NR452 Capstone Evidence: Bacterial Pneumonia Among Elderly

Bacterial Pneumonia among the Elderly
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Bacterial Pneumonia among the Elderly
Health promotion and maintenance of health is one of the categories of NCLEX-RN examination themes. Although energy has been focused on the younger population, there is an ever increasing evidence of the approach among the older people of 65 and above years of age (Peel, McClure & Bartlett, 2005). The health promotion and maintenance of health approach is the best strategy to control the prevalence of chronic infections and functional impairments among the elderly. Even though this strategy cannot replace or match medication, it has the capability of reducing the numerous incidences and prevalence of both acute and chronic diseases among the general population especially the elderly (Peel, McClure & Bartlett, 2005). The healthcare providers assigned to the elderly have noted the benefits of health promotion and maintenance. In fact, some healthcare providers have advised for this strategy to be implemented among the elderly due to their age. The age factor normally hinders the prophylactic measures and medication. Thus, health promotion and maintenance of health among the elderly is the best strategy to prevent most of the infections. However, chronic and acute infections such as the bacterial pneumonia are currently on the rise due to the omission of the health promotion and maintenance of health among the older people (Peel, McClure & Bartlett, 2005). In the USA alone, a combination of pneumonia and influenza are the sixth leading causes of deaths with almost 90% of the deaths occurring in the adult of 65 years and above. Furthermore, 60 percent of the adult population of 65 years and above is frequently admitted to hospitals due to bacterial pneumonia. These patients normally experience changes in their pulmonary reserves, decreased cough reflex, reduced mucociliary transport, reduced elasticity if the alveoli and poor ventilation which diminish a cough and airway patency resulting to pneumonia. However, proper implementation of health promotion and health maintenance paying attention to the various risk factors may enhance the physicians' assessment of the severity of the infection or may lead to the implementation of preventive measures as well as ensure the proper determination of the need for further medical assistance (Yoshikawa& Marrie, 2000).
Importance of Bacterial Pneumonia among the Elderly
Bacterial pneumonia is a major problem in the life of the elderly. In most cases, reports concentrate on the diagnostic issues concerning the disease and the advances in the treatment, invasive and intensive care procedures among others. Despite the tremendous progress use of the antibiotics and advanced diagnoses as well as improved technology, the infection is still high among the elderly with a mortality rate of 65%. About forty percent of the sepsis cases have been noted in persons of 60 years and above and 60% deaths in relation to the same (Yoshikawa& Marrie, 2000).
The reasons for the increased incidences of bacterial pneumonia among the elderly include underlying chronic infection, which includes lung diseases, diabetes mellitus, peripheral occlusive vascular diseases and urinary incontinence. In addition, the improper use of sedatives and tranquilizers may result in mobility as well as staying in an environment where antibiotic-resistant bacteria exist. Besides, the decreased T-cell lymphocyte functions in the elderly usually reduce the body's resistance to bacterial pneumonia coupled with decreased levels of the immunoglobulin-A which make the skin and mucous membranes more susceptible to numerous pathogens (Yoshikawa& Marrie, 2000). Even though actions have been carried out to decrease the prevalence, the infection has been of significance which includes health risks, reduced quality of life among the elderly, loss of finance due to the costs of treatment among the families and insurance companies. On a separate note, the disease also results in ethical issues due to the prolongation of the patients' lives that has become poor (Yoshikawa& Marrie, 2000).
Patient Population
Bacterial pneumonia in older age has diversified based on the types of bacteria and the environment that heightens the infection. Regarding the types of bacteria, Streptococcus pneumonia is currently the leading bacteria responsible for bacterial pneumonia. The bacteria can enter the lungs via inhalation as well as through the bloodstream. However, it can be prevented through vaccination. Secondly, the Haemophilus influenza is also a common bacterium that causes the infection. It usually lives in the upper respiratory tract. However, it is unable to cause harm to an individual unless the person has a suppressed immune system. Other bacteria responsible for bacterial pneumonia among the elderly include Staphylococcus aureus, Streptococcus pyrogens, Neisseria meningitides, Legionella pneumophila, Chlamydophila pneumonia and Klebsiella pneumoniae(Welte, Torres & Nathwani, 2010).
On a separate note, bacterial pneumonia may be diversified based on the mode of infection or environment. For example, community-acquired pneumonia (CAP) is the most common type acquired in crowded places such as workplace and schools among others. In addition, there is hospital-acquired pneumonia, which infects the patients during the hospital stay. In the year 2010, it is noted that 2.3% of all the nursing home residents were diagnosed with healthcare-associated pneumonia. In addition, the aspiration pneumonia infects a person upon inhalation of food, liquids, dust and gasses. The chemical or toxic related pneumonia is common among older people who problems with swallowing, especially victims of stroke who inhale acidic substances that cause aspiration pneumonia. Lastly, opportunistic pneumonia comes as a result of a weakened immune system (Welte, Torres & Nathwani, 2010).
Elsewhere, cultural values play a critical role in the plan for the management and prevention of bacterial pneumonia. These values are categorized in the form of the socioeconomic status of both individual and community levels, educational levels, municipality family, and financial income among others. It is noted that the community care programs for the elderly embrace improved hygiene, discourages contacts with cigarette smoke and embrace a healthy lifestyle for the elder. Such activities enhance the prevention of bacterial pneumonia as well as leading to the improvement of the quality of health (Welte, Torres & Nathwani, 2010). On a separate note, community values that appreciate elderly involvement in the community activities help in moderation of risk factors such as poverty, discrimination, homophobia as well as reducing risky behaviors such as smoking. This is coupled with the effective promotion of values that diminish cultural barriers such as stigmatization and other negative activities towards the prevention and management of bacterial pneumonia (Welte, Torres & Nathwani, 2010).
Proposed Solution
Bacterial pneumonia has been detrimental to the health of the elderly which has resulted in poor quality of health and deaths of these age categories. Therefore, different measures have been put in place to solve the problem. Such solutions include
Diagnosis: the frequent and routine laboratory tests have prognostic importance in patients of 60 years and above. The diagnosis involves the use of the Gram stain and examination of the bacterial culture of the sputum from the patient with pneumonia. Furthermore, there is a need for quantification of the cultured bacteria and the correlation of the stain which help in the interpretation of the oropharyngeal contaminations and real pneumopathogens. In addition to such, examination of blood culture has been effective in the diagnosis processes to reveal the outcome, especially among the hospitalized patients (Watkins & Lemonovich, 2011).
Treatment: due to the ever increasing potential pathogens that result to bacterial pneumonia in the elderly, it is recommended to conduct an earlier etiological diagnosis. Streptococcu...