week 10 two peer responses ,NURS 6521: Advanced Pharmacology,Week 10: Women’s and Men’s Health/Infections and Hematologic Systems, Part II

HH is a 68-year-old male admitted to the medical ward with community-acquired pneumonia for the past three days. His past medical history PMH is significant for chronic obstructive pulmonary disease (COPD), hyperlipidemia diabetes. He remains on an empiric antibiotic, including Ceftriaxone 1 gram IV  (3 days) and azithromycin 500 mg IV daily (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.

Height 5ft "8" inches, weight: 89 Kg

Allergies: Penicillin (Rash)

Introduction

   Subsequently, community-acquired pneumonia is the most common infectious disease and is a significant cause of mortality and morbidity globally. In this case scenario, the patient has a past medical history of Chronic Obstructive Pulmonary Disease, which predisposed the patient to community-acquired pneumonia. Pneumonia is the most common infectious disease condition and significantly affects individuals with chronic respiratory disorders. According to Restrepo, Sibila and, Anzueto,2018 reveal COPD patients are more susceptible to develop pneumonia base on their clinical characteristics, such a having chronic bronchitis with present mucus production presence of potentially pathogenic bacteria in the airway. Given the prevalence of chronic disease, nurse practitioners must be prepared to manage patient acute care needs in conjunction with chronic conditions. Hence, the purpose of this discussion is to explain the treatment regimen recommendation for treating the patient, which includes the pharmacotherapeutic of choice. Also, it will explain the patient education strategy for assisting with management.

Identified bacteria associated with Community-Acquired Pneumonia (CPA) include Streptococcus pneumoniae, Haemophilus influenza, Moraxella catarrhalis, and others. In treating the patient's pneumonia, it is essential to utilize an antibiotic to eradicate the specific bacteria. Firstly, determining the type of organism associated with the diagnosis will provide a concise vision of the appropriate pharmacotherapy needed for the treatment regimen. In selecting the antibiotic, the practitioner wants to ensure that the medication choice is a narrow or broad-spectrum based on the microorganism identified with a holistic approach. According to Rosenthal and Burchum,2021 a prime rule of antimicrobial therapy is to match the drug with the bug; the drug should be active against known or suspected pathogens, but its spectrum should be no broader than required. The patient noted with an allergy to penicillin, and Ceftriaxone is a third-generation cephalosporin that is contraindicated in patients with PCN allergy (Davis,2021). Hence patient appears to tolerate the medication without reaction. Azithromycin is a macrolide and is recommended for respiratory infection initial dose of 500 mg the 250 mg for the remaining four days (Davis,2021).

Adding an antiemetic such as Zofran (Ondansetron) will alleviate nausea and vomiting; also, it is feasible to add corticosteroids for inflammation in the lungs concurrently monitor patient blood sugar closely. Consequently, nausea and vomiting will lead to dehydration; therefore, IV fluids should be added if no contraindications.

In treating the patient in an inpatient environment, acute illness can require an assertive eye for the care of their longstanding health condition. Ensuring that we properly treat acute illness while doing our best not to exacerbate chronic illness is fundamental in providing competent care. The practitioner must consider the patient holistically and not just the presented issues.

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