Case Analysis: Pneumonia

Maryville University

NURS 640

Concepcion

CASE ANALYSIS: PNEUMONIA 2

Case Analysis

This case presents an 84 years old male comes to the hospital with shortness of breath

upon exertion for about two days accompanied by a productive cough with a yellow sputum. The

patient also complaints of unusual fatigue and lack of appetite. Because of his age, this patient is

already at a high risk for community acquired pneumonia (Ramirez, 2020). This risk is

accompanied by medical history of asthma, hypertension, and consumption of alcohol. There are

unknown environmental factors that can also contribute to his exposure and risk. The patient

could not remember if he ever had a pneumonia vaccination which is a recommendation for

adults 65 year or older (CDC, 2020). Using the CURB65 assessment is one of the latest

evidences to predict patient’s mortality and a great indicator for admission when scoring two or

higher (Oktariani, Pitoyo, Singh, & Mansjoer, 2019). The use of pneumonia severity score is a

great resource to determine the need of hospitalization (Kaya, Ozkan, Usul, & Arslan, 2020).

This patient scores high on both assessments which warrants the hospitalization for management

and treatment of the pneumonia. The diagnosed of community acquired pneumonia is evident by

the results of the chest Xray, elevated white count, ABG results, and yellow sputum.

Nevertheless, it is also crucial to consider the patient’s history of asthma and include it in the

plan of care for evaluation and treatment. In this case, asthma can easily be exacerbated by the

pneumonia, so is important to treat both.

CASE ANALYSIS: PNEUMONIA 3

References

Ahmed, A., & Graber, M. (2019). Evaluation of the adult with dyspnea in the emergency

department. Retrieved on January 25, 2020, from https://www-uptodate-

com.proxy.library.maryville.edu/contents/evaluation-of-the-adult-with-dyspnea-in-the-

emergency-

department?search=chest%20xray&source=search_result&selectedTitle=2~150&usage_t

ype=default&display_rank=2

Aynur Ecevit Kaya, Seda Ozkan, Eren Usul, & Engin Deniz Arslan. (2020). Comparison of

pneumonia severity scores for patients diagnosed with pneumonia in emergency

department. Indian Journal of Medical Research, 152(4), 368–377. https://doi-

org.proxy.library.maryville.edu/10.4103/ijmr.IJMR_595_18

Centers for Disease Control and Prevention. (2020). Pneumococcal Disease:

Surveillance and Reporting. Retrieved on January 26, 2021, from

https://www.cdc.gov/pneumococcal/surveillance.html

Nur R Oktariani, Ceva W Pitoyo, Gurmeet Singh, & Arif Mansjoer. (2019). CURB 65 score as a

predictor of early mortality in hospital-acquired pneumonia. Egyptian Journal of Chest

Disease and Tuberculosis, 68(2), 231–235. https://doi-

org.proxy.library.maryville.edu/10.4103/ejcdt.ejcdt_146_18

Ramirez, J. A. (2020). Overview of community-acquired pneumonia in adults. Up To

Date. https://www-uptodate-com.proxy.library.maryville.edu/contents/overview-of-

community-acquired-pneumonia-in-

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