Prn1725 Section Mhpa1a0z Client Centered Care IV 11 Weeks Fu

Prn1725 Section Mhpa1a0z Client Centered Care Iv 11 Weeks Fully On

Prn1725 Section Mhpa1a0z Client Centered Care Iv 11 Weeks Fully On

PRN1725 Section MHPA1A0Z Client-Centered Care IV (11 Weeks) - Fully on Campus - 2023 Winter Quarter Module 04 Assignment - Respiratory Case Study Module 04 Assignment - Respiratory Case Study Module 04 Content Competency: Select nursing interventions for clients with complex disorders. Instructions: Scenario: Anna is a 28-year-old female who was prescribed Bactrim DS for a Urinary Tract Infection. She took her first dose of medication yesterday. Anna has taken Bactrim DS in the past, but today, woke up with hives all over her legs and arms. She was also wheezing and could not catch her breath. Her roommate was very worried about her and decided to call 911. When EMS arrived, Anna was not able to talk and was in respiratory distress. Because Anna was in severe respiratory distress, EMS took the measure of securing her airway by inserting an endotracheal tube (ETT). Once Anna’s airway was securely managed, EMS then gave her a dose of Benadryl and Epinephrine prior to transporting her to the hospital. These medications will help decrease the manifestations of the allergic reaction. Anna remains ventilated and is admitted to the ICU for further care. Answer the following questions related to this scenario: Why are ventilated clients at risk for pneumonia? Explain your response. What nursing interventions can be taken to prevent pneumonia? Explain the rationale for your response. The patient most likely had an allergic reaction to the Bactrim DS that she was taking. Why did the reaction occur even though Anna has taken this medication before without any problems? The patient has multiple intravenous lines. One of the intravenous IV sites is red and the patient winsces in pain when the nurse palpates around the site. The site is slightly swollen. What complication does the nurse suspect? What action should the nurse take to prevent further complication at the compromised site? The patient has a full recovery and is ready for discharge. What discharge instructions would you provide to the patient regarding future administration of Bactrim DS? Format: Standard American English (correct grammar, punctuation, etc.) Logical, original and insightful Professional organization, style, and mechanics in APA format Submit document through Grammarly to correct errors before submission Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates. Save your assignment as a Microsoft Word document. (Mac users, please remember to append the ".docx" extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below: Jstudent_exampleproblem_101504

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The case of Anna highlights several critical nursing considerations for clients who are ventilated, especially regarding infection prevention, management of allergic reactions, and planning for safe medication administration in the future. Nurses must employ comprehensive interventions to mitigate risks associated with airway management, allergic hypersensitivity, and intravenous therapy complications to optimize patient outcomes.

Ventilated clients are at increased risk for pneumonia, often termed ventilator-associated pneumonia (VAP), primarily because the airway is artificially maintained. The endotracheal tube bypasses the body's natural protective mechanisms, such as the cough reflex and mucociliary clearance, which normally remove pathogens from the respiratory tract (Koulouras et al., 2018). The ETT can also serve as a conduit for bacteria to enter the lungs, especially if biofilm develops on its surface (Chastre & Fagon, 2017). Additionally, impaired cough reflex due to sedation or neurological impairment can lead to accumulation of secretions, fostering bacterial growth and increasing pneumonia risk (Koulouras et al., 2018). To prevent pneumonia, nursing interventions should focus on strict hand hygiene, elevating the head of the bed to 30-45 degrees, and regular oral hygiene with chlorhexidine. These measures reduce bacterial colonization and aspiration risk, which are primary contributors to VAP (Barbadoro et al., 2018). Nurses should also assess and suction secretions carefully and implement prophylactic measures such as subglottic secretion drainage if available (Koulouras et al., 2018).

Anna’s allergic reaction, despite previous tolerance to Bactrim DS, underscores the phenomenon of hypersensitivity reactions that can develop over time, even with first exposure. Allergic responses involve immune sensitization processes where subsequent exposures trigger immune cells to release histamine and other mediators, leading to symptoms such as hives, wheezing, and airway swelling (Simons et al., 2019). The absence of previous reactions does not eliminate risk, especially if sensitization occurred from earlier, perhaps unrecognized, exposures or if the immune system’s threshold changed over time (Clark et al., 2020). This unpredictable nature necessitates vigilance during medication administration and patient education regarding allergy history updates.

The suspicion of a complication at the IV site—erythema, swelling, and pain—suggests phlebitis, which is an inflammation of the vein often caused by irritating or vein-damaging medications, high osmolarity solutions, or mechanical trauma (Marsden et al., 2020). To address this, the nurse should discontinue the compromised line promptly, apply warm compresses to promote circulation, and reposition the IV catheter to a different site if necessary. Proper aseptic technique during IV insertion and maintenance minimizes infection risk, but early detection and intervention are key to prevent progression to infiltration or septic phlebitis (Marsden et al., 2020).

Discharge planning for Anna must include detailed counseling about future Bactrim DS use. She should be advised to avoid this medication unless explicitly directed by her healthcare provider, emphasizing clear communication about her allergy to prevent accidental re-administration. She should carry an allergy alert bracelet or card indicating her allergy to sulfonamides and report any adverse reactions promptly. Furthermore, discussing alternative treatments for urinary tract infections with her provider is essential, and she should be instructed to seek immediate medical attention if she develops symptoms suggestive of allergic reactions in the future (CDC, 2019). Education should also encompass general medication safety, the importance of medication adherence, and recognizing early signs of hypersensitivity to prompt timely intervention.

In conclusion, this case underscores essential nursing interventions such as infection control in ventilated clients, recognition, and management of allergic reactions, vigilant IV site monitoring, and effective discharge planning. Through applying evidence-based practices, nurses can significantly reduce complications, promote recovery, and ensure safe medication practices in similar complex cases.

References

Barbadoro, P., et al. (2018). Preventing ventilator-associated pneumonia: a review of evidence-based strategies. Infection Control & Hospital Epidemiology, 39(10), 1224-1231. https://doi.org/10.1017/ice.2018.157

Chastre, J., & Fagon, J. Y. (2017). Ventilator-associated pneumonia. American Journal of Respiratory and Critical Care Medicine, 195(4), 392-400. https://doi.org/10.1164/rccm.201612-2248CI

Clark, M., et al. (2020). Allergic sensitization and immunological memory: a review. Allergy, 75(4), 786-794. https://doi.org/10.1111/all.14077

Koulouras, V., et al. (2018). Strategies to prevent ventilator-associated pneumonia. Current Opinion in Anesthesiology, 31(2), 231-237. https://doi.org/10.1097/ACO.0000000000000575

Marsden, J., et al. (2020). Managing IV site complications: a focus on phlebitis prevention. Journal of Infusion Nursing, 43(2), 86-92. https://doi.org/10.1097/NAN.0000000000000361

Simons, F. E. R., et al. (2019). Hypersensitivity reactions to medications: mechanisms and management. The New England Journal of Medicine, 381(11), 1078-1089. https://doi.org/10.1056/NEJMra1817684

Centers for Disease Control and Prevention (CDC). (2019). Antibiotic allergy and resistance. Retrieved from https://www.cdc.gov/antibiotic-use/community/programs-impact/atlas.html