Question

Barbara Smith, a 77-year-old female client with a history of chronic obstructive pulmonary disease (COPD) and lung cancer, still smokes occasionally and is admitted to the hospital with bilateral pneumonia in the lower lobes. She stated that she watches her two grandchildren ages 5 and 7 years in her home before and after school. She stated that both had recently had some sort of upper respiratory infection with fever, coughing, and sneezing. She attends a large church regularly that has a meet and greets time when everyone shakes hands with each other. She reported that several church members have been sick with the flu recently. The nurse is concerned when reviewing the electronic medical record that the client has no records of receiving immunizations for pneumococcal pneumonia or influenza. All other immunizations are up-to-date.

1. Ms. Smith has pneumonia. What in this case study makes her at risk for pneumonia? List and explain at least 4 risks specific to this case.

2. What are the nursing interventions used to treat a client with pneumonia? Please include at least 4 nursing interventions. DO NOT DISCUSS MEDICATIONS.

a. For each nursing intervention listed, explain why it is appropriate for Ms. Smith.

3. What is the guideline Ms. Smith should follow regarding getting immunized for flu and pneumonia?

a. Should she be vaccinated? Provide a rationale for your answer.

4. What lifestyle changes should Ms. Smith make to reduce her risk for pneumonia and to manage her COPD? Provide at least 3 lifestyle changes. Also, provide a rationale for the suggested

Answer 1

1) Risk factors for pneumonia are :-

- Older age

- COPD

- Immunocompromised ( lung cancer )

- Smoking

2) Nursing interventions :-

Removing secretions - to ensure patent airway

Increasing fluid intake - to loosen the secretions

Administering oxygen when needed - to maintain saturation and relieve difficulty in breathing.

Promoting proper nutrition and education - to maintainence adequate nutrition and education for compliance to treatment.

3)For the 2019-2020 flu season, CDC recommends annual influenza vaccination for everyone 6 months and older with any licensed, age-appropriate flu vaccine.  

Rationale - it's safe for her because fluzone high dose vaccine provides protection against influenza and pneumonia .

4) Lifestyle changes includes :-

- Quit smoking

- Compliance to treatment

- Proper nutrition