Nursing Assignment Acers

ND is a 82-year-old female who lives in a skilled nursing facility

ND is a 82-year-old female who lives in a skilled nursing facility

ND is a 82-year-old female who lives in a skilled nursing facility

ND is a 82-year-old female who lives in a skilled nursing facility. She suffers from rheumatoid arthritis, coronary artery disease, chronic bronchitis, and hypertension. She is wheelchair bound and tends to spend most of her days in bed. She smoked for 52 years but quit 14 years ago. She has lost 10 pounds in the last month and has had a productive cough for about 2 weeks that has copious amounts of white to yellow mucous. Over the last 3 days, she has refused to get out of bed and has been refusing to eat or drink. This morning she is confused, has a fever, and is coughing continuously. Her sputum now is rust-colored. Her lungs sounds are coarse rhonchi throughout with crackles and diminished lung sounds in her right middle lobe area. Her vital signs are BP 86/54, HR 98, RR 28, and temperature 102.4. She is being admitted to the hospital.

Pneumonia can be classified many different ways. Which classification of pneumonia best fits ND’s situation? Explain. What is the most probable cause of ND’s pneumonia? Which diagnostic tests would you expect to be done to diagnose ND’s pneumonia?

Sample Approach

ND is most likely suffering from community acquired, bacterial pneumonia. ND’s comorbidities place her at high risk for developing such pneumonia. Her age, long history of smoking, heart disease, prolonged immobility, chronic bronchitis and malnutrition are all factors predisposing to pneumonia. Given ND’s health state she is susceptible to many illnesses that may be present in the nursing facility due to her body’s inability to fight against invading organisms. (Copstead, 2014)Diagnostic studies to diagnose ND should include, a complete history and physical, chest x-ray, sputum culture, and two blood cultures. Pulse oximetry and ABGs should be obtained to monitor for hypoxemia, hypercapnia, and acidosis. A CBC with diff and routine blood chemistries should be drawn also. It is important for the nurses caring for ND to closely monitor and assess ND, facilitate lab and diagnostic test, monitor results, provide treatment and monitor her response to treatment. Prompt specimen collection and administration of antibiotics id critical in her care. She will also need oxygen therapy, bronchodilators, hydration, nutritional support, and therapeutic positioning. (Lewis, 2007)

Lewis, H. D. (2007). Medical-Surgical Nursing, Assessment and Management of Clinical Problems.St. Louis: Mosby Elsevier.Copstead-Kirkhorn, Lee-Ellen, Banasik, J. L. (2014). Pathophysiology, 5th Edition. [VitalSource Bookshelf Online]. Retrieved from

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