The patient, about whom the author is going to discuss for this case-study assignment, is Sarah Byrnes, a ten-year old girl who was in the author’s care while on their paediatric placement. A pseudonym has been used throughout this assignment to maintain patient confidentiality. The condition Sarah had which lead to her admission was bilateral-pneumonia. Sarah had previous admissions to hospital in the past for asthma exacerbations and chest infections. She currently still suffers from asthma and visits the doctor regularly regarding same. She was on medication on admission for her asthma, such as bronchodilators and steroids.
Pneumonia is a lower respiratory tract infection, which is caused by tiny micro-organisms disturbing the natural bacteria in the lung tissue causing inflammation, the most common one is Streptococcus Pneumoniae (Smeltzer S. el at 2013). It is generally characterised in patients with a chesty cough, pyrexia, tachypnoea, cyanosis and cackling or wheezy sounds on lung auscultation (Paul S. 2011, Hoving P. and Brand P. 2013) There are two types of pneumonia, hospital-acquired and community-acquired; the type of pneumonia Sarah was diagnosed with was community-acquired pneumonia as she was a healthy child before being contracting it (Paul SP. et al. 2011).
One patient problem, with which Sarah presented to the hospital, was poor oxygenation related to an ineffective breathing pattern. This was caused by excess secretions and due to Sarah feeling slight discomfort and pleuritic pain in her chest when she inhaled deeply so she was using shallow breaths, this also increased her respiration rate. On admission, Sarah’s oxygen saturations, when taken were 94% on pulse oximetry and remained around 94-98% on room air and her respirations were 37. Sarah became breathless easily on exertion and often appeared pale. The goals of care for Sarah in relation to this problem include: relieving the breathlessness felt by Sarah on exertion, Sarah would be able to maintain her oxygen saturations higher than 98% on room air. Finally, that Sarah’s pneumonia would subside with the help of antibiotics and she will show signs that she is no longer in respiratory distress, through obtaining adequate vital signs.
The nursing care interventions that were put in place for Sarah were that she was nursed in a ward room close to the nursing station for observation; this helped the nursing staff as they were able to help Sarah quicker when she got into distress her bed was also placed next to an oxygen port. Sarah was placed on Hartmann’s Solution of intravenous fluids as patients can become dehydrated quickly due to an increase loss of fluids through exhalation and from perspiring as she had an increased temperature. She was also encouraged to drink fluids. As Sarah had a decreased appetite, she was also put on Hartmann’s Solution of intravenous fluids to help maintain her electrolyte balance as it is infused with nutrients. (Smeltzer S. and Bare B....