Nursing Care Plan
The nurse will educate the pt and the pt’s family about the seriousness of pneumonia and how to comply with treatment in order to maximize therapeutic effect and facilitate healing.
When a patient and their family are educated about illness, medications, and other treatments, they are more likely to be interested in their healthcare and comply with the plan.
An infection of the lungs triggers an inflammatory response, which results in edema in the alveoli. As a result of pulmonary edema, gas exchange becomes impaired leading to decreased activity tolerance.
At the end of the shift, pt’s pulse oximetry will increase and remain above 90%.
The nurse will position the pt’s bed into the semi-Fowler's position for most of the shift.
Rationale: An elevated position such as the semi-Fowler's position pulls abdominal organs down and allows for maximum diaphragm excursion and lung expansion. (Treas & …show more content…
Wilkinson, 2014, p. 1311).
3.The nurse will advise the pt to use an incentive spirometer at least ten times per hour.
Rationale: An incentive spirometer encourages the pt to take deep breaths, thus clearing the lungs and increasing oxygen levels in the blood. (Treas & Wilkinson, 2014, p. 1312). Ceftriaxone is a third generation cephalosporin antibiotic for the treatment of respiratory tract infections. It works by binding to the bacterial cell wall membrane, causing cell death.
The nurse will encourage the pt to rest in order to recuperate
Rationale: Sleep is restorative and conserves energy needed for ambulation and healing. (Treas & Wilkinson, 2014, p. 616).
The nurse will gradually incorporate ambulation into the pt’s daily activity without creating fatigue.
Rationale: Mobility increases lung function and oxygen circulation. (Treas & Wilkinson, 2014, p. 616).
d. Medications (cont’d)
Amlodipine:
10 mg = 1 tab, oral, qAM for 90 days
Amlodipine is an antihypertensive/calcium channel blocker which works by inhibiting the transport of calcium into myocardial and vascular smooth
muscle. Azithromycin:
500 mg, IV q24hrs for 7 days
Azithromycin is an agent for atypical myobacterium/macrolide that is a treatment for respiratory tract infection. It works by inhibiting synthesis at the level of the 50S bacterial ribosome.
Potassium Chloride:
40 mg q, IV @ 6.25 ml/hr for 1 dose
Potassium Chloride is a mineral and electrolyte replacement/supplement. It works by maintaining the acid-base balance, isotonicity, electro-psychologic balance of the cell.
3. The nurse will educate the pt and the pt’s family about the importance of early and regular mobilization.
Rationale: When a patient and their family are educated about illness, medications, and other treatments, they are more likely to be interested in their healthcare and comply with the plan. (Treas & Wilkinson, 2014, p. 1564).
Outcome:
At end of shift, pt’s pulse oximetry will increase to 90% or higher.
At end of shift, pt will tolerate ambulating through hospital hall without pulse oximetry desaturating to less than 90%.
When a patient and their family are educated about illness, medications, and other treatments, they are more likely to be interested in their healthcare and comply with the plan.
An infection of the lungs triggers an inflammatory response, which results in edema in the alveoli. As a result of pulmonary edema, gas exchange becomes impaired leading to decreased activity tolerance.
At the end of the shift, pt’s pulse oximetry will increase and remain above 90%.
The nurse will position the pt’s bed into the semi-Fowler's position for most of the shift.
Rationale: An elevated position such as the semi-Fowler's position pulls abdominal organs down and allows for maximum diaphragm excursion and lung expansion. (Treas & …show more content…
Wilkinson, 2014, p. 1311).
3.The nurse will advise the pt to use an incentive spirometer at least ten times per hour.
Rationale: An incentive spirometer encourages the pt to take deep breaths, thus clearing the lungs and increasing oxygen levels in the blood. (Treas & Wilkinson, 2014, p. 1312). Ceftriaxone is a third generation cephalosporin antibiotic for the treatment of respiratory tract infections. It works by binding to the bacterial cell wall membrane, causing cell death.
The nurse will encourage the pt to rest in order to recuperate
Rationale: Sleep is restorative and conserves energy needed for ambulation and healing. (Treas & Wilkinson, 2014, p. 616).
The nurse will gradually incorporate ambulation into the pt’s daily activity without creating fatigue.
Rationale: Mobility increases lung function and oxygen circulation. (Treas & Wilkinson, 2014, p. 616).
d. Medications (cont’d)
Amlodipine:
10 mg = 1 tab, oral, qAM for 90 days
Amlodipine is an antihypertensive/calcium channel blocker which works by inhibiting the transport of calcium into myocardial and vascular smooth
muscle. Azithromycin:
500 mg, IV q24hrs for 7 days
Azithromycin is an agent for atypical myobacterium/macrolide that is a treatment for respiratory tract infection. It works by inhibiting synthesis at the level of the 50S bacterial ribosome.
Potassium Chloride:
40 mg q, IV @ 6.25 ml/hr for 1 dose
Potassium Chloride is a mineral and electrolyte replacement/supplement. It works by maintaining the acid-base balance, isotonicity, electro-psychologic balance of the cell.
3. The nurse will educate the pt and the pt’s family about the importance of early and regular mobilization.
Rationale: When a patient and their family are educated about illness, medications, and other treatments, they are more likely to be interested in their healthcare and comply with the plan. (Treas & Wilkinson, 2014, p. 1564).
Outcome:
At end of shift, pt’s pulse oximetry will increase to 90% or higher.
At end of shift, pt will tolerate ambulating through hospital hall without pulse oximetry desaturating to less than 90%.