NURS 6521 Discussion: Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders

NURS 6521 Discussion: Women’s and Men’s Health, Infectious Disease, and Hematologic Disorders

HH is a 68 yo M who has been admitted to the medical ward with community-acquired pneumonia for the past 3 days. His PMH is significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3) and azithromycin 500 mg IV qday (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a diet at this time with complaints of nausea and vomiting.

The 2010 IOM report had four key messages or recommendations for nurses to position themselves strategically in healthcare provision. Firstly, the report stresses the need for nurses to practice to the fullest level of their education and training without any hindrances imposed by state boards of nursing. The message influences nursing practice as it means that nurses should be barred from practicing what they have trained on in different specialties (Price & Reichert, 2018). Secondly, the report asserted that nurses should engage in lifelong learning to acquire higher levels of education and training based on a better education system. The message means that the nursing practice requires professional nurses to engage in continual professional de

NURS 6521 Discussion Women’s and Men’s Health, Infectious Disease and Hematologic Disorders

velopment to attain the latest skills and knowledge in healthcare provision, especially the deployment of technology.

Allergies: Penicillin (rash)

Community acquired pneumonia is pneumonia that is obtained outside of the hospital; the most common symptom is a cough that makes sputum, also chest pain, chills, fever, and shortness of breath are also common.  Pneumonia is diagnosed by a provider, during a work up the provider listens to lungs with a stethoscope and by reading x-rays or CT scans of the chest (Sehti, at.el).  This patient is older in age and has multiple comorbidities.  I would request medical records from the primary care providers office to see what medications the patient is prescribed to control the comorbidities listed above.  I would ask the patient if home oxygen were ever used.  I would include the patient in the treatment plan.  I would ask the patient the name and schedule of the medications he takes daily.   Empiric antibiotics are medications that are given for an unknown cause of infection another phrase is called broad spectrum antibiotics.  A sputum sample would be obtained and once the results came back stating the type of infection then direct therapy would begin with the antibiotic that treats that specific infection.  With excluding penicillin since that patient has a documented allergy to this medication.  Weaning this patient completely off oxygen successfully with the goal between 88-93% room air would be a great start for a COPD patient.  Since this patient has a decreased appetite because of nausea and vomiting I would add an as needed medication Zofran intravenously to the medication list with a medication to help boost appetite for example Megace.  FYI Zofran side effect are dizziness, headache, and diarrhea (Rosenthal, L. D., & Burchum, J, R. 2021 pg. 605).  A consult would be ordered for dietary to consult with this patient for a healthy diet.  Obesity is a risk factor especially for this patient that has multiple health risks and currently has lack of energy to complete daily ADL’s.  The discharge plan for this patient would be to continue to take prior prescribed medications for HTN, HLD, and DM.  The new added medications would be to take azithromycin 500 mg daily by mouth with breakfast for 7 days.  Zofran by mouth as needed for nausea every 6 hours.  Encouragement to continue being active whether that means small brisk walks in the neighborhood or light cardio exercises at home.  Anything that gets the heart rate up to maintain healthy activity to help promote a healthy weight, healthy health.  

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