Question

The nurse is caring for a frail, older patient in the hospital after surgery to repair a bowel obstruction. The patient has a nasogastric NG tube, through which all her scheduled drugs are given, oxygen at 1 liter/nasal cannula at night, an indwelling urinary caterer, and a saline lock. The patient is weak and fatigued, has pain not relieved by IV opioids, and is reluctant to participate in any activities.

What risk factors does this patient have for developing pneumonia?

What actions does the nurse take to decrease the patient’s risk for pneumonia?

Two days later, the NG tube is removed and the patient is started on ice chips and other clear liquids. The patient swallows repeatedly when given sips of water. What action does the nurse perform?

The nurse does hourly rounds on the patient, and the patient’s daughter states, “Something is just not right with mom” What action should the nurse take first? What other actions should the nurse perform?

The physician orders a chest x-ray, and the results show pneumonia. What actions by the nurse are most important?

Answer 1

What risk factors does this patient have for developing pneumonia?

• Geriatrics more than 65 years
• Being hospitalized
• Weakened immune system
• Difficulty in swallowing and coughing
• Recent history of abdominal surgery

What actions does the nurse take to decrease the patient’s risk for pneumonia?

• The pneumococcal vaccine is one of the most effective ways to prevent pneumonia
• Avoiding smoking is another important way to prevent pneumonia
• Elevating the head end to 30 – 60 degree
• Oral hygiene at least twice a day
• Administer oral fluids to liqudify the secretions
• Avoiding the use of normal saline lavages when suctioning

What action should the nurse take first? What other actions should the nurse perform?

• Feeding through post pyloric tube to avoid regurgitations
• Administer antibiotics to prevent the accumulations of bacteria
• Advice the patient to maintain sitting position after meals
• Modification in the type of diet provided

What actions by the nurse are most important?

• Respiratory support by oxygenation and suctioning
• Maintain semi- Fowlers position to increase the lung space.
• Advice deep breathing exercise