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Primary Level Of Prevention:

Primary level of prevention:

1)Health promotion.

Increase awareness and health education about healthy life style that should be followed strictly to prevent the occurrence of pneumonia among elderly people, such as :

‘ Maintain Proper hand hygiene

‘ Clean all the surfaces that are frequently touched like the knob door .

‘ Coughing or sneezing using tissue to prevent spread of droplet infection..

‘ Avoid overcrowded & bad environmental sanitation.

‘ Proper nutrition especially foods which high amount of Vit.C

‘ Adequate ventilation.

‘ Sleeping pattern

‘ Regular exercise

2)Specific protection:

Immunization and Vaccine

There are two types of vaccines:

1- pneumococcal conjugate vaccine (PCV13 or Prevnar 13”)

PCV13 which is recommended for all children younger than 5 years old, all adults 65 years or older, and people who are 6 years or older with certain risk factors.

2- and pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax”).

PPSV which is recommended for all adults who are 65 years or older.

Secondary level of prevention:

Include :

1-Early case:

‘ Early case finding through survey : To identify prevalence & incidence of pneumonia among elderly people

2-Diagnosis :

its include:

1-Investigations (discussed above)

2-Signs and symptoms (discussed above)

3-Mangement

A-Medical management :

1-Pharmacological:

By use of some medication that are recommended by physician accordingly such as ;

Antiviral Antibacterial Antifungal

Zanamivir (Relenza) Azithromycin (Zithromax) Amphotericin B

Oseltamivir (Tamiflu) Clindamycin (Cleocin) Voriconazole

2-Surgical intervention:

No surgical intervention required although in emergency situation patient will be ventilated till his prognosis become better

B-Nursing management:

Through

1-providing Nursing Care: such as

‘ Check vital signs including O2 saturation and depth and rate of respiration.

‘ Observe chest movement and breathing pattern .

‘ Auscultate the lung for breathing sound if there is any crackles or wheezing present.

‘ Elevate head of bed and change position frequently to mobilize present secretions Suction if needed .

‘ Encourage fluid intke at least 3L/day unless contraindicated such as heart and kidney failure .

‘ Administer medication as doctor order e.g.; bronchodilator, mucolytic and analgesics if indicated .

‘ Observe color of skin and nail bed to detect any sign of cyanosis .

‘ Assess mental status.

‘ Maintain bed rest and relaxation.

‘ Monitor ABG result & Intake &Output record.

‘ Provide well balanced nutrition but limit milk product.

‘ Offer frequent oral hygiene.

‘ Limit visitors as indicate &institute isolation precaution as individually appropriate.

2- Health Education:

‘ Teach the patient to practice deep breathing& coughing exercises frequently and correctly .

‘ Encourage the high risk patient to take pneumococcal vaccine and annual flu shot as prevention measures.

‘ Advise patient that fatigue, weakness and depression may prolonged after pneumonia.

‘ Encourage chair rest after fever subside, gradually increase activity to bring energy level back to pre-disease stage.

‘ Explain that chest x-ray is taken 4 to 6 weeks after recovery to evaluate lungs for clearance and improvement .

‘ Advice to quit smoking .

‘ Advise the patient to keep up natural resistance with good nutrition& adequate rest.

‘ Instruct the patient to avoid fatigue , sudden extremes in temperature and excessive alcohol intake which lower resistance to pneumonia.

‘ Advise avoidance of contact with people who have URTI for several month after pneumonia resolves.

‘ Practice frequent hand washing especially after contact with others.

3-Disability limitation to prevent complications ( prognosis and complication)

1-Prognosis:

‘ Most people with pneumonia improve after three to five days of treatment.

‘ Cyanosis and dyspnea reduced ,ABG result and O2 saturation improved.

‘ Coughs effectively with absence of crackles or wheeze .

‘ Appears more comfortable and free of pain.

‘ Fever controlled and no signs of resistant or recurrent infection.

‘ mild cough and fatigue can last longer, up to a month then improve.

2-complication:

As Discussed before

Tertiary level of prevention:

Outcomes of the disease

Disabilities includes:

1-Rehabilitation :

There are 5 types of rehabilitations :

Can be by :

‘ Physical include:

‘ Understanding the Medications has been prescribed

‘ Chest physiology therapy frequently

‘ Diet controlled according to dietitian plan

‘ Planning for regular Activity

‘ Pain Management

‘ Recognizing Danger Signs as discussed before

‘ Psychological include:

‘ By avoiding stress, depression and anxiety

‘ Encourage relaxation techniques

‘ Social include:

Social support by assisting the elderly in the recovery process and this can be categorized into six types:

‘ Listening

‘ technical appreciation

‘ technical challenge

‘ emotional support

‘ emotional challenge

‘ and shared social reality .

‘ Recreational include:

‘ thinking about the interests, values, skills and preferences

‘ social media

‘ the practice of sports and hobbies

‘ exploring the life

‘ involve in therapeutic cessations (group therapy)

‘ Vocational or industrial( Occupational) include:

‘ Choosing the right job which free from the risks that affected the health

‘ Leaving away from harmful climate and environment such as pollutions

‘ Ensuring that the work fits with personal circumstances

2-Follow up:

follow-up in clinic every 4-6 weeks at least with follow up chest x-ray and lab investigation for reassessment

and routine visit by home care team if ordered

https://www.youtube.com/watch?v=nC-goeA2vZc

Case Presentation:

Mr. A is a 68 years old married male he was working in chemical production factory ,heavy smoker started smoking since he was 20 years old he presented to the emergency room complaining of productive cough ,left sided chest pain ,fever and shaking that has become progressively worse over the past several days .he appears anxious and his face is flushed with history of colon cancer .

His Vital are as follows:

Bp:150/ 90 mmHg

Temp: 102.6 F

HR: 118

RR: 32 / MT shallow

Physical examination finding:

Auscultation:

Crackling or bubbling noises (rales) made by movement of fluid in the tiny air sacs of the lung.

Percussion:

Dull thuds heard when the chest is tapped which indicate that there is fluid in a lung or collapse of part of a lung.

The doctor order for chest x-ray after that report collected and he made his diagnosis?

1-So what is the diagnosis the doctor has suspected ?

Pneumonia

3- What is pneumonia and what was this case type or classification?

Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses

Type is Pneumonia in the Immunocompromised patient

4- List the predisposing factor and the signs and symptoms presented by Mr.A?

Predisposing Factor: 1-Age

2-working in chemical production factory

3-heavy smoker

Sing and Symptoms :1-productive cough

2-left sided chest pain

3-fever and shaking

5- are the major complications if Mr.A did not comes to ER?

1- Respiratory failure

2- Abscesses

3- Pleural effusions

4- Lung collapsed

5- Shock

6- Bacteremia

College Of Nursing

Geriatric Nursing (1610- 129)

Academic Y.1437- 1438 H (2016-2017)

Bridging Program ‘ 2nd Semester

Application about prevention and control

of C.D among elderly

(Upper Respiratory Tract Infection & Pneumonia)

Prepared by:

I.D. Students’ Names No

2160030252 Basma Hashim Al Musalam 1

2170030109 Zahra Taysser Al Saif 2

2170030113 Alya Matooq Al Janabi 3

2170030102 Safa Habib Al Abyad 4

2170030125 Latifa Subhe Al Anezi 5

2170030120 Huda Sulaiman Ba Maqbarh 6

2170030115 Salha Mefreh Aal Mushafea 7

2170030118 Amal Mohd Al Kotobi 8

Supervised by :

Dr.Lamia Amin

Primary level of prevention:

1)Health promotion.

Increase awareness and health education about healthy life style that should be followed strictly to prevent the occurrence of pneumonia among elderly people, such as :

‘ Maintain Proper hand hygiene

‘ Clean all the surfaces that are frequently touched like the knob door .

‘ Coughing or sneezing using tissue to prevent spread of droplet infection..

‘ Avoid overcrowded & bad environmental sanitation.

‘ Proper nutrition especially foods which high amount of Vit.C

‘ Adequate ventilation.

‘ Sleeping pattern

‘ Regular exercise

2)Specific protection:

Immunization and Vaccine

There are two types of vaccines:

1- pneumococcal conjugate vaccine (PCV13 or Prevnar 13”)

PCV13 which is recommended for all children younger than 5 years old, all adults 65 years or older, and people who are 6 years or older with certain risk factors.

2- and pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax”).

PPSV which is recommended for all adults who are 65 years or older.

Secondary level of prevention:

Include :

1-Early case:

‘ Early case finding through survey : To identify prevalence & incidence of pneumonia among elderly people

2-Diagnosis :

its include:

1-Investigations (discussed above)

2-Signs and symptoms (discussed above)

3-Mangement

A-Medical management :

1-Pharmacological:

By use of some medication that are recommended by physician accordingly such as ;

Antiviral Antibacterial Antifungal

Zanamivir (Relenza) Azithromycin (Zithromax) Amphotericin B

Oseltamivir (Tamiflu) Clindamycin (Cleocin) Voriconazole

2-Surgical intervention:

No surgical intervention required although in emergency situation patient will be ventilated till his prognosis become better

B-Nursing management:

Through

1-providing Nursing Care: such as

‘ Check vital signs including O2 saturation and depth and rate of respiration.

‘ Observe chest movement and breathing pattern .

‘ Auscultate the lung for breathing sound if there is any crackles or wheezing present.

‘ Elevate head of bed and change position frequently to mobilize present secretions Suction if needed .

‘ Encourage fluid intke at least 3L/day unless contraindicated such as heart and kidney failure .

‘ Administer medication as doctor order e.g.; bronchodilator, mucolytic and analgesics if indicated .

‘ Observe color of skin and nail bed to detect any sign of cyanosis .

‘ Assess mental status.

‘ Maintain bed rest and relaxation.

‘ Monitor ABG result & Intake &Output record.

‘ Provide well balanced nutrition but limit milk product.

‘ Offer frequent oral hygiene.

‘ Limit visitors as indicate &institute isolation precaution as individually appropriate.

2- Health Education:

‘ Teach the patient to practice deep breathing& coughing exercises frequently and correctly .

‘ Encourage the high risk patient to take pneumococcal vaccine and annual flu shot as prevention measures.

‘ Advise patient that fatigue, weakness and depression may prolonged after pneumonia.

‘ Encourage chair rest after fever subside, gradually increase activity to bring energy level back to pre-disease stage.

‘ Explain that chest x-ray is taken 4 to 6 weeks after recovery to evaluate lungs for clearance and improvement .

‘ Advice to quit smoking .

‘ Advise the patient to keep up natural resistance with good nutrition& adequate rest.

‘ Instruct the patient to avoid fatigue , sudden extremes in temperature and excessive alcohol intake which lower resistance to pneumonia.

‘ Advise avoidance of contact with people who have URTI for several month after pneumonia resolves.

‘ Practice frequent hand washing especially after contact with others.

3-Disability limitation to prevent complications ( prognosis and complication)

1-Prognosis:

‘ Most people with pneumonia improve after three to five days of treatment.

‘ Cyanosis and dyspnea reduced ,ABG result and O2 saturation improved.

‘ Coughs effectively with absence of crackles or wheeze .

‘ Appears more comfortable and free of pain.

‘ Fever controlled and no signs of resistant or recurrent infection.

‘ mild cough and fatigue can last longer, up to a month then improve.

2-complication:

As Discussed before

Tertiary level of prevention:

Outcomes of the disease

Disabilities includes:

1-Rehabilitation :

There are 5 types of rehabilitations :

Can be by :

‘ Physical include:

‘ Understanding the Medications has been prescribed

‘ Chest physiology therapy frequently

‘ Diet controlled according to dietitian plan

‘ Planning for regular Activity

‘ Pain Management

‘ Recognizing Danger Signs as discussed before

‘ Psychological include:

‘ By avoiding stress, depression and anxiety

‘ Encourage relaxation techniques

‘ Social include:

Social support by assisting the elderly in the recovery process and this can be categorized into six types:

‘ Listening

‘ technical appreciation

‘ technical challenge

‘ emotional support

‘ emotional challenge

‘ and shared social reality .

‘ Recreational include:

‘ thinking about the interests, values, skills and preferences

‘ social media

‘ the practice of sports and hobbies

‘ exploring the life

‘ involve in therapeutic cessations (group therapy)

‘ Vocational or industrial( Occupational) include:

‘ Choosing the right job which free from the risks that affected the health

‘ Leaving away from harmful climate and environment such as pollutions

‘ Ensuring that the work fits with personal circumstances

2-Follow up:

follow-up in clinic every 4-6 weeks at least with follow up chest x-ray and lab investigation for reassessment

and routine visit by home care team if ordered

https://www.youtube.com/watch?v=nC-goeA2vZc

Case Presentation:

Mr. A is a 68 years old married male he was working in chemical production factory ,heavy smoker started smoking since he was 20 years old he presented to the emergency room complaining of productive cough ,left sided chest pain ,fever and shaking that has become progressively worse over the past several days .he appears anxious and his face is flushed with history of colon cancer .

His Vital are as follows:

Bp:150/ 90 mmHg

Temp: 102.6 F

HR: 118

RR: 32 / MT shallow

Physical examination finding:

Auscultation:

Crackling or bubbling noises (rales) made by movement of fluid in the tiny air sacs of the lung.

Percussion:

Dull thuds heard when the chest is tapped which indicate that there is fluid in a lung or collapse of part of a lung.

The doctor order for chest x-ray after that report collected and he made his diagnosis?

1-So what is the diagnosis the doctor has suspected ?

Pneumonia

3- What is pneumonia and what was this case type or classification?

Pneumonia is an inflammation of the lung parenchyma caused by various microorganisms, including bacteria, mycobacteria, fungi, and viruses

Type is Pneumonia in the Immunocompromised patient

4- List the predisposing factor and the signs and symptoms presented by Mr.A?

Predisposing Factor: 1-Age

2-working in chemical production factory

3-heavy smoker

Sing and Symptoms :1-productive cough

2-left sided chest pain

3-fever and shaking

5- are the major complications if Mr.A did not comes to ER?

1- Respiratory failure

2- Abscesses

3- Pleural effusions

in here…