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Unit V Promoting Health in Patients With Oxygenation Disorders
l Symptom surveillance When managing a patient at home, it is important for them to know concerning symptoms and when to reach out to their primary care provider, and when to call 911. l Self-proning Recruits lesser-used lung units (alveoli) reducing atelecta- sis, improves ventilation/perfusion, and promotes secretion drainage. l Family support Family updates frequently, video chats with patient and involvement in care during restricted hospital visitation. l Disease process and treatments Patient and patient’s support system should understand the pathophysiology, trajectory, and treatment of the disease. l Post-COVID syndrome Long-term morbidity and mental health issues due to trauma and deconditioning in hospital setting. Evaluating Care Outcomes COVID-19 infection can be minimized by following cur- rent public health guidelines aimed at reducing community spread and by receiving approved vaccinations. Individuals who experience mild symptoms usually have a full recovery without complications. The successful treatment of COVID-19 disease hinges on early diagnosis and a comprehensive, interprofessional approach addressing the clinical, psychosocial, economic, and environmental issues.
Staphylococcus aureus (MRSA) community-acquired pneu- monia (MRSA CAP), hospital-acquired pneumonia (HAP), and healthcare-associated pneumonia (HCAP). Table 24.8 describes the classifications and common caus- ative organisms. Community-acquired pneumonia occurs in individuals who have not been recently hospitalized or are living outside of a healthcare/long-term care facility. Streptococcus pneumo- niae is the most common causative organism. Few clinical studies have been able to confirm MRSA as a frequent cause of CAP; however, the data to date may indicate that inci- dence is escalating. Methicillin-resistant CAP results from colonization of MRSA within the upper respiratory tract. This can produce mild, virtually asymptomatic illness that is customarily treated on an outpatient basis with oral anti- biotics. Healthy individuals with no existing risk factors for MRSA colonization are most frequently diagnosed with MRSA CAP after experiencing a viral illness. Hospital-acquired pneumonia typically develops in patients 48 hours after hospital admission. The diagnosis is made 48 to 72 hours after admission and is accompa- nied by the following risk factors: l Recent antibiotic therapy l Receiving immunosuppressive therapy l Diagnosed with a chronic disease l Treated within healthcare facilities, such as dialysis clinics, adult daycare centers, and rehabilitation facilities, where they are in frequent, close contact with healthcare personnel and other patients who may be colonized with various infection-causing organisms Healthcare-associated pneumonia occurs in individuals outside of the hospital but after significant exposure to the healthcare setting. Pneumonia caused by atypical organisms is often asso- ciated with mild respiratory illness. The inability to iden- tify them by culture or Gram staining is what makes them
PNEUMONIA Epidemiology
Infectious pneumonia can occur at any time and in individu- als of any age. According to the CDC, in the United States, there are approximately 3 to 4 million cases reported annually. One-third of these cases occur in persons over 65 years of age. The National Center for Health Statistics reports that older individuals (over 65 years) are at higher risk of death from respiratory infections. Nearly 90% of deaths are in this age group, but pneumonia is also responsible for 16% of deaths in children under age 5. Overall, approximately 60,000 deaths are attributable to pneumonia each year. Pneumonia remains among the most frequent conditions for which the death rate has not significantly declined over the past decade. Key risk factors for the development of pneumonia among the adult population include but are not lim- ited to advanced age; long-term care residence; smok- ing; chronic respiratory disease (asthma, emphysema); immune system dysfunction (malignancy, transplan- tation, HIV/AIDS); altered mental status; prolonged immobility; aspiration of stomach contents or foreign material; prolonged nothing-by-mouth (NPO) status; diminished cough, gag, and/or swallow reflexes; expo- sure to air pollutants, gases, or noxious inhalants; and hospitalization for longer than 48 hours. Pneumonia can be classified into several types: community-acquired pneumonia (CAP), methicillin-resistant
Table 24.8 Pneumonia Classifications and Common Causative Organisms
Community Acquired Streptococcus pneumoniae Mycoplasma pneumoniae Haemophilus influenzae
Hospital Acquired
Healthcare Associated
Pseudomonas aeruginosa
Staphylococcus aureus
Methicillin-resistant S. aureus
S. aureus
Klebsiella pneumoniae
Legionella
Escherichia coli Enterobacter sp.
P. aeruginosa H. influenzae
Methicillin- resistant S. aureus
Chlamydia pneumoniae
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