NURS 6521 Walden University Wk 9 Patients Education and Health Needs

NURS 6521 Walden University Wk 9 Patients Education and Health Needs

NURS 6521 Walden University Wk 9 Patients Education and Health Needs

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Linnae Frisby Sample Paper

Week 9 Discussion & Assignment

HH, a 68-year-old man, has spent the last three days in the medical ward after being diagnosed with community-acquired pneumonia. His PMH is important for diabetes, hyperlipidemia, COPD, and HTN. He continues to take empiric antibiotics, which include azithromycin 500 mg IV once daily and ceftriaxone 1 g IV qday (day 3). (day 3). His clinical condition has improved since his admission, and his oxygen needs have decreased. He is currently complaining of nausea and vomiting and is not able to tolerate a diet.

Ht: 5’8” Wt: 89 kg

Allergies: Penicillin (rash)

Patient health needs:

In addition to continuing the patient’s antibiotics as a top priority, this patient will also require evaluation and treatment for nutrition since he is currently unable to tolerate a diet. Parenteral nutrition (PN) is used when oral or enteral feeding is not an option because malnutrition raises the risk of complications in hospitalized patients. If the patient can’t tolerate a diet, TPN should be taken into consideration (Comerlato, Stefani, Viana, & Viana, 2020).

Due to its high sugar content and the fact that infections thrive on sugar, TPN is also regarded as having a high risk in patients who already have an infection. Due to the patient’s diabetes, blood sugar levels must be checked at least every six hours. NURS 6521 Walden University Wk 9 Patients Education and Health Needs

Another consideration is with the allergy to penicillin, the provider will cover this patient with Ceftriaxone and azithromycin until the patient’s sputum and blood cultures result. Cultures are important to be sure the patient’s specific infection is covered and treated effectively. Bloodcultures are one of the most important specimens managed by the clinical microbiology laboratory and are the primary and most sensitive method for diagnosing bloodstream infections (bacteremia, fungemia, and sepsis), in addition to influencing appropriate antimicrobial therapy (Snyder, 2015). NURS 6521 Walden University Wk 9 Patients Education and Health Needs

Depending on what the sputum and blood cultures result, the provider will likely start the patient on vancomycin. The patient will also be assessed by the nutrition team to determine if the patient is a candidate for TPN or is an NG/OG is appropriate. The provider should also consider pre-treating the patient with an antiemetic prior to meals or at least a nutrition supplement drink. Antiemetics to consider could be: Zofran, Granisetron, Dolasetron, Haldol, Phenergan, Reglan, ect (Rosenthal & Burchum, 2021). NURS 6521 Walden University Wk 9 Patients Education and Health Needs

Patient Education:

Thorough education on the importance of nutrition and compliance with prescribed medications must be emphasized. The patient must be set up for success before discharge. The nurse and provider must be congruently to be sure that the patient understands the importance of their plan of care at home. This plan of care must include an adequate understanding of what nutritional needs need to be met at home, when to take his antibiotics and nausea medications, proper hand hygiene, and ways to prevent community-acquired infections. The patient must also be educated on the importance of following up with a primary care provider to ensure the patient is in compliance with his home care plan.

References:

  • Comerlato, P. H., Stefani, J., Viana, M. V., & Viana, L. V. (2020). Infectious complications associated with parenteral nutrition in intensive care unit and non-intensive care unit patients. Brazilian Journal of Infectious Diseases24(2), 137–143. https://doi-org.ezp.waldenulibrary.org/10.1016/j.bjid.2020.02.002
  • Rosenthal, L. D. & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
  • Snyder, J. W. (2015). Blood Cultures: the Importance of Meeting Pre-Analytical Requirements in Reducing Contamination, Optimizing Sensitivity of Detection, and Clinical Relevance. Clinical Microbiology Newsletter37(7), 53–57. https://doi-org.ezp.waldenulibrary.org/10.1016/j.c…