Nursing care of Pneumonia Patients with Acute Respiratory Failure and Sepsis: Two Case Studies

Abstract

Objective: To study nursing care guidelines for pneumonia patients with acute respiratory failure and sepsis through two case studies. A case study approach was conducted to compare nursing processes between two pneumonia patients with acute respiratory failure and sepsis throughout critical care, continuous care, and discharge planning phases. The concept of Gordon's 11 functional health patterns was used as a guide to assess a patient problem, define a nursing diagnosis, plan for nursing care, and evaluate nursing care outcomes.

Results: Case Study 1: A 69-year-old Thai male patient, having diabetes mellitus type II, hypertension, and dyslipidemia, presented at the hospital due to having fever, cough, shortness of breath three days prior to admission. During admission at a community hospital, his symptoms worsened and, then, he was transferred to Khon Kaen Hospital for further treatment. The patient was intubated and mechanically ventilated, as well as received antibiotics. When his condition had improved, tracheal intubation was removed and rehabilitation was provided. The patient was discharged with a total hospitalization period of 14 days. Case Study 2: A 79-year-old Thai male patient with diabetes mellitus type II, hypertension, and chronic kidney disease stage 3 was transferred from a community hospital due to symptoms including low fever, cough, shortness of breath and less urine output, but not swelling, 3 hours prior to admission. The patient was intubated and mechanically ventilated. He also received antibiotics and diuretics. When his symptoms were stabilized, tracheal intubation was removed. The patient was referred back to the initial hospital to continuously received antibiotic treatment for seven days. The total hospitalization period at Khon Kaen Hospital was four days.