Pneumonia Core Measures
Pneumonia, an acute respiratory disorder, is the leading cause of death amongst children. Caused by bacteria, viruses and fungi, it accounts for 1.1 million annual deaths in kids under 5 years old.
Although common in children, pneumonia affects young and older adults as well. Causing an average of 5.2 days in confinement, the registered nurse can help lessen its medical and financial burdens by following these pneumonia core measures:
As it has been mentioned, pneumonia can be caused by bacteria, viruses or fungi. Depending on the culprit, the doctor will prescribe the appropriate antibiotic, anti-viral or anti-fungal agent.
Because of the various microorganisms that can cause pneumonia, it is important that the nurse facilitates blood cultures. Know that they should be done within 24 hours upon admission, especially if the patient is transferred to the ICU. Since it helps determine the organism and the subtype that can cause the disease, blood cultures pave the way for better and immediate pneumonia hospital treatment.
Since pneumonia can be caused by a variety of organisms, the foremost health care is to give appropriate antibiotics. The treatment will of course, depend on the blood cultures, as well as the patient’s condition.
For non-ICU pneumonia patients, the treatment options are:
- Beta-lactams (IV or IM) with Macrolide (IV or PO)
- Beta-lactams (IV or IM) with Doxycycline (IV or PO)
- Macrolide Monotherapy (IV or PO)
ICU patients with pneumonia, on the other hand, are given the following antibiotics for urgent care:
- Macrolide (IV) with Beta-lactams (IV) OR Antipneumococcal/ Antipseudomonal Beta-lactam (IV)
- Antipneumococcal/ Antipseudomonal Quinolone (IV) with Beta-lactam (IV) OR Antipneumococcal/ Antipseudomonal Beta-lactam (IV)
- Antipneumococcal/ Antipseudomonal Beta-lactam (IV) with Aminoglycoside (IV) with Antipneumococcal Quinolone (IV) OR Macrolide (IV)
Non-ICU patients with pneumococcal risk are prescribed the following medications:
- Antipneumococcal/ Antipseudomonal Beta-lactam (IV) with Antipseudomonal Quinolone (IV or PO)
- Antipseudomonal Beta-lactam (IV) with Aminoglycoside (IV) with Antipneumococcal Quinolone (IV or PO) OR Macrolide (IV or PO)
- Aztreonam (IV or IM) with Antipneumococcal Quinolone (IV or PO) with Aminoglycoside (IV)
- Aztreonam 2 (IV or IM) with Levofloxacin (IV or PO)
Depending on the medications prescribed to your patient, you should observe the appropriate nursing interventions per drug. For example:
- Beta-Lactams: Monitor for signs of opportunistic infections. Discontinue at the first sign of colitis.
- Aminoglycosides: Watch for signs of neurotoxicity, renal impairment or ototoxicity. Ensure patient is well-hydrated.
- Quinolones: Ensure that pneumonia patient is well-hydrated. Provide antacids 2 hours after administration.
- Macrolides: If taking Azithromycin or Erythromycin, advise patient to take the meds 1 hour before/2 hours after meals. Monitor for hepatic dysfunction.
- Levofloxacin: Advise patient to take the meds 1 hour before/2 hours after meals. Ensure patient is well-hydrated. Discontinue at first sign of hypersensitivity.
- Aztreonam: Inform pneumonia patient that IV Aztreonam may cause taste changes.
Proper nursing care can help reduce the cases of pneumonia, a very prevalent disease. Make Obama care successful by learning more about the various core measures here at nclexpreceptor.com.