...Before treating a patient for any type of disease, a diagnosis must first be made to establish what exactly needs to be treated. A diagnosis is the identification of the nature of an illness or other problem by examination of the symptoms. The incubation time of Legionnaires’ disease is anywhere between 2-6 days, which is the time that it takes for the symptoms to appear after exposure to the bacteria. The incubation period of Legionnaires’ disease is between 3-6 days. It has been stated that fewer than 5% of the patients’ exposed to Legionnaires’ disease during outbreaks will develop clinical symptoms (CITE). The symptoms for Legionnaires’ disease are very similar to any other type of pneumonia; however, “initial findings seemed to indicate...
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...CASE STUDY: PNEUMONIA SUBJECTIVE: This is a 63 year old female with complain of cough for 1-week with yellowish sputum accompanied with fever and chills at home. She denies current chest pain during examination but claims of on and off chest pain episodes for about 5 days from the visit. She complains of having shortness of breath for 2 weeks. She went to ER 6 days ago with fever of 100.4 ḟ. She reports a Computed Tomographic Pulmonary Angiography (CTPA), which was negative for Pulmonary Embolism (PE) but found positive for Pneumonia. Patient reports to take antibiotic started during the ER visit but has not been taking the breathing treatment at home. The patient has no known drug allergy. Patient denies postnasal drip and sneezing and no hemoptysis. Patient denies any abdominal pan, nausea, vomiting, diarrhea, lower extremity swelling nor dysuria. He also denies smoking. Past Medical History is coronary artery disease with stent, hyperlipidemia, hypertension, diabetes mellitus, CKD, Stage 3 (GFR 30-59), anxiety disorder, stridor 2nd to history of intubation and tracheostomy, gastric rectal bleeding with chronic anemia, major Depression – recurrent, non-alcoholic cirrhosis, obesity (BMI-30-39.9), obstructive sleep apnea and venous stasis. OBJECTIVE: PHYSICAL ASSESSMENT Ht. 5’1, Wt. 175 lbs. BMI = 33.1 VS are BP 155/69, HR= 83-97, T 37.7, RR 32, SpO2 91-93% @ 2L O2 by nasal cannula General: She appears to be calm and breathing fairly, saturating well without oxygen but...
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...Clinical Case Study Assignment 2014 Jennifer Ahonen Cambrian College a00050951 BSN 2144: Nursing Practice Frances Carvalho & Jillian Smythe March 21, 2014 Clinical Case Study Assignment 2014 The purpose of this paper is to utilize the data collected in the Gordon’s Functional Health Patterns Assessment Tool (Appendix A). After data collection, it will be analyzed and a priority nursing diagnosis will be used to make a care plan (Appendix B). Patient X is an 82 year old male, who presented to the emergency department from his home at Extendicare York with a fever of 38.9 degrees Celsius, a blood pressure of 75/40 mm Hg, blood glucose level of 3.7, diaphoretic and a three day history of diarrhea, nausea and generalized weakness. The admitting diagnosis for this 82 year old male was Pneumonia. Pneumonia is an acute inflammation of the lower respiratory tract due to an infectious agent that impairs gas exchange due to alveolar edema and congestion (Thiem, Heppner, & Pientka, 2011). There are many factors that predispose individuals to pneumonia; however, in the case of this patient the predisposing factors are age and the presence of chronic diseases. The patient’s complete history and demographics can be found in Appendix A. The classic clinical manifestations of pneumonia consist of a temperature above 38 degrees Celsius, diaphoresis, cough, and shortness of breath, chest pain, tachycardia, purulent sputum, fatigue, nausea, vomiting, and diarrhea (Thiem, Heppner...
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...This is the second case study that is required for the class. Please submit a paper (doesn’t have to be long; you could even give me bullet-point answers to the questions listed below) that answers all of the questions posed after Case Study 1. I have included an easy second case study which, if you complete it, will be worth extra credit. Answers to the first Case Study are worth 25 points and responding to Case Study 1 is required work for the course. The extra credit, which is not required, will be worth a total of 10 points. Both are due at the beginning of class on Tuesday, March 10, 2015. Case 1 R.S. has smoked for many years and has developed chronic bronchitis, a chronic obstructive pulmonary disease (COPD). He also has a history of coronary artery disease and peripheral arterial vascular disease. His arterial blood gas (ABG) values are pH = 7.32, PaCO2 = 60 mm Hg, PaO2 = 50 mm Hg, HCO3- = 30 mEq/L. His hematocrit is 52% with normal red cell indices. He is using an inhaled ß2 agonist and theophylline to manage his respiratory disease. At this clinic visit, it is noted on a chest x-ray that R.S. has an area of consolidation in his right lower lobe that is thought to be consistent with pneumonia. Discussion Questions 1. What clinical findings are likely in R.S. as a consequence of his COPD? How would these differ from those of emphysematous COPD? Chronic Obstructive Pulmonary Disease (COPD) is comprised primarily of two related diseases: Chronic Bronchitis...
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...Karim Hall Bronchitis Florida Technical College Abstract Bronchitis is one of the top 10 conditions for which most patients seek medical care for. Some physicians show considerable variability in describing the signs and symptoms when it is necessary to its diagnosis. A cough is also a most common symptom bringing patients to the primary care physician’s office, and bronchitis is usually the diagnosis in these patients. However, studies have indicated that many physicians treat bronchitis with antibiotics. These drugs have generally shown to become ineffective in patients with complicated bronchitis. A patient satisfaction with their treatment of bronchitis is related to the quality of the physician-patient interaction rather than to the prescription of an antibiotic. Bronchitis Bronchitis is an inflammation of the membrane that lines the air passages, or, bronchial tubes, of the lungs and results in the narrowing of these air passages. This disorder may be of either an acute or chronic type. Irritation of mucus-producing glands within the membrane results in the production of excess bronchial secretions. The main symptoms of bronchitis are cough and increased expectoration of sputum, with or without associated wheezing and shortness of breath. Men are more of a target to bronchitis then most women, men out numbering them 10 to 1 for reasons that are unclear. Acute bronchitis is a self-limited infection of the lower respiratory tract causing inflammation of the bronchi...
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...and 10. zero is equated with no dyspnea and 10 is equated with the worst brethlessness the client has experienced ( & , 2004) Dyspnea is difficult to quantify and to treat (Potter & Perry, 2004). Interventions need to be individualized for each patient, and more than one therapy is usually implemented. The underlying process that causes or worsens dyspnea must be treated and stabilized initially. Three additional therapies have to be implemented: pharmacological measures, physical techniques, and psychosocial techniques are then implemented. Evaluation of how nursing interventions in dyspnea is usually done by evaluating the underlying cause of dyspnea. Coughing up green and yellow sputum The nurse should determine if the cough is a manifestation of any underlying diseases. In addition, other diagnostic tests must be performed. Interventions can be geared towards curing...
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...Case Study – Chronic Bronchitis Admitting History A 68 year old retired geologist arrived in the emergency room with his daughter. Well known to the respiratory care consult team, he has a 40 year history of smoking 1.5 packs of cigarettes a day, is widowed, lives alone, and has difficulty managing his daily activities. For the past week the man has experienced increased dyspnea and cough and has been unable to care for himself. On observation, his personal hygiene appeared to have deteriorated. The man stated that he has been unable to get his breath or inhale deep enough to cough up secretions. He complained of mild nausea without abdominal pain or vomiting. His physician had given him an unknown oral antibiotic 3 days before this admission. The man was diagnosed with severe chronic bronchitis approximately 6 years ago and had an acute myocardial infarction 2 years ago. His pulmonary function studies 1 year before this admission showed severe airway obstruction and air trapping. He has a history of high blood pressure, congestive heart failure, chronic dyspnea on exertion, and chronic cough and he experienced two episodes of pneumonia within the last year. In recent months, according to a neighbor, he has become increasingly depressed. According to his daughter, his physical activity is minimal. He generally spends most of his days watching television, smoking, and napping. All his children, none of whom live in the immediate area, have tried to coax...
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...Asthma Case Study Lisa, a four-year-old with status asthmaticus, is admitted from the emergency room via a wheelchair to a medical pediatric unit. She is accompanied by her parents who both have anxious, tense facial expressions. Lisa’s vital signs are T-36.9° C, P- 140 (apical, regular), R 38 (regular but shallow), BP 118/78. She is pale but has no evidence of cyanosis. Her breath sounds are normal in upper lobes, with inspiratory and expiratory wheezing and scatter crackles in all lobes. Breath sounds in lower lobes are diminished. She has moderate intercostal retractions, some nasal flaring, and an occasionally loose, productive cough. Lisa has thin, whitish nasal discharge and tears are dried on her cheeks. She is irritable and appears frightened. Other significant data include: Wt 19 kg, Hemoglobin 12.5, Hematocit 37.3, theophylline level 10.5 mg/dl before treatment in ER. The chest x-ray films show that her lungs are hyper inflated with some infiltrates but no atelectasis or consolidation. Three days ago, Lisa came home from the day care center with the sniffles. By evening, she had rhinorrhea and a cough but no fever. This developed into a head cold. Two days ago, she helped her father rake leaves and then played in the leaves pile with a friend. About noon today, the day care center called Lisa’s mother because she said she couldn’t catch her breath and was tired. At home, Lisa’s mother gave her an Albuterol treatment, which helped for about 30 minutes...
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...Current diagnosis COPD/Emphysema. Patient XX was diagnosed with COPD in 2009. COPD is a progressive disease with presence of airflow obstruction, which may be cause by chronic bronchitis or emphysema. Emphysema is a pathological condition caused by the destruction of alveolar walls and a consequent permanent enlargement of the alveolar sacs. According to the National Institute of Health (NIH), a diagnosis of COPD is made based on the patient’s signs and symptoms, medical and family history, and results of diagnostic tests. Common signs and symptoms of COPD include cough, dyspnea, wheezing, and chest tightness. Most patients are older than 50 years. They present with major complaints of severe dyspnea and require the use of accessory muscles...
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...This is the second case study that is required for the class. Please submit a paper (doesn’t have to be long; you could even give me bullet-point answers to the questions listed below) that answers all of the questions posed after Case Study 1. I have included an easy second case study which, if you complete it, will be worth extra credit. Answers to the first Case Study are worth 25 points and responding to Case Study 1 is required work for the course. The extra credit, which is not required, will be worth a total of 10 points. Both are due at the beginning of class on Tuesday, March 10, 2015. Case 1 R.S. has smoked for many years and has developed chronic bronchitis, a chronic obstructive pulmonary disease (COPD). He also has a history of coronary artery disease and peripheral arterial vascular disease. His arterial blood gas (ABG) values are pH = 7.32, PaCO2 = 60 mm Hg, PaO2 = 50 mm Hg, HCO3- = 30 mEq/L. His hematocrit is 52% with normal red cell indices. He is using an inhaled ß2 agonist and theophylline to manage his respiratory disease. At this clinic visit, it is noted on a chest x-ray that R.S. has an area of consolidation in his right lower lobe that is thought to be consistent with pneumonia. Discussion Questions 1. What clinical findings are likely in R.S. as a consequence of his COPD? How would these differ from those of emphysematous COPD? Chronic Obstructive Pulmonary Disease (COPD) is comprised primarily of two related diseases: Chronic Bronchitis...
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...pneumonia it causes is called Pneumocystis carinii Pneumonia (PCP). It is classified as a fungus. This fungus appears to look like cysts when looked at closely. P. carinii was originally thought to be classified with the group protozoan. Recent studies have shown that it is more closely related to the fungus group. P. carinii has two main forms it can exist as a cyst or as a trophozoite. This organism is usually found in the alveolar spaces and attaches to the cells in the lungs. P. carinii can be diagnosed in many ways. A sample can be obtained, such as sputum and then it could be...
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...Pneumonia Case Study August 27th, 2014 Mrs. Yolanda Bone South University Pneumonia Case Study A major cause of morbidity and mortality is Pneumonia. Pneumonia is a lung infection caused by bacteria, fungi or viruses (Center for Disease Control, 2014).The infection is classified into two categories; community-acquired pneumonia (CAP) or health care-associated pneumonia (HCAP). The classification is determined by the environment in which the infection develops (CDC, 2014). HCAP develops during or following a stay in a healthcare facility. In contrast, patients who are diagnosed with CAP have had no contact within a health care setting prior to presenting with the infection (Driver, 2012). Pneumonia may be present as a mild illness but has the potential to be life-threatening. Despite advances in research, pneumonia remains a common illness contributing to the death of young children in developing countries and the elderly population of developed countries throughout the world (Ruuskanen, et al., 2011). In 2010, approximately 50,000 people in the U.S. died after developing the infection (CDC, 2014). From a global perspective, 450 million cases of pneumonia are recorded annually and roughly 4 million of those diagnosed will die from this illness (Ruuskanen, et al., 2011). CAP is the eighth-leading cause of death within the U.S. and is the leading cause of death from infection in the developed world (Brown, et al., 2012). While anyone is susceptible to contracting...
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...Obstructive Pulmonary Disease has a major impact on both physical and psychological well-being {Donna R. Falvo, 420.} Realizing that this is a life-changing condition, with one cure and treatment [makes you think] ‘what does that mean?’ A pulmonologist told me, “That any person that is face with COPD would have to have a lung transplant to get rede of the disease.” The etiology of Chronic Obstructive Pulmonary Disease {COPD} is that cigarette smoking is the number one reason in developing COPD and is ten times likely to develop this disease. Secondhand smoke exposure can also cause COPD. When this happen hyperplasia in our cells produce more mucous, reduced airway due to hyperplasia, reduce ciliary activity that bring up foreign bodies to cough things up. Cigarette smoke will cause lung damage, which can lead into COPD over time. Smoking harms the cilia that line the airways. Damage cilia can’t sweep mucus and particles away. Some of the cilia are destroyed. This damage makes the problem even worse {Kramesondemand, 2.}. The two months most common months patients have trouble with breathing problems are February and November, which patients die mostly from- limitation not...
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...I. Introduction This is a case of a 74 year old woman who was diagnosed with Community Acquired Pneumonia. Pneumonia is an inflammation or infection of the lungs most commonly caused by a bacteria or virus. Pneumonia can also be caused by inhaling vomit or other foreign substances. In all cases, the lungs' air sacs fill with pus , mucous, and other liquids and cannot function properly. This means oxygen cannot reach the blood and the cells of the body. Most pneumonias are caused by bacterial infections.The most common infectious cause of pneumonia in the United States is the bacteria Streptococcus pneumoniae. Bacterial pneumonia can attack anyone. The most common cause of bacterial pneumonia in adults is a bacteria called Streptococcus pneumoniae or Pneumococcus. Pneumococcal pneumonia occurs only in the lobar form. An increasing number of viruses are being identified as the cause of respiratory infection. Half of all pneumonias are believed to be of viral origin. Most viral pneumonias are patchy and the body usually fights them off without help from medications or other treatments. 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. Community-acquired pneumonia develops in people with limited or no contact with medical institutions or settings. The most commonly identified pathogens areStreptococcus pneumoniae, Haemophilus influenzae, and...
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...Name: Meredith Hillegass Date: 04/10/16 Instructions: All questions apply to this case study. Your responses should be brief and to the point. When asked to provide several answers, list them in order of priority or significance. Do not assume information that is not provided. Please print or write clearly. If your response is not legible, it will be marked as ? and you will need to rewrite it. Scenario D.Z., a 65 year-old man, is admitted to a medical floor for exacerbation of his chronic obstructive pulmonary disease (COPD, emphysema). He has a past medical history of hypertension, which has been well controlled by Enalapril (Vasotec) for the past 6 years, has had pneumonia yearly for the past 3 years, and has been a 2 pack-a-day smoker for 38 years. He appears as a cachectic man who is experiencing difficulty breathing at rest. He reports cough productive of thick yellow-green sputum. D.Z. seems irritable and anxious; he complains of sleeping poorly and states that lately feels tired most of the time. His vital signs (VS) are 162/84, 124 HR, 36 RR, 102 degrees F, Sao2 88%. His admitting diagnosis is an acute exacerbation of chronic emphysema. Chart View Physician’s OrdersDiet as toleratedOut of bed with assistanceOxygen (O2) to maintain Sao2 of 90%IV of D5W at 50 ml/hrECG monitoringArterial blood gases (ABGs) in AMCBC with differential nowBasic metabolic panel (BMP) nowChest x-ray (CXR) q 24 hrs. Sputum cultureAlbuterol 2.5 mg plus ipratropium 250 mcg nebulizer treatment...
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