Question

Patient Profile:

Gladys Young is a 68 year old female that resides in an Independent Living facility with her husband. She presents to her primary care physicians office with complaints of fever, chills, nausea and vomiting. She also states that she has had some mild hemoptysis occasionally with her persistent coughing. She has recently completed treatment with Chemotherapy for Breast cancer and is concerned that she may have an infection. You are the nurse caring for her.

You complete the following assessment:

Subjective Data:

She is able to complete a sentence in its entirety, but she is persistently coughing during the history. She is a former smoker, she smoked ½ pack of cigarettes per day for 30 years and quit when she was diagnosed with breast cancer 6 months ago. She denies shortness of breath or chest tightness. She has not yet gotten her influenza vaccine, but did receive the Pneumovax vaccine last year. She has had problems with persistent coughing at night which has prevented her from getting a good night’s sleep for the past two weeks. She also states that she has been waking up soaked in sweat in the morning.

Objective Data:

• Temp – 38.6 C; HR – 132 beats/min; RR—28; BP – 168/87; O2 sat – 90% on Room Air
• Auscultation: Lungs with faint crackles at bases bilaterally. No wheezing present.
• Patient is flushed and warm to touch

Answer the following questions:

1) What pharmacologic interventions do you expect will be ordered for this patient? What routes of administration will be best indicated for this patient? (Include mechanism of action, indication for use and desired outcomes)

2) What are the nursing implications for the above listed pharmacologic treatments (teaching pearls, things to anticipate, adverse reactions)?

Answer 1

A bacterial infection about seven to 12 days after your chemotherapy infusion if your white blood cells are low. Most bacterial types of infection result from your body's inability to fight off normal bacteria present in your gastrointestinal tract or skin. Parentral route antibiotics are administered to reduce infection 2) Infection can occur through autocontamination or cross infection Common infection site are the skin , respiratorytract and gastrointestinal tract Initiate protective isolation procedures Ensure frequent and thorough hand washing by the client , family and Health worker