Pneumonia Case Study

C.M an 85 year old male came to the hospital presenting with short of breath, cough, increased respiratory effort, and wheezing. He was diagnosed with Pneumonia. C.M is a former smoker. He smoked a half a pack of cigarettes for 25 years. When smoking, the toxins breathed in irritate the respiratory system causing inflammation. Smoking for 25 years probably contributed to chronic bronchitis. C.M had a cough. The cough could have been from the chronic bronchitis. The bronchial mucus gland becomes enlarged and mucous is then secreted. Towards the end of the day he was producing blood tinged sputum. Productive cough with sputum is also a sign of pneumonia. The neutrophils engulf the foreign bacteria and leave an exudate substance that …show more content…
Hyperlipidemia can be caused by a high fat diet. The fat accumulates on the arteries. This can narrow the arteries, which makes it more difficult for blood to pass through. This causes hypertension. The heart has to work harder to pump the blood through the narrowed arteries. If the coronary arteries become narrowed coronary artery disease occurs. The coronary arteries supply the heart muscle with blood. When blood is restricted to the heart chronic heart failure can occur. The heart cells become deprived of oxygen and die. C.M is taking atorvastatin to lower his LDL levels and slightly increase his HDL levels. He is also taking amloipine, a calcium channel blocker, to help lower his blood pressure by inhibiting calcium into myocardial cells. By inhibiting calcium into the cells it inhibits excitation-contraction. He is also taking lisinopril, an ACE inhibitor, that blocks the conversion of angiotensin I to angiotensin II (a vasoconstrictor). The ACE inhibitor helps keep vessels open, lowering blood pressure. Aspirin is used to thin the blood by decreasing platelet aggregation (Vallerand). Keeping blood thin, helps prevent MIs. With CAD he is at risk for an MI because the heart’s blood supply is limited due to the narrowed coronary arteries. C.M’s blood pressure was 110/64. The medications are helping to keep his BP …show more content…
The EKG shows he is in A-Fib. There are no P waves indicating that the atrium is not contracting and just fibrillating. A-Fib is an irregular-regular dysrhythmia. The QRST complex is normal just appearing at unequal intervals. C.M’s heat rate went into the 130s. He went into RVR (rapid ventricular response), which is when the ventricles beat too fast (pulse 130s). This can become a problem because if the ventricles are beating too fast, they aren’t filling adequately. Not enough blood is ejected out of the ventricle and dispersed to the rest of the body. There is a risk for hypoxia. Decrease SpO2, cyanotic lips, and nail beds would be seen if hypoxia occurs. Risk factors for A-Fib that relate to C.M are older age, male, HTN, and heart failure. C.M takes metoprolol, a beta-blocker, that prevents vasoconstriction by keeping the vessels open. He also takes amloipine, a calcium channel blocker, to help slow the heart down. Warfarin, and anticoagulant, is needed to prevent blood clots forming in the atrium (Vallerand). The atrium isn’t contracting, so blood stasis may occur. Warfarin helps prevent strokes (INR=3.55). C.M has a pacemaker to send electricity to help the heart contract. The pacemaker acts as the SA node, sending electrical impulses that travel through the atrium, then to the ventricle to contract. The pacemaker only sends the electrical impulses if the heart rate is below 60. The pacemaker does nothing when the