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A . M a t e r n a l a n d B i r t h H i s t o r y Date of birth:
July 18, 2008Birth weight: 6 lbs. (as recalled by the
mother)Type of delivery: normal deliveryCondition after birth:
normal, nocomplications afterbirthHospital: mother gave birth at
their house by a
hilot
B . M o t h e r Complications of delivery: there were no
complications asrecalled by themotherAnesthesia: no
anesthesiaExposure to teratogens: none
TreatmentI f t h e c a u s e i s b a c t e r i a l , t h e g o a
l i s t
o c u r e t h e infection with antibiotics. If the cause is
viral,antibioticsw i l l n o t b e e f f e c t i v e . I n s o m e
c a s e s ,i t i s d i f f i c u l t t o d i s t i n g u i s h b e
t w e e n v i r
a l a n d b a c t e r i a l p n e u m o n i a , s o
antibiotics
may be prescribed.Many people treated at home with antibiotics.
Ifthere isan underlying chronic disease, severe symptoms, or
lowoxygenlevels, it will likely require hospitalization
forintravenousantibiotics and oxygen therapy. Infants and the
el de rl y ar emore commonly admitted for treatment of
pneumonia.
If at home:
D r i n k p l e n t y o f f l u i d s t o h e l p l o o s e n s
e c r et i o n s a n d bring up phlegm
Get lots of rest. Have someone else do household chores
Control your fever with aspirin or acetaminophen. Donot give
aspirin to children.When in the ho spi tal , r esp ira tor y
tre at me nt s to remo vesecretions mat be necessary.
Occasionally,steroid medicationsmay be use d to re duce wh ee zi ng
if th er eis a n un derlyin g l ungdisease.
IX.LIST OF IDENTIFIED PROBLEMS
ACCORDING TO PRIORITY (P + E) A . I n e f f e c t i v e a i r w
a y c l e a r a n c e r e l a t e dt o i n c r e a s e d s p u t u
m production in response to
respiratory infectionB . I m p a i r e d g a s e x c h a n g e r
e l a t e d t o
c o l l e c t i o n o f m u c u s i n airwaysC . I n f e c t i o
n r e l a t e d t o i n v a d i n g b a c t e r i a l o r g a n i s
m s
D . D i s c o m f o r t r e l a t e d t o r e s p i r a t o r y
di s t r e s s E . H i g h r i s k f o r a l t er e d n u t r i t i
o n ( l e s s t h a n
b o d y requirements) related to lack of appetite
XIII.DISCHARGE PLAN (HEALTH TEACHINGS)
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Take the entire course of any prescribed medications.Af te r
ap a t i e n t s t e m p e r a t u r e r e t u r n s t o n o r m
a l , m e d i c a
t i o n m u s t b e c o n t i n u e d a c c o r d i n g t o t h
e d o c t o r s in st ru ct io n s , o th er wi s ethe pneumonia
may recur. Relapsescan be far more serious thanthe first
attack.
Ge t p l en ty o f r e s t . A d e q u a t e r e s t i s i m p o
r t a n t t o m a i n t a i n progresstoward full recovery and to
avoid relapse.
Dr ink l o t s o f f l u i d s , e spe c i a l l y wa te r . L i
q u i d s w i l l k e e p pat ie nt fr om becomi ng deh yd ra te
dand help loosen mucus in thelungs.
Keep all of follow-up appointments. E v e n t h o u g h t h e p
a t i e n t fe el s bet te r, hi s lu ngs ma yst il l be in fe ct
ed . It s importantto have the doctor monitor hisprogress.
Encourage the guardians to wash patients hands. T he h an ds c o
m e i n d a i l y c o n t a c t w i t h g e r m s t h a t c a n c a
u s e p n e u m o n i a . These germs enter ones
body when he touch his eyes or rub hisno se. Washin g ha nd
sthoroughly and often can help reduce therisk.
Tell guardians to avoid exposing the patient to
anenvironmentwith too much pollution (e.g. smoke). Smoking damages
oneslungsnatural defenses againstrespiratory infections.
Give supportive treatment.Pr op er die t an d oxy gen to incr ea
se oxygen in the blood when
needed.
Protect others from infection.T r y t o s t a y a w a y f r o m
a n y o n e w it h a co mp ro mi se d
immune system. When that isnt possible,
ap e r s o n c a n h e l p p r o t e c t o t h e r s b y w e a r
i n g a f a c e m a s k a n d always coughing into a tissue.
Nursing Interventions (Independent
andDependent)RationaleIndependentDocument actual weight and height.
IndependentPatientmother may be unaware of the actual height and
weightloss of his child due to estimating weightObtain nutritional
history Monitor or explore attitudestoward eating and food. Patient
Mother perception ofactual intake may differ Proper assessment
guidesinformationAdvice the mother to serve food and fluids those
are
appealing to the client. To stimulate appetite and
promoteinterest in eating.
Home Treatment
The following tips are suggested:
Drink plenty of liquids.
Do not suppress a cough. Coughing is animportant reflex for
clearing the lungs. Some
doctors advise taking expectorants, such asguaifenesin
(Breonesin, Glycotuss, Glytuss,Hytuss, Naldecon Senior EX,
Robitussin) toloosen mucus. However, there is no proof thatany of
these products make much difference ina patient's outcome.
Mild pain can be treated with aspirin (in adultsonly),
acetaminophen (Tylenol), or ibuprofen(Advil, Motrin).
For severe pain, codeine or another stronger
pain reliever may be prescribed. It should benoted, however,
that codeine and othernarcotics suppress coughing, so they should
beused with care in pneumonia. Such painrelievers often require
monitoring.
A laboratory study reported that aromatic oilscontaining
oregano, thyme, and rosewooddestroyed S. pneumoniae. It is not
knownwhether they have any effect on pneumonia inpeople.
Practice chest therapy.
Surgery:
Although most patients with pneumonia do not needinvasive
therapy, it may be necessary in patients withabscesses, empyema, or
certain other complications.
Thoracotomy
Thoracotomy is the standard surgery for pneumonia. Itrequires
general anesthesia and an incision to open thechest and view the
lungs. This procedure allows thesurgeon to remove dead or damaged
lung tissue. Insevere cases, the entire lobe of the lung is
removed.This is called a lobectomy. Remaining healthy lungtissue
re-expands after surgery to make up for tissuethat has been
removed.
Chest Tubes
Chest tubes are used to drain infected pleural fluid.Tubes are
not typically required for pneumonia orabscesses. The tubes are
inserted after the patient isgiven a local anesthetic. They remain
in place for 2 - 4days, and are removed in one quick movement.
Thiscan be very distressing, although some patientsexperience no
discomfort. Complications of chest tubesinclude:
Accidental injury to the lung
Fluid build-up within the lung if the pleural fluidis removed
too rapidly
Infection
Perforation of the diaphragm
Removing the chest tubes may cause the lung tocollapse. In this
case, a chest tube may be needed toinflate the lung
