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Pneumonia

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by

Dana Rose

on 26 November 2017

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Transcript of Pneumonia

Pneumonia
Patient Overview:
Admitting Diagnosis: Pneumonia
Chief Complaint: Shortness of Breath
Medical History
Surgical History
Social History
Family History
Support Systems
Pathophysiology:
Etiology
Risk factors
Signs and symptoms
Contributing comorbidities

Pathophysiology continued:
Diagnostic Studies
Treatment Options
Nursing Considerations
Treatments patient received
Physical Assessment:
Head to Toe
Neuro
Cardiac
Respiratory
Abnormalities
Medications
Nursing Care and Treatments
Nursing Diagnosis:
1. Impaired gas exchange related to pneumonia as evidenced by shortness of breath, cough and oxygen dependent on six liters.

Goal:
Pt will be weaned to four liters of oxygen (to go home rate/baseline) and maintain a 92% or above oxygen saturation before end of shift today at 1830.
Nursing Diagnosis:
2. Diarrhea related to radiation as evidenced by three loose stools before 1100 and hyperactive bowel sounds in all four quadrants.

Goal:
Pt will decrease in number of bowel movements and have formed stools by end of shift today at 1830.
Nursing Diagnosis:
3. Risk for bleeding related to adenocarcinoma on the left lung as evidenced by elevated coagulation and bruising bilaterally upper extremities.

Goal:
Pt will be able to discuss precautions to prevent bleeding complications today before end of shift at 1830.
Question and Answer
References:

Ackley, B. J., &Ladwig, G.B. (2014). Nursing diagnosis handbook (10th

ed.). St. Louis, MO:Elsevier Mosby.

Amalia, A., & Torres, A. (2013). Pathophysiology of Pneumonia. Clinics in

Chest Medicine, 26, 39-46. doi: 10.1010/j.com.2013.10.004

Ignatavicius, D.D. & Workman, M. L. (2015). Medical-surgical nursing:

Patient-centered collaborative care. (8th ed). St. Louis: Saunders/

Elsevier.

J. George (2014, May 10). Pneumonia vs. Pneumonitis [Video file].

Retrieved from http://khanacademy.org/science/health-and-medicine/

respiratory-system- diseases/pneumonia/v/pneumonia-vs-pneumonitis


Full transcript