Health Alteration and Context of Practice


In the present case, discussion has been included regarding Mr. Edward Hunter who is an 89 year old widower and is was admitted in the medical ward because of the saturated oxygen and viral influenza. From last 6 months, he has been receiving intensive home support from the acute care home which also includes oxygen therapy. Hence, considering his situation, discussion has been included altered pathophysiology of his health dimensions. In this respect, research has also stated difference between hospital acquired pneumonia and community acquired pneumonia. Along with this, suitable nursing care and its research method for the patient is also included in the study with the strategies of controlling and monitoring.

Question 1

What are the specific considerations a registered nurse should understand in relation to the clinical manifestations of pneumonia in the older person?

It is important for a Registered Nurse to understand and interpret the differentiating clinical manifestations of the older patient in comparison to younger patients. Clinical manifestations can be objective as seen by a professional, or subjective as expressed by the patient. In many cases, older individuals conditions develop and progress contrarily making understanding by health professionals crucial for treatment and patient wellbeing (Söderström and et. al., 2017). The elderly have a poorer immune system that means, it is more difficult for their bodies to fight infections naturally. It is important for the RN to consider all clinical manifestations presented by Mr Hunter. The clinical manifestations existing on Mr Hunters arrival are concerning and show his condition is rapidly deteriorating. As Mr Hunter suffered a myocardial infarction only one month ago, his chances of adapting pneumonia were increasingly high.

As per the requirement of clinical manifestation, it is essential for the registered nurse to emphasize on the immune system as through then only, the patient is able to cope up with the diseases. It is also analysed that overnight Mr Hunter becomes restless and at the same time he barely eats because of little appetite (Scannapieco and Shay, 2014). Thus, considering the same aspect it is essential for the registered nurse to review the pleuritic pain on inspiration so as to identify if the patient has the chances to develop pneumococcal pneumonia. Thus, registered nurse is required to focus on all the diagnosis because that depicts the actual condition of the patient. At the same time, emphasis can also be laid towards the symptoms as that might affect the health prospects of Mr Hunter.

Question 2

Outline the pathophysiology of altered ventilation and diffusion in relation to Mr Hunter’s pneumonia. Include pathological response in cells and tissues.

Afterwards, reviewing the existing case of Mr Hunter, it is clear that the degree of ventilation and diffusion has been changed because of pneumococcal pneumonia. Ventilatory failure and hypoxemic respiratory are the major forms that exists in pneumococcal pneumonia. It also brings changes in the lungs; hence it leads inflammatory exudate that affects the normal functioning residual capacity (Rogus‐Pulia and et. al., 2016). At the same time, it also causes loss of volume in the pulmonary infiltrate. It also consolidates the air space; hence it easily enhances the transpulmonary pressure. At the same time, the loss of volume also diminishes the total lung compliance which further enhances the level of oxygen saturation.

There is also an evidence that arterial hypoxemia exists in pneumococcal pneumonia and that is also caused by pulmonary artery blood flow. This also fuses the lung in an intrapulmonary diversion. This is also caused by intrapulmonary oxygen consumption that exist in the lung because of ventilation perfusion (Quinn and et. al., 2014). It is also ascertained that the persistence of pulmonary blood flow to lungs is caused by failure in the hypoxic pulmonary vasoconstriction mechanism. There are a number of factors that change the distribution of pulmonary blood flow. Similarly, it also increases consolidation in the lungs which systematically changes the ratio of diffusion. Therefore, it brings certain changes in the respiratory system; hence intensive supportive measures can be applied to treat

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