Case Study-Pneumonia: 977540

Pneumonia is termed as a possibly fatal inflammation and infection of the lower respiratory tract that is often caused by the inhaled viruses and bacteria that contain both elements of (Streptococcus pneumonia). This type of infection is regularly featured with shortness of breath, high fever, sharp chest pain, rapid breathing, and productive cough that is accompanied by thick phlegm (Marchello et al., 2016, 552-556). Pneumonia can be categorized into two; thus pneumonia that develops outside the hospital environments which is known as community-acquired pneumonia. On the other hand, pneumonia that emerges after admission to the hospital or 48 hours later is referred to as hospital-acquired pneumonia or nosocomial. The focus of the study is affiliated with Mrs. Xyz who has been diagnosed on the ICU with community-acquired pneumonia (CAP) (Sharma et al., 2017, 49). This paper will begin by the outline of her condition that comprises of a summary of her symptoms and the assessment of the pertinent history of her situation. Moreover, it will demonstrate the affiliation amid physiology, anatomy and the pathophysiological elements that are linked to CAP for proper diagnosis on the affected patient since it is vital health concern (Troy et al., 2016, 1005).

The hospitalization of elderly patients with CAP has been a considerable burden to the Australian community since it is a critical condition that requires immediate health care attention (Almatar et al., 2015, 259- 266). According to Mrs. Xyz she became vulnerable to the infection because of underlying COPD and her old age. Confusion and fatigue are the symptoms that are often presented from elderly patients like Mrs. Xyz. Fever symptoms that are usually evident in pneumonia were not identified in her; thus it replicates an inadequate immune response due to her age and the infection. She signified frequent and severe complications related to pneumonia. A fall in the blood pressure or shock was resulted due to the overwhelming reaction due to the sepsis-like picture. Respiratory failure and sepsis are the core impacts of death amid the pneumonia patients (Saukkoriipi et al., 2016, 552-556). The other common complications that are evident constitute of the low oxygen levels and fluid collection around the lungs.

CAP is a potentially severe and frequent infection that is affiliated with mortality and morbidity (Grosso, Famiglietti, and Luna, 2015, 117). Etiology microorganisms are often identified in the majority of the pneumonia cases. Therefore, the majority of the bacteria can lead to pneumonia, and the infection of the lungs may lead to primary and secondary infections (Musher et al., 2013, 11-13). The most common cause is the Streptococcus pneumonia, and this chronic infection often affects the elderly people due to their weak immune system (Bhuiyan et al., 2018, 14). Bacteria may not be available due to the administration of antibiotics that suppresses their growth or at the moment when the blood cultures are drawn. This trend is common among pneumonia patients.

A 75 -year old woman who will be referred to as Mrs. Xyz complained of shortness of breath accompanied with fatigue and white grey sputum due to her past smoking history that is affiliated with the Chronic Obstructive Pulmonary Disease (COPD) (Vliegenthart, 2018, 19). During her arrival time to the hospital, she had no chest pain or fever. In addition, she was admitted to the ICU to examine her condition. It was found that she had low blood oxygen levels, low blood pressure, elevated white blood cells count and anew shadow on the chest x-ray image on her right lung. This sign and symptoms led to the confirmation that she was diagnosed with pneumonia. This led to her admission with the diagnosis of sepsis and community-acquired pneumonia. Sepsis is termed as an infection that has spread throughout the entire body via the bloodstream.

According to Mrs Xyz case study, we find out that it is essential to investigate the history of the patients diagnosed with pneumonia. Therefore physical examination and combination of Mrs. Xyz history are beneficial since it aided to diagnose her pneumonic condition. The specialist found it challenging to determine the symptoms in Mrs. Xyz because they were not visible. The elderly people at times may be infected with pneumonia without the symptoms like the fever, cough and breathless showing up (Menzies, Jardine, and McIntyre, 2015, p.927 -933).

        As per Mrs Xyz, she was treated with intravenous fluids, antibiotics, blood pressure support mechanism, and oxygen via a face mask. Despite her condition improving she underwent computed tomography (CT) scan that displayed an extensive collection of fluid on her right lung. The appropriate medical procedure that was conducted in regards to that situation was by the use of the two needle drainage procedure. The method was beneficial because it led to the improvement of her oxygen requirement and the shortness of breath. After two weeks, she completed her diagnosis and had to depart from the hospital. Mrs. Xyz left the hospital setting without any bacteria identification in cultures of her blood, sputum or the fluid around the lungs.

In regards to Mrs Xyz case study analysis it is evident that there is no efficient prevention mechanism of pneumonia. However, numerous strategies can be established to mitigate the impact of the condition (Waterer and Bennett, 2015, 219). These measures constitute to avoid smoking; dental hygiene and adequate nutrition are factors that are associated with a healthy lifestyle; hence it will reduce the chances of an individual being affected with pneumonia (World Health Organization, 2016, 98).

Chest x- ray is regarded as the most appropriate test that is utilized in diagnosing pneumonia and it significant for it to be performed to all the patients that have been supposed to be having pneumonia. Thus an x-ray was conducted on Mrs. Xyz lungs and findings constitutes of the interstitial infiltrates and patchy alveolar. Therefore CT is not the initial step recommended being performed for a suspected pneumonic patient.

On the other hand, the patients who are often suspected of pneumonia in primary care unit are often put under empirical antibiotic therapy (Wunderink and Yin, 2016, 819). When the body of the patients responds to antibiotics therapy, there will not be the need to use microbiological testing.

Organ failure can be impacted when the pneumonic bacteria penetrate the bloodstream and spread the disease to other vital organs. When the pneumonic condition of a patient has been examined to be chronic due to difficulty in breathing, there is a need for hospitalization just as the case scenario of Mrs. Xyz. The patient will have to use a breathing machine as the lung recovers (Hurley, 2016, 577). On the other hand, pneumonia may propagate the build-up of the fluid accumulation around the lungs. In the situation when the lung fluid becomes infected, it is vital for it to be removed through surgery or drained by the use of the chest tubes. The situation was witnessed in Mrs. Xyz case study when she was hospitalized since fluids had accumulated around her right lung. The fluid had to be extracted by the use of tubes for her to recover.

According to Mrs Xyz, her pneumonic condition is based on the history of abnormal breath sounds, typical symptoms that could be heard with the use of chest radiographs that display the feature shadows, the use of the stethoscope and at times through laboratory tests. The disease was identified to be pneumonia, and it was critical to determine its severity for proper assumptions on whether the patient is going to be admitted to the hospital. Due to the chronic situation that Mrs. Xyz was undergoing, she had to be placed under the ICU. In other cases scenarios where the severity of the infection is mild, the patients are often treated as out-patients by through administering of the fluids and antibiotics. This type of mechanism is referred to as “walking pneumonia.”

In regards to Mrs Xyz, the microbe that was responsible for her pneumonic condition was unknown since it is difficult to identify. However, antibacterial agents were designated to recuperate the most likely culprit. Majority of the viral causes of pneumonia lack efficient drug treatments however the patients often recover without any long term consequences (Montalto et al., 2015, 441-442).

The cough reflex, sticky mucus layer lining the airways, the structure of the upper airway, hair-like cilia that propel mucus upwards are physical mechanisms that regulate the microbes to reach the alveoli. Therefore, reducing the spread of pneumonia that could have been as a result of inhalation of the microbes.

        The proportion that requires hospitalization as a result of pneumonia is increasing due to the aged population that is growing rapidly with numerous vulnerabilities (Jain et al., 2015, 415-427). As per, Mrs Xyz she had to be hospitalized because they have been a developing problem where the pneumonic microbes are resistant to antibiotics. A factor that leads to the resistance of the antibiotics is the inappropriate use such as for common colds.

Pneumonia is an infection that can affect any individual; however, there are two groups of people that are at high risk of being affected by pneumonia. These include the aged people between the age of 65 years and the children that range within two years (Earle and Williams, 2016, 9). In addition, they are other factors that propagate the pneumonia infection. An individual may be at high risk of acquiring pneumonia in the ICU especially when the patient is under the breathing machine. This because pneumonia is transmitted during the inhalation process; thus the airborne microbes from the infected end being inhaled by another individual. In addition, the hospitalized based pneumonia is impacted by the majority of the bacteria that are resistant such as the Klebsiella pneumonia, Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa.

The individuals with the complicated immune system are vulnerable to pneumonia due to the opportunistic microbes that constitute of the viruses, fungi, and bacteria (Siow et al., 2016, 276). A typical example is Mrs. Xyz whose immune system had been weakened as a result of smoking and old age thus making her body to be susceptible to pneumonia. Smoking harms the body since it weakness the natural defense mechanism of the body allowing the viral and bacterial microbes of pneumonia to penetrate the immune system of the body (Jain, 2017, 1-9).

It is difficult to treat pneumonia; thus living a healthy life can help to reduce the chances of being exposed to the microbes (World Health Organization, 2015, 45). Pneumonia has been one of the most significant challenges in the past; thus it is essential to reduce its burden on aged people like Mrs. Xyz (Trad and Baisch, 2017, 120-124). On this note, there is a need for the development of modern laboratory approaches that have the potential of identifying the causative microbe of pneumonia (Jain and Pavia, 2016). This will enable the physicians to be able to recognize the causative microbe and select the appropriate antimicrobial drug that facilitates the treatment of pneumonia. A vivid example was evident during the Mrs. Xyz case study since the physicians had difficulty in administering medication because they lacked sufficient machinery to identify causative microbe.

Effective antibiotics need to be manufactured against the microbes since they are recently unavailable. The antibiotics that are present have at times failed to be effective due to the resistance ability of the pneumonic microbes. This has been evidenced because the outpatients often complete the doses of the drug that they prescribed without complete healing. In addition, the current vaccines need to be enhanced too by developing new vaccines (Bruhn et al., 2017, 1524-1529). This is because the old microbes progressively change and new ones erupt. Thus the development of new antibiotics alone will not be sufficient due to the resistance of the microbes to antibiotics.

In conclusion, it is difficult to treat pneumonia; thus living a healthy life can help to reduce the chances of being exposed to the microbes (World Health Organization, 2015, 45). In regards to Mrs. Xyz, Pneumonia has been one of the most significant challenges in the past; thus it is essential to reduce its burden on aged people (Trad and Baisch, 2017, 120-124). On this note, there is a need for the development of modern laboratory approaches that have the potential of identifying the causative microbe of pneumonia (Jain and Pavia, 2016). This will enable the physicians to be able to recognize the causative microbe and select the appropriate antimicrobial drug that facilitates the treatment of pneumonia. A vivid example was evident during the Mrs. Xyz case study since the physicians had difficulty in administering medication because they lacked sufficient machinery to identify causative microbe.

Moreover, it is evident that the risk of acquiring pneumonia is affiliated to factors such as age, disability, and comorbidity (Mathot et al., 2015, 1014). It is therefore appropriate prevention measure of pneumonia need to be encouraged and established. Thus it is significant for the people to practise cough etiquette, smoking cessation, reduce alcohol intake, maintain healthy nutrition, hand hygiene and undertake regular physical activities (Menzies, Jardine, and McIntyre, 2015, 927). The preventive measures that need to be adopted comprise of the pneumococcal vaccination and influenza (Sabapathy et al., 2014, 927 -933).

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