easily

. Exposure to children and other people with flu

. Pneumococcal polysaccharide vaccine or PPV23 is not taken

As the immune system is weak, elderly people should get vaccinated at the age of 65.

2.nursing interventions

. Assess cough effectiveness and productivity

. Check for abnormal breath sounds such as wheezing and crackles.

. Elevate head end of the bed

. Frequently change position

. Teach and ecourage to do deep breathing exercises

. Suction if it is necessary

. Instruct to improve fluid intake, provide only warm water.

. Postural drainage

. Incentive spirometry

. Steam inhalation

. Supply oxygen if needed

. Educate regarding the lifestyle

3.why

. Health education on lifestyle and immunization help the patient to limit and gradually stop smoking which reduces the further complication and recurrence of pneumonia.

.incentive spirometry Improves deep breething and prevents atlectasis.

. Elevating head end aid in easy breathing

. Improved fluid intake helps to soften the thick secretions which becomes easier to cough out.

. Deep breething helps in lung expansion, improves the productivity of cough

. Suction stimulates cough and clears airway