\u00a0<\/span><\/h2>\nPost<\/span><\/b>\u202fa brief description of your patient\u2019s health needs from the patient case study you assigned. Be specific. Then, explain the type of treatment regimen you would recommend for treating your patient, including the choice or pharmacotherapeutics you would recommend and explain why. Be sure to justify your response. Explain a patient education strategy you might recommend for assisting your patient with the management of their health needs. Be specific and provide examples.<\/span>\u00a0<\/span><\/p>\nYou will respond to your colleagues\u2019 posts in Week 10.<\/span>\u00a0<\/span><\/p>\nclicking on\u202f<\/span>Post Reply<\/span><\/b>!\u202f<\/span>\u00a0<\/span><\/p>\nBY DAY 6 OF WEEK 10<\/span>\u00a0<\/span><\/h2>\nRead<\/span><\/b>\u202fa selection of your colleagues\u2019 responses from Week 9 and\u202f<\/span>respond<\/span><\/b>\u202fto\u202f<\/span>at least two<\/span><\/b>\u202fof your colleagues on\u202f<\/span>two different days<\/span><\/b>\u202fwho were assigned a different patient case study, and provide recommendations for alternative drug treatments to address the patient\u2019s pathophysiology. Be specific and provide examples.<\/span>\u00a0<\/span><\/p>\n<\/h2>\nA Sample Answer For the Assignment: NURS 6521 WOMEN\u2019S AND MEN\u2019S HEALTH, INFECTIOUS DISEASE, AND HEMATOLOGIC DISORDERS<\/strong><\/h2>\nTitle: NURS 6521 WOMEN\u2019S AND MEN\u2019S HEALTH, INFECTIOUS DISEASE, AND HEMATOLOGIC DISORDERS<\/strong><\/h2>\nCase Study<\/span><\/b>\u00a0<\/span><\/h2>\nHH is a 68 yo M who has been admitted to the medical ward with community-acquired pneumonia for the past 3 days. His PMH is significant for COPD, HTN, hyperlipidemia, and diabetes. He remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3) and azithromycin 500 mg IV qday (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements. He is not tolerating a diet at this time with complaints of nausea and vomiting.<\/span>\u00a0<\/span><\/p>\nHt: 5\u20198\u201d Wt: 89 kg<\/span>\u00a0<\/span><\/p>\nAllergies: Penicillin (rash)<\/span>\u00a0<\/span><\/p>\nDiscussion<\/span><\/b>\u00a0<\/span><\/h2>\nCommunity-acquired pneumonia remains the single most common cause of death from infectious diseases in the elderly population. Adults aged over 65 years are a rapidly expanding cohort with growth rates more than twice that of younger populations with an expected 20% of the world\u2019s population reaching elderly status by 2050, the burden of CAP will be even more significant in the coming years. Moreover, the annual incidence of CAP in elderly patients is estimated to be 25\u201344 cases per 1000 persons (Stupak et al., 2009). In the above case study patient is an elderly 68yrs old who has been admitted to the medical ward with community-acquired pneumonia for the past 3 days with his PMH is significant for COPD, HTN, hyperlipidemia, and diabetes who remains on empiric antibiotics, which include ceftriaxone 1 g IV qday (day 3) and azithromycin 500 mg IV qday (day 3). Since admission, his clinical status has improved, with decreased oxygen requirements however he is not tolerating a diet at this time with complaints of nausea and vomiting. Therefore, the following treatment and health needs are important.<\/span>\u00a0<\/span><\/p>\n\u202f<\/span>\u00a0<\/span><\/p>\nPatient\u2019s Health needs<\/span><\/b>\u00a0<\/span><\/h2>\n\n- Treatment and need for longer hospitalization stay with longer IV ABX treatment<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
Mr. HH is 68ys old elderly patient and he is at risk of infection for a longer period. To prevent the spread of infection, he might need more than 7days of IV ABX treatment even though he is improving. Moreover, he is not tolerating the diet currently and complains of nausea and vomiting. Therefore, he may require a longer hospitalization stay with a longer duration of parenteral IV ABX therapy before switching to an oral antibiotic along with antiemetic medication. The oral course of ABX can be started once his nausea\/vomiting stop and able to tolerate the diet. Moreover, Pharmacists should evaluate medication choices, check for allergies and interactions, and educate patients about side effects and the importance of compliance.<\/span>\u00a0<\/span><\/p>\n\n- Need for treatment of his co-morbidities<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
Mr. HH has other significant co-morbidities like COPD, HTN, hyperlipidemia, and diabetes and should be treated with a bronchodilator and steroids for COPD, anti-hypertensive for HTN, Statin and Cholesterol for hyperlipidemia and Metformin or insulin for diabetes along with treatment of community-acquired pneumonia.<\/span>\u00a0<\/span><\/p>\n\n- Need for hydration and nutritional diet<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
Particular attention should also be paid to nutritional status, fluid administration, functional status, and comorbidity stabilizing therapy in this group of frail patients (Simonetti et al., 2014).<\/span>\u00a0<\/span><\/p>\nMr. HH is an elderly patient and risk of malnutrition since he is not tolerating his diet and complain of nausea and vomiting. Continuous iv fluids should be given for hydration and a nutritionist Consult should be done and parenteral nutrition should be started according to the needs of the patient.<\/span>\u00a0<\/span><\/p>\n\n- Need for financial support<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
The patient\u2019s financial status for treatment should be assessed by the case manager. If a Patient has Medicare or Medicaid, it will be covered by insurance but if the patient does not have insurance or financial support then the hospital should provide financial support via a charity fund or a discount should be given if possible.<\/span>\u00a0<\/span><\/p>\n\u202f<\/span>\u00a0<\/span><\/p>\n\n- Need for physical and psychological support<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
Physical support should be given by providing physical and occupational therapy to increase the activity of daily living, breathing exercises, and self-care. Help patient to maintain hygiene throughout the hospital stay. Similarly, emotional support should be provided by allowing him to express his feeling and allowing family time for emotional support that prevents depression.<\/span>\u00a0<\/span><\/p>\nRecommended Treatment<\/span><\/b>\u00a0<\/span><\/h2>\n\u202f<\/span>\u00a0<\/span><\/p>\n\n- In the presence of comorbid illness (chronic heart disease excluding hypertension; chronic lung disease – COPD and asthma; chronic liver disease; chronic alcohol use disorder; diabetes mellitus; smoking; splenectomy; HIV or other immunosuppression), a respiratory fluoroquinolone (high-dose levofloxacin, moxifloxacin, gemifloxacin) or a combination of oral beta-lactam (high dose amoxicillin or amoxicillin-clavulanate, cefuroxime, cefpodoxime) and macrolide is recommended (Regunath & Oba, 2022).<\/span>\u00a0<\/span><\/li>\n
- For patients with a CURB 65 score of greater than or equal to 2, inpatient management is recommended. A respiratory fluoroquinolone monotherapy or combination therapy with beta-lactam (cefotaxime, ceftriaxone, ampicillin-sulbactam, or ertapenem) and macrolide are recommended options for nonintensive care settings (Regunath & Oba, 2022).<\/span>\u00a0<\/span><\/li>\n
- The pneumonia severity index score can be used to assess the severity and need for more hospitalization in patients with community-acquired pneumonia<\/span>\u00a0<\/span><\/li>\n
- Diagnostic tests like chest X-ray, CT, or MRI can be done to identify infiltration or effusion<\/span>\u00a0<\/span><\/li>\n
- A complete blood count with differentials, serum electrolytes, and renal and liver function tests are indicated for confirming evidence of inflammation and assessing severity.<\/span>\u00a0<\/span><\/li>\n
- A chest x-ray will be needed to identify an infiltrate or effusion, which, if present, will improve diagnostic accuracy.<\/span>\u00a0<\/span><\/li>\n
- Blood and sputum cultures should be collected, preferably before the institution of antimicrobial therapy, but without delay in treatment.<\/span>\u00a0<\/span><\/li>\n
- Urine for Legionella and pneumococcal antigens must be considered as they aid in diagnosis when cultures are negative.<\/span>\u00a0<\/span><\/li>\n
- Influenza testing is recommended during the winter season. If available, testing for respiratory viruses on nasopharyngeal swabs by molecular methods can be considered. CURB 65 (confusion, urea greater than or equal to 20 mg\/dL, respiratory rate greater than or equal to 30\/min, blood pressure systolic less than 90 mmHg or diastolic less than 60 mmHg),<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
\n- Pneumonia Severity Index (PSI) are tools for severity assessment to determine the treatment setting, such as outpatient versus inpatient, but accuracy is limited when used alone or in the absence of effective clinical judgment.<\/span>\u00a0<\/span><\/li>\n
- Serology for tularemia, endemic mycoses, or\u202f<\/span>\u202fpsittaci<\/span><\/i>can be sent in the presence of epidemiologic clues<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
Education Strategy<\/span><\/b>\u00a0<\/span><\/h2>\nThe interpersonal level communication helps to use the community volunteer to alert the surrounding people about health hygiene, the impact of community-acquired pneumonia, treatment, antibiotic therapy, diagnosis, tests, and other health care services. Which can be conveyed even by conducting small-group educational programs. Moreover, elderly patients like HH should be provided education on the following topic:<\/span>\u00a0<\/span><\/p>\nThe following education strategy for the Community-acquired Pneumonia<\/span>\u00a0<\/span><\/p>\n\n- Staying compliance with medication helps in full recovery<\/span>\u00a0<\/span><\/li>\n
- Vaccination<\/span>\u00a0<\/span><\/li>\n
- All adults 65 years and older and those considered at risk for pneumonia must receive the pneumococcal vaccination. There are two vaccines available: PPSV 23 and PCV 13.<\/span>\u00a0<\/span><\/li>\n
- For all unvaccinated adults 65 years or older, first vaccinate with PCV 13, followed by PPSV 23 at least a year later for immune-competent patients and at least eight weeks or more apart for patients who are immune-compromised or asplenic.<\/span>\u00a0<\/span><\/li>\n
- Influenza vaccination is recommended for all adult patients at risk for complications from influenza. Inactivated flu shots (trivalent or quadrivalent, egg-based or recombinant) are usually recommended for adults.<\/span>\u00a0<\/span><\/li>\n
- Cessation of smoking: – Smoking is injurious to health and will damage the lungs by deteriorating their health condition. Educate patient on smoking cessation therapy and offer therapy like nicotine treatment<\/span>\u00a0<\/span><\/li>\n
- Hand Hygiene and mask<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
Proper hand hygiene and the use of a face mask while traveling in crowded places helps to prevent the transmission of disease and encouraged to wash hand with soap water or hand sanitizer<\/span>\u00a0<\/span><\/p>\n\n- Diet and exercise: – Eating a well balanced diet like protein-rich food, and green leafy vegetables help to increase the immune system and prevent infection as well as malnutrition. Breathing exercise helps to improve respiration<\/span>\u00a0<\/span><\/li>\n
- Follow up with PCP to monitor the health status<\/span>\u00a0<\/span><\/li>\n<\/ul>\n
\u202f<\/span><\/b>\u00a0<\/span><\/p>\n
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