Community Acquired Pneumonia Case Study

| This is important because we need to look at the relevant data and realize that she seems to be in distress and first take care of that. Also realize that she seems to have an infection. With this information we are able to prioritize

Pneumonia is classified according to the organism causing the infection and where the infection was acquired. Community-acquired pneumonia is contracted by individuals with minimal contact with health care facilities – such as a hospital, nursing home, or rehabilitation facility – and contract the infection by people in the wider community (MedlinePlus, 2016). Hospital-acquired pneumonia and ventilator assisted pneumonia, can be caused by a wide variety of bacteria and other organisms that can originate from the health care environment (Oxford Journals, 2016). Pneumonia that develops whilst an individual is in hospital, can be extremely severe and is more likely to be fatal. This is due to the fact, that individuals within a health care setting, often already have a serious illness, causing a weakened immune system. Also, the types of bacteria present in hospitals, are often more dangerous and resistant to treatment – then the bacteria found in the outside community (MedlinePlus, 2016). Aspiration pneumonia – or anaerobic pneumonia - results after the inhalation of a foreign matter into the lungs. If foods, liquids, saliva, or vomit make their way into the airways or lungs, instead of the oesophagus and stomach, it can cause aspiration pneumonia. It is more likely in individuals with a disturbed gag reflex – commonly due to having a brain injury or being under the influence of drugs or anaesthetics (MedlinePlus,

As such, the diagnosis and management of AOM has a significant impact on the health of children, cost of providing care, and overall use of antibacterial agents (AAFP, 2004). Watchful waiting can have many benefits for the children and the provider if used properly. Diagnosing AOM can be tricky. The signs and symptoms can also be related to other illnesses such as an upper respiratory virus. Throwing antibiotics at any illness use to be the course of action. However, now that there is evidence that bacteria have become resistant to some antibiotics, clinicians are testing out other means of treating illnesses. If the child presenting with symptoms of AOM has no underlying conditions and has means to follow up with the doctor if the symptoms progress, watchful waiting is an appropriate approach for treating the child. According to the research, placebo controlled trials have shown that children have responded well without antibacterial intervention. Giving the opportunity for the illness to resolve without antibacterial intervention not only benefits the child but, the caregivers and the clinician. It benefits the child by not being exposed to antibiotics that are not needed, therefore creating a potential resistance to that antibiotic. It benefits the caregiver by not spending money on a medication their child does not need. Last, it benefits the clinician by preventing resistance to an antibiotic that may be useful in the near future.

This paper explores Pneumonia and the respiratory disease process associated with bacterial and viral pathogens most commonly located in the lung. The paper examines the process, symptoms and treatments most commonly viewed in patient cases of Pneumonia. My goal is to educate the reader and to warn of the

The article from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) that addresses acute otitis media (AOM) is a filtered resource. This article is appropriate for use in nursing practice as it establishes diagnosis and management guidelines for the treatment of AOM. In addition the article recommends treatment options for the symptoms of AOM and addresses the concept of watchful waiting. The is an evidence based guideline as it provides recommendations for practice and was created a systematic review and best clinical research in clinical literature. The Block article, Causative Pathogens,

When CAP occurs, it is determined if the need for hospitalisation is necessary as it depends on the seriousness of the infection. Gram- positive organisms such as S. pneumoniae, naturally occur in the upper respiratory tract, is one cause of lower respiratory infections such as pneumonia, but is also a culprit in causing upper respiratory infections like otitis media. H. influenzae is just one of many bacterial infections that can result in CAP, it therefore can be subacute and present with a low-grade fever and a persistent cough for a few weeks before a patient has a diagnosis. Adults that have very little or no immunity are an easier target for certain viruses such as that of the Cytomegalovirus, which is a viral pathogen that is commonly contracted within the community, other common virus are adenovirus and herpes simplex. When a virus starts to become acute, it starts an infection within the ciliated cells within the airway. When pneumonia occurs from this viral infection, the inflammatory action starts to seep into the alveolar areas and leads to the problem of excess exudation and oedema within the respiratory tract. It is sometimes often difficult to differentiate symptoms of a viral pneumonia from that of bacterial pneumonia (Smeltzer &

I have personally seen how fast the symptoms progressed in a 10-month old child whose symptoms started as a regular cough. Next day his body temperature went up to 104 for and kept coming back constantly for couple of days. Cough became painful and started sounding more like wheezing and child could not eat or drink anything. Two separate trips to emergency room resulted in bringing toddler’s fever down, but even with chest x-rays and physical examinations, they were unsuccessful in detecting pneumonia until 911 was called and paramedics detected low oxygen and severe dehydration. I was informed by the admitting hospital physician that without prompt fluids, oxygen and antibiotic treatments, this cold complication may result in child’s

Pneumonia is described in Tabers cyclopedia medical dictionary, “as inflammation of the lungs, usually due to an infection with bacteria, viruses, or other pathogenic organisms” (p.1833)

A health-issue known to be documented in the pre-school setting is pertussis, or better known as whooping cough (Kid Source Online, n.d.). Whooping cough, as it’s name implies, is a very communicable, infectious disease of the respiratory tract, which causes the child to make a “whooping” sound when trying to draw breath after a prolonged cough spell (Kid Source Online, n.d.). Nonetheless, not all children are known to make this said “whooping” sound while having this disease; thus, one must be aware of the general symptoms indicating whooping cough, which include, however aren't limited to, a runny nose and an extreme cough, both which gradually seem to only get worse, and perhaps can even end with the child profusely vomiting (Kid Source Online, n.d.). It is important to catch any symptoms of abnormal cold indications as soon as possible, as once the whooping stage begins, antibiotics can no longer help (Kid Source Online,

Pneumonia is an inflammation of the lung which results into an excess of fluid or pus accumulating into the alveoli of the lung. Pneumonia impairs gas exchange which leads to hypoxemia and is acquire by inhaling a contagious organism or an irritating agent. (Ignatavicius & Workman, 2013). Fungal, bacteria and viruses are the most common organisms that can be inhale. Pneumonia could be community-acquired or health care associated. Community –acquired pneumonia (CAP) occurs out of a healthcare facility while health care associated pneumonia (HAP) is acquired in a healthcare facility. HAP are more resistant to antibiotic and patients on ventilators and those receiving kidney dialysis have a higher risk factor. Infants, children and the elderly also have a higher risk of acquiring pneumonia due to their immune system inability to fight the virus. Pneumonia can also be classified as aspiration pneumonia if it arises by inhaling saliva, vomit, food or drink into the lungs. Patients with abnormal gag reflex, dysphagia, brain injury, and are abusing drug or alcohol have a higher risk of aspiration pneumonia (Mayo Clinic, 2013). In the case of patient E.O., this patient had rhonchi in the lower lobe and the upper lobe sound was coarse and diminished. Signs and symptoms of pneumonia include difficulty breathing, chest pain, wheezing, fever, headache, chills, cough, confusion, pain in muscle or

Pneumonia is an illness of the lower respiratory tract in which the lungs become inflamed and congested and alveolar spaces are filled with fluid and cells-polymorphs and lymphocytes (Mandell L.A). It is an inflammatory condition of the lung and it is one of the most serious infections, causing two million deaths annually among the young and elderly. Pneumonia is the largest killer, accounting for 28% to 34% of all child deaths below five years of age in low-income countries and is an important cause of mortality in the elderly in high-income countries (Suárez).

Mrs. A (pseudonym) is an 83-year-old Samoan female of Christian religion who was admitted to an urban hospital on 02/04/15 by GP referral. She came in with chest pain associated with productive cough and shortness of breath (SOB) on exertion. She also complained of having recurrent episodes of vomiting mixed with saliva and fatigue. She has a history of asthma, hypertension, type 2 diabetes mellitus on Metformin and double incontinence due to a long-standing history of intermittent constipation. Her chest computed tomographic (CT) revealed right lower lobe opacity indicating pulmonary consolidation, which means that her right lower lung has accumulated exudates in the alveoli that would have normally been filled by gas, indicative of bacterial pneumonia. Furthermore, a sputum gram stain sample collected from Mrs. A showed gram-positive bacteria, which is also a characteristic of pneumonia. Her blood tests revealed a high haemoglobin count, which may be caused by an underlying lung disease, as well as high white blood cell count confirming the presence of infection. Considering all diagnostic results, Mrs. A was diagnosed with right lower lobe bacterial pneumonia.

The clinical manifestations of pneumonia will be different according to the causative organism and the patient’s underlying conditions and/or comorbidities (Smeltzer, et al). Some of the manifestations are

This is a case of a 74 year old woman who was diagnosed with Community Acquired Pneumonia.

The patient's overall symptoms and lab work suggest that she is suffering from hospital acquired pneumonia. Currently the patient is presenting a moist chesty cough. Additionally, her heart rate is elevated, her oxygenation is low, and her RR is high. She has a raised white blood cell count, which indicates infection. Finally, the patient is acting confused and disoriented, which can be the direct result of a lack of oxygenation to the brain. All of these symptoms point to pneumonia (Torres, 1999).