659-A3 Advanced Practice Nursing: Case Study

Elevator Consult-Case Study #2
NameAdvanced Practice Nursing: Case Study
InstructorDate
Subjective
Amanda Smith is a 69 year old, retired black female who has been coughing continually intermittently. She stated that the cough began 5 days ago, which became constant 2 days ago. Amanda has hypertension, but this has been controlled for the past 4 years, and her father suffered both diabetes II and renal complications. Her temperature is above 100 for the past five days. Amanda experiences substernal pain on cough, and there has been no relief using OTC medication.
Objective
Vital Signs: Resp 30 labored, no retractions, BP 135/92, HR 110, Pulse Ox 90, Temp 101.4, Wt 130 lbs. The regular rhythm was 110 beats per minute, and there were no abnormal sounds. There is mild respiratory distress, and Amanda answers the questions with short sentences, tripod breathing.
Assessment
CAP
Acute bronchitis
Congestive heart failure
Influenza
Amanda takes Hydrochlorothiazide (HCTZ) 25 mg, which is mainly used in treating high blood pressure, congestive heart failure and reducing the risk of edema or fluid retention.
Plan
Discuss the nature of the diagnoses, as well as measures to improve health outcomes and reduce the risk of coughing for a longer period of time by treating the respiratory infections and other underlying causes. Amanda will drink plenty of fluids and there will be ongoing monitoring of her condition. Since Amanda is experiencing chest pains, the intervention also targets to ease the pain and monitoring progress during checkups.
Respiratory infections
Respiratory infection includes a set of diseases, which affect the respiratory system respiratory and can be caused by viral, bacterial and other microorganisms. There are universal requirements to improve health outcomes and ensure that a person lives a healthy lifestyle. Maintaining sufficient supply of air and other respiratory requirements is prioritized and to deal with chest pain. Maintenance of a sufficient supply of water is also necessary to remain healthy. Additionally, maintenance of a sufficient supply of food is necessary considering, maintaining the normal body weight levels and the BMI. Maintenance of the balance between activity and sedentary lifestyle, ensuring there is social support, preventing measures as well a promotion of human functioning and development. Once the nursing process has been applied to the patient there is focus on dealing with the coughing and reducing the chest pain
Community-acquired pneumonia (CAP)
Community-acquired pneumonia (CAP) is an acute infection of the parenchyma affecting the patient and includes the appearance of fever and symptoms that are corroborated using the chest radiography. The microorganisms can reach the lung via the pharyngeal, which is the most frequent as well as inhalation of the contaminated air. The presence of CAP coincides with an alteration of defense mechanisms, and in this case Amanda Smith is 69 years old and in an age where there is higher risk of pneumonia and other respiratory diseases and conditions. For there to be effective treatment, there is a need to establish how age and health condition affect health outcomes of the patient as there is a close relationship between age and etiology of the CAP, the clinical-radiological findings of CAP, severity of symptoms and immunity levels (Brown et al., 2018).
Advanced age and the immunocompromised status are risk factors for CAP, and considering the patient’s health status, but health professionals are crucial to integrate relevant interventions. The role of health personnel in influencing health interventions extends to the nurse care plans, patient education and health advice (Collins-Bride et al., 2017). The interaction of a health professional with the patient will help to reduce the risk of worsening health outcomes involving the health professionals in health interventions is associated with focus on preventive care and management of the identified patient problems. The health personnel are responsible for promoting the clinical practice and using the best evidence in decision-making.
Acute bronchitis
Respiratory infections are common among children and the elderly and Amanda started coughing 5 days ago and there is a concern that this could worsen because of the weakened immunity common in older people. Acute bronchitis in patients with underlying disease mostly other respiratory conditions, and patients over 65 is a concern, but medication reduces coughing duration (Soch et al., 2017). There is acute bronchitis without comorbidity and this is considered when deciding on the treatment plan. Patients with acute bronchitis should avoid smoking and tobacco and Amanda smoked 1 pack a day for 15 years, but quit 5 years ago. One of the most common symptoms is acute productive or wet cough that tends worsens at night. There is a need for further patient evaluation and monitoring to reduce the risk of purulent sputum. The presence of purulence does not imply there is bacterial infection in patients without chronic lung disease.
The most common complication in bronchitis is getting pneumonia and acute bronchitis is the result of a viral infection and sometimes bacterial infection or lung irritation. The treatment for acute bronchitis targets relieving their symptoms and helping to facilitate the patient's breathing. Like oth...