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INTRODUCTION
This is a case of a 74 year old woman who was diagnosed with
Community Acquired Pneumonia.
Pneumococcus can affect more than the lungs. The bacteria can also cause
serious infections of the covering of the brain (meningitis), the bloodstream, and
other parts of the body.
Sex: Female
General Data:
Time Assessed:
Vital Signs:
Temperature: 35.7 C
General appearance:
Streptococcus Pneumoniae
Productive/non-productive
FEVER
Overwhelming sepsis
DEATH
VIII. Diagnostic Exam
Hematology Result:
Hct: 0.29 Normal: 0.37-0.47
Segmenters: 0.87
Lymphocytes: 0.13
Urinalysis:
Color: Light Yellow
Protein: +1
Glucose: negative
RBC: 2-3/hpf
Pharmacokinetics:
Metabolism: Hepatic; half life 80-120min.
Distribution: Crosses Placenta; enters breast milk
Excretion: Urine
Indications:
Replacement therapy in adrenal cortical insufficiency
Hypercalcemia; associated with cancer
Short term inflammatory disorders
Contraindications:
Infections, especially tuberculosis, fungal infections, amoebiasis,
hepatitis B, liver disease, liver cirrhosis, active or latent peptic ulcer.
Adverse Reaction:
Vertigo, headache, hypotension, shock, thin, fragile skin, petechiae,
amenorrhea, muscle weakness.
Nursing Considerations:
1. Give daily before 9AM to mimic normal peak diurnal corticosteroid
levels and minimize HPA suppression.
Dosage:
Pharmacokinetics:
Metabolism: Hepatic; half life 6.25 hr
Excretion: Urine (30%)
Indications:
Mucolytic Adjuvant therapy for abnormal, viscid, or inspissated mucus
secretion in acute and chronic bronchopulmonary disease
(pneumonia,asthma,TB).
Contraindications:
Contraindicated with hypersensitivity to acetylcysteine; use caution
and discontinue if bronchospasm occurs.
Adverse Reaction:
Nausea, rhinorrhea, bronchospasm especially in asthmatics,
stomatitis,and urticaria.
Nursing Considerations:
1. dilute with normal saline solution or sterile water for injection.
REASON
Subjective: Ineffective Increased Short term Independent: Goal half
airway mucus goal: met.
“nagrereklamo clearance production is 1.Assessed 1.Tachypnea,
nga yang si related to often caused After 3-4 hours rate/depth of shallow After 4 hours of
nanay na increase by an of intervention, respiration and respiration are nursing
nahihirapan mucus underlying patient will chest movement. usually intervention,
siya huminga, production illness. If expectorate present. patient
dami din kasi mucus is the secretions expectorated
plema eh” as effectively and 2.Lowers
most prevalent 2.Elevated head diaphragm, secretion and
verbalized by symptom, it is RR will of bed and RR decreased
relative. decrease from promoting
usually caused changed position chest from 26/min to
by something 26 to normal frequently. 22/min.
Objective: range of 16- expansion,
simple like mobilization
*RR- 26 allergies or the 20/min.
and
common cold. expectoration
Other illnesses of secretion.
that result in Long term
*Dyspnea excessive goal:
mucus
*(+)non- production After 3 days of
productive include intervention,
cough pneumonia, flu patient will
and bronchitis maintain 3.Deep
*Use of patent airway
accessory breathing
as evidenced 3.Assisted facilitates
muscle by normal RR. patient with maximum
frequent deep expansion of
breathing the lungs and
exercises. smaller
airways.
4.Fluids aid in
mobilization
4. Encouraged and
increase in fluid expectorations
intake. of secretions
Collaborative: 5.Aids in
mobilization of
5.Administered secretion.
mucolytics as
indicated.
(Fluimucil)
6.Fluids are
required to
6.Provided replace
supplemental insensible loss
fluids. and aids in
(IVF: PNSS) mobilization of
secretions.
7.Follows
progress and
effects of
7.Monitored
disease
chest Xray, ABG
process.
and pulse
oximetry results.