The Core Measures for Pneumonia Treatment Case Study
SITUATION
Maria is a 40-year-old female presented to the emergency department with breathlessness. She was brought to the hospital by her husband who noticed the signs of dyspnea. Maria was quite sweaty and had yellow colored productive cough (yellow coloration of exudate usually reflects undergoing bacterial infection). Her sputum had traces of blood (due to inflammation of alveolar wall associated with hyperemia). The patient had a history of fever (raise of body temperature usually reflects activation of immune system and there is undergoing phagocytosis). Upon arrival, pulmonological examination was done which revealed herpes labialis, pain in the left axilla and dyspnea. She was suspected to have Pneumonia. “Pneumonia is defined as inflammation of the substance of the lungs” (Kumar and Clark 8th edition, p. 833). Generally caused by bacteria this disease causes inflammation of the lungs and infiltration of white blood cells which causes accumulation of exudate and consolidates the lung tissue leading to breathlessness and other characteristic symptoms of the lungs. The infectious agent enters human body through aspirated air. Non-specific defense mechanisms of human body try to terminate this infectious agent by means of enzymes which are present in saliva, the mucous produced by goblet cells also helps in terminating the bacteria. Human bronchi have ciliated epithelium which also help in expulsion of the mucous along with bacteria. This happens as a cough reflex when bronchi are irritated. The macrophages present in the alveoli swallow the pathogen by means of phagocytosis. Since Maria had a past of herpetic infection this puts her on higher risk of developing Pneumonia. Usually herpes infection decreases non-specific and specific immune reactions of human body, thus giving an opportunity to infections such as pneumonia to attack the human and may even take chronic form and cause extensive damage to the lungs consolidating them over the time and decreasing the patient’s ability to breathe properly.
Interpretation of data
Several diagnostic procedures were ordered. Chest x ray showed involvement of left lobes of lung. The x-rays cannot pass through the consolidated lung tissue representing them on the x-ray film. The exudate present in the alveoli shows as a whitish layer which can be easily located. Respiratory rate was found out to be more than 30/min. This condition is called as tachypnea. It occurs as a compensatory mechanism of human body to cope up with decreased oxygen content in the blood. Increased carbon dioxide levels are noted in the blood and decreased oxygen 7 kpa. which activated the respiratory center of medulla oblongata and causes tachypnea. Blood test was done to determine the levels of urea it stated more than 7mmol/l. blood pressure was 87/59 which is very low and a sign of pneumonia. White blood cell count was performed 21109/l which was high indicating the phagocytosis. Sputum culture tests were ordered which showed us the presence of pneumococcus.
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