Being that it's a new semester, I have new clinical experiences for your reading enjoyment. Now, this semester I have something special in store for you. Anybody want to guess what it is? Perhaps you...or you...maybe the beautiful woman behind you? lol. Well, the suprise is: "MORE!!! That means MORE clinical experiences, MORE clients, MORE cases and MORE knowledge for your mind. Isn't that exciting? I don't know about everyone else but I'm pumped :-) Anyways, this evening, I am proud to present you w/ my first clinical case of the semester. I had a 54 y.o. client w/ severe Parkinson's disease that was admitted w/ respiratory failure: pneumonia.
Pneumonia is an infection of the lungs. Many different organisms can cause it, including bacteria, viruses, and fungi. Pneumonia can range from mild to severe, and can even be deadly. The severity depends on the type of organism causing pneumonia, as well as your age and underlying health.
Bacterial pneumonias tend to be the most serious and, in adults, the most common cause of pneumonia. The most common pneumonia-causing bacterium in adults is Streptococcus pneumoniae (pneumococcus).
Respiratory viruses are the most common causes of pneumonia in young children, peaking between the ages of 2 and 3. By school age, the bacterium Mycoplasma pneumoniae becomes more common.
People who have trouble swallowing are at risk of aspiration pneumonia. In this condition, food, liquid, or saliva accidentally goes into the airways. In the case w/ my client, since he had severe Parkinson's I had to be very careful when feeding him b/c of this potential risk.
The main symptoms of pneumonia are:
* Cough with greenish or yellow mucus; bloody sputum happens on occasion
* Fever with shaking chills
* Sharp or stabbing chest pain worsened by deep breathing or coughing
* Rapid, shallow breathing
* Shortness of breath
Additional symptoms include:
* Headache
* Excessive sweating and clammy skin
* Loss of appetite
* Excessive fatigue
* Confusion, especially in older people
If you have pneumonia, you may be working hard to breathe, or may be breathing fast.
Crackles are heard when listening to your chest with a stethoscope. Other abnormal breathing sounds may also be heard through the stethoscope or via percussion (tapping on your chest wall).
The health care provider will likely order a chest x-ray if pneumonia is suspected.
Some patients may need other tests, including:
* Gram's stain and culture of your sputum to look for the organism causing your symptoms
* CBC to check white blood cell count; if high, this suggests bacterial infection
* Arterial blood gases to check how well you are oxygenating your blood
* CAT scan of the chest
* Pleural fluid culture if there is fluid in the space surrounding the lungs
Based on the lab results:
If the cause is bacterial, the doctor will try to cure the infection with antibiotics. If the cause is viral, typical antibiotics will NOT be effective. Sometimes, however, your doctor may use antiviral medication. It may be difficult to distinguish between viral and bacterial pneumonia, so you may receive antibiotics.
Patients with mild pneumonia who are otherwise healthy are usually treated with oral macrolide antibiotics (azithromycin, clarithromycin, or erythromycin).
Occasionally, steroid medications may be used to reduce wheezing if there is an underlying lung disease.
When in the hospital, respiratory treatments to remove secretions may be necessary. In the case w/ my client he had a respiratory therapist come in and give him nebulizer treatments every 4 hrs. via venturi mask. In addition, the doctor ordered that he have O2 @ 3 L/min via nasal cannula.
With treatment, most patients will improve within 2 weeks. Elderly or debilitated patients may need treatment for longer.
Your doctor will want to make sure your chest x-ray becomes normal again after you take a course of antibiotics.
Prevention
* Wash your hands frequently, especially after blowing your nose, going to the bathroom, diapering, and before eating or preparing foods.
* Don't smoke. Tobacco damages your lung's ability to ward off infection.
* Wear a mask when cleaning dusty or moldy areas.
Vaccines can help prevent pneumonia in children, the elderly, and people with diabetes, asthma, emphysema, HIV, cancer, or other chronic conditions:
* Pneumococcal vaccine (Pneumovax, Prevnar) prevents Streptococcus pneumoniae.
* Flu vaccine prevents pneumonia and other problems caused by the influenza virus. It must be given yearly to protect against new viral strains.
* Hib vaccine prevents pneumonia in children from Haemophilus influenzae type b.
Taking deep breaths may help prevent pneumonia if you are in the hospital -- for example, while recovering from surgery. Often, a breathing device will be given to you to assist in deep breathing. In the case w/ my client, he had to do breathing exercises w/ an incentive spirometer. An incentive spirometer is used to examine the health of your lungs by measuring inspiratory volume. This means that an incentive spirometer measures how well you are filling your lungs with each breath.
Call your doctor if you have:
* Worsening respiratory symptoms
* Shortness of breath, shaking chills, or persistent fevers
* Rapid or painful breathing
* A cough that brings up bloody or rust-colored mucus
* Chest pain that worsens when you cough or inhale
* Night sweats or unexplained weight loss
* Signs of pneumonia and weak immune system, as with HIV or chemotherapy
THE END.
As I sit back and reflect upon my day, I must say: "It was quite eventful." It was very busy b/c I had a completely dependent client but nevertheless I made the most out of the experience and definitely improved my medical skills in the process. Therefore, my report: MISSION ACCOMPLISHED. :-)
With that being said, thank you for taking the time to read this post. I hope you found it informative. Feel free to share your thoughts and/or leave any comments you may have. Well, I hope everyone has a lovely evening and be sure to tune in tomorrow for another clinical experience for your reading enjoyment. Take care. Peace, Love, and God Bless. This is 'thedoc' and I'm signing out. 1.
No comments:
Post a Comment