Unfolding Case Study
1.
The patient is exhibiting several concerning respiratory cues, including low oxygen saturation, crackles in the right lung, dyspnea, increased shortness of breath, and cough with yellow sputum.
2.
Based on the cues, it can be inferred that the patient has developed pneumonia. Because the patient has been in the hospital for the last several days, this can be classified as a hospital-acquired infection.
3.
The patient likely developed pneumonia through contact with infected droplets. This is most likely related to poor hand hygiene, one of the major causes of healthcare-associated infections. The patient may also have underlying health conditions that put them at an increased risk for developing infection.
4.
The provider has ordered a sputum culture to determine the causative agent of the pneumonia. The patient was started on vancomycin at first because it is a broad-spectrum antibiotic. However, once the sputum culture comes back, the antibiotic may be changed to one that is more specific for the type of pathogen causing the infection. Supplemental oxygen was ordered because the patient is experiencing shortness of breath and dyspnea secondary to the infection. Droplet precautions have been initiated to prevent the spread of infection to staff and other patients on the unit.
5.
The patient has been placed on droplet precautions, which requires the nurse to wear a mask when entering the room. If the patient requires transport outside of the room, the nurse should ensure the patient is wearing a surgical mask.
6.
Findings that would indicate an improvement in the patient’s condition include improved oxygen saturation with less supplemental oxygen needed, improved crackles in the lungs, no fever, normal respiratory rate, and improvement in shortness of breath. If the patient is not improving, it may require a change in antibiotics because the patient has MRSA, which is resistant to several kinds of antibiotics.