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INTRODUCTION
A. OVERVIEW
childhood, occurring more frequently in infancy and early childhood. It is also called
another illness.
wood, dung, or other biomass fuels), living in crowded houses and parental
smoking
2
INTRODUCTION
TRANSMISSION
Inhalation of viruses and bacteria that are commonly found in a childs nose or
throat
Inhalation of contaminated airborne droplets from someone elses cough or
sneeze
Bloodstream infections
In newborns, contact with organisms in the birth canal or contaminated
Fever
Cough: unproductive to productive with whitish sputum
Breath sounds: rhonchi or fine crackles
Chest pain
Nasal flaring
Pallor to cyanosis (depends on severity)
vaccine
3
INTRODUCTION
Reference:http://www.wpro.who.int/philippines/typhoon_haiyan/media/Pneumonia.pd
f?ua=)
B. STATISTICAL DATA
Local
According to the latest WHO data published in may 2014 Influenza and Pneumonia
Deaths in Philippines reached 51,889 or 9.95% of total deaths. The age adjusted
Death Rate is 90.40 per 100,000 of population ranks Philippines #46 in the world.
4
INTRODUCTION
International
Pneumonia remains the leading infectious cause of death among children under five,
killing 2,500 children a day. Pneumonia accounted for 15 per cent of all under-five
deaths and killed 920,000 children in 2015. Most of its victims were less than 2 years
old.
confinement, it was Thursday, October 13, 2016. The student nurses handled the
patient at 6-2 shift with an IVF of D5 0.3 Na Cl 500 cc, 35 drops per minute inserted
medication in Pediatric Ward at Laguna Provincial Hospital, San Pablo City, under
After the patients confinement, the group decided to conduct a home visit
for further assessment and to observe the patients progress at November 17, 2016 in
Purok 5 San Antonio San Pablo City, Laguna. During the duty and home visit, the
students doesnt encounter any problems in gathering data and information about the
patient since they had explained to the parents of the patient the purpose and motives
very well and as a result, they had willingly participated all throughout the interview.
Management 101.They want to implement and apply all the learnings and skills which
they acquired in their lectures taught by their clinical instructors. The student nurses
chose Pneumonia in a 1 year old, because it focuses on the disease of the child. Also
to enhance their critical thinking in analyzing their case and their decision making
additional information about the case and to further understand the normal
and control.
General Objective:
At the end of the case study, the Level II nursing students will be able to understand
and gain knowledge about patient diagnosed with Pneumonia Moderate Risk.
Specific Objectives:
As supported by the main objective, the level 2 student nurses will be able to:
Thoroughly assess the patient about her health condition through interacting
Plan appropriate nursing intervention with patient and family for identified
nursing diagnosis
3. Relate with patient and his family and the health team appropriately.
Gender: Female
7
INTRODUCTION
Nationality: Filipino
A. Present History
cough, and colds since October 9, 2016, she observed that the chest expansion has
more effort, abdominal distention, and she thinks that the patient has Difficulty of
Breathing. She said that, hindi siya makatulog tapos iyak ng iyak, tapos hindi rin siya
The mother also verbalized that she thinks patient CB acquired this illness
from her grandmother and she also thinks that infants and toddlers are prone to
Ang tagal na nung sakit niya, nakaka-ilang lingo naring nakakalipas, kasi
nung una, lagnat at sipon lang, tapos hanggang sa dalhin ko sya sa mga lola niya,
lalong lumala tapos napadala na sa ospital pagka-isang lingo, kaso masyadong mahal
doon sa ospital nayun, kaya umuwi na kami, tapos hanggang sa nahirapan na talaga
The mother gave ASCOF Lagundi 1/2 tsp two times a day since the illness
On October 9, 2016, the day before baby CB admitted to San Pablo District
Hospital, baby CB had fever, cough, and cold that lasted until the day after the student
nurses duty that was on October 13, 2016. On the night where the illness perceived,
the mother also gave Neozep Forte 2 mL for every 6 hours. At October 10, 2016,
exactly 5:30, the client was admitted in the Pediatric Ward with Chief Complaints of
Difficulty of Breathing accompanied with Fever, Cough and Cold. Patient CB was
The client had Intravenous Fluid (D50.3NaCl) 500 mL, 35 micro drops per
minute that was run for eight hours. Intravenous fluid is necessary to supply fluid,
especially toddlers, because they tire so easily with sucking and the patient cannot
Since the client had difficulty of breathing, the doctor ordered the mother
under Nothing per Orem the day she was admitted. As a relief for breathing, the
patient had oxygen inhalator via oxygen mask as needed until the day of the students
On the morning of students duty, client had temperature of 38.7C that was
why the doctor ordered Paracetamol through IV for faster effects to the patient. The
patient had prescription of several drugs such as: Salbutamol (1 neb, q4), Ceftriaxone
(200 mg, TIV, q12), Amikacin (64 mg, IV, q12), Immunozinc drop (1.0 mL, OD),
Neozep (1 mL, q6), Cetirizine [Allerkid drops] (1.0 mL, BID), and Forgam (200 mg,
TIV, q12)
The client also needs rest to prevent exhaustion. She needs to conserve
strength at the same time, the student turned and repositioned her frequently to avoid
pooling of secretions.
During the time of our duty, the assigned student nurse had taken the vital
signs of patient CB, with temperature of 38.6C, pulse rate of 133 bpm, and
B. Past History
IMMUNIZATION RECORD
intramuscular)
OPV (2 drops depending on 1st dose August 14, 2015
The patient is currently one year old. She was born in a health center at
Tiaong, Quezon and her mother claimed that her daughter was her 9 th child and that
her child failed to cry after the delivery and several minutes passed before she
stimulated to cry.
But after what happened, the mother perceived that her daughter was normal
On, September 20, 2016, one week prior to admission to San Pablo Colleges
Medical Center, the patient was experiencing cough and cold, then she was sent to her
maternal parents house to take care of CB because her mother was busy with work
and her other children. The mother of the patient didnt take heed that her mother or
This last September 27, 2016 the patient has complaints of 1 week cough, cold
and fever and has been hospitalized in San Pablo Colleges Medical Center in San
Pablo City, Laguna and was diagnosed with Community Acquired Pneumonia
associated with obstructive airway diseases in patients who require more than a single
On October 4, 2016, a week after, the patients mother requested for Home
Against Medical Advice due to lack of financial resources. The mother insisted that
C. Family History
Legend:
Deceased
Patient
Male
Female
Narrative:
One of the patients family has Pneumonia, which is her grandmother and
Grandfather Grandmother
Grandfather Grandmother
Father
Daughter Daughter Son Mother Son
PATIENT
D. Developmental History
mouth. It gets much satisfaction from putting all sorts of things in its mouth to satisfy
the libido, and thus its id demands. Which at this stage in life are oral, or mouth
According to clients mother, she didnt breastfeed CB since the day she was
born. She also said that this child is very fond of having a pacifier in his mouth most
of the time. She easily gets irritated every time her pacifier was being removed from
her. Even when she is sleeping, she will get awake and cry when she doesnt have to
suck into. Sometimes when doesnt have her pacifier, she instead sucks her own
In terms of handling different things, she always put directly in her mouth,
every object that her hands w they think has the possibility to harm the baby. All their
attention and eyes were focused on their son to avoid any unexpected accidents and
E. Psychological
But the mother said that her daughter still doesnt know how to control her
F. Sociocultural
The patients mother is also manghihilot, so the patient surely consults with
the mother and the mother is also the primary health provider of the patient.
G. Spiritual
Patient CBs religion is Roman Catholic. The patient goes to church with her
H. Nutrition
Breakfast
Lunch
Dinner
I. Elimination
changing her childs diaper her childs diaper after changing her childs diaper
after urination, it is not urination, its not as damp after urination, it is not
fully soaked but of its as the urination before her fully loaded but of its
verbalized that her child client was admitted to the verbalized that her child
usually eliminates his stool hospital during his first eliminates her stool 2-3
2-3 times a day before the day, she does not eliminate times. She describes it as
intestine is immature,
of discomforts in
eliminating stool. It is
napansin ko simula ng
October 9, 2016.
18
PATIENTS HISTORY
J. Exercise
because when patient CB plays, it requires all the body parts to move.
K. Hygiene
Before Hospitalization
The guardian is bathing the patient once a day in the morning. Everyday her
guardian brushes her teeth twice, in the morning and in the evening. Parents barely
wash her hands. Parents are the one who spoon feeding the patient. The parents also
During Hospitalization
The guardian provides sponge bath for the patient. The guardian provides oral
care for the patient once a day. The guardian still barely wash hands. The guardian is
After Hospitalization
The guardian is bathing the patient once a day. The guardian provides oral care
for the patient 2 times a day. The guardian learns from the nurse to wash hands all the
niya, nagigising siya kasi patient was able to sleep at the hospitalization, the
19
PATIENTS HISTORY
nahihirapan siyang 7:30 in the evening and patient can sleep well
yun na nahihirapan siya morning because of hot hours of sleep. Because the
tapos iiyak siya, tapos environment that made her patient before she got
kapag tinatanong ko kung uncomfortable, but ableto sleep, she was really a
of the patient.
Interpretation
Sweating is the bodys attempt to cool
itself in response to the temperature
elevation, and the patient might
experience chills and shaking as a result
of the process.
Reference: Weber& Kelley Health
Assessment in Nursing 5th Edition (2013)
page 251 Assessment of the Skin
Palpation Skin is soft and Warm to touch because of the bodys
smooth compensation to the bacteria. The
When pinched, patients body temperature was 38.6 C.
skin back to Inflammatory reaction occurs in the
previous state alveoli and then the white blood cells
(elastic) migrates and accumulates in the alveoli.
No signs of WBC and macrophages will release
edema while pyrogen (a substance, typically produced
palpating by a bacterium, which produces fever
Warm to touch when introduced or released into the
blood.) And then it will circulates in the
blood. Then it will stimulates
No clubbed
fingers
Palpation Capillary The patients lab also results with Low
refillof more Hematocrit it is becauseof
than 3seconds theinflammation of the alveoli that leads
With slightly to inadequate oxygen to the blood,
pale nail beds mucous secretion blocks the alveoli to
Smooth and firm circulatethe blood. Resulting in signs of
oxygen deprivation,Reduced oxygen levels
in the blood may produce a blue
21
PATIENTS HISTORY
nodules
Nose and Inspection With clear Because of the first line of defense, foreign
Sinuses And watery nasal material which is the streptococcus
Palpation discharge pneumoniae, there will be sneezing reflex
and cough.
Can able to
move the
tongue in all
direction
Uvula is at the
midline
No presence of
Areas Methods inflammation Interpretation
in oral mucosa
Findings
23
PATIENTS HISTORY
Findings
Palpation No palpable NORMAL
mass, lymph
nodes and
thyroid gland
enlargement
24
PATIENTS HISTORY
With gurgling
sounds
No bruits heard
Percussion With tympanic NORMAL
Palpation Tenderness in NORMAL
the left lower
quadrant,
specifically
there is
tenderness on
the descending
colon.
No pain, heat,
swelling or
nodules are
noted
Extremities Inspection Has no signs of NORMAL
lesions
Areas Method Findings Interpretation
26
PATIENTS HISTORY
No deformity
Warm to touch
.
27
ANATOMY AND PHYSIOLOGY
Oversees gas exchanges (oxygen and carbon dioxide) between the blood and external
environment
Exchange of gasses takes place within the lungs in the alveoli(only site of gas
Passageways to the lungs purify, warm, and humidify the incoming air
28
ANATOMY AND PHYSIOLOGY
External Nose
Nasal Cavity
Pharynx (throat)
Larynx
Trachea
Bronchi
Lungs
29
ANATOMY AND PHYSIOLOGY
Gas Exchange
Respiratory gas transport transport of oxygen and carbon dioxide via the
bloodstream
30
ANATOMY AND PHYSIOLOGY
Internal respiration gas exchange between blood and tissue cells in systemic
capillaries
31
ANATOMY AND PHYSIOLOGY
Inspiration
External air is pulled into the lungs due to an increase in intrapulmonary volume
Exhalation
External Respiration
1. Blood returning from tissues has higher concentrations of carbon dioxide than
Internal Respiration
33
ANATOMY AND PHYSIOLOGY
intercostal nerves
Neural centers that control rate and depth are located in the medulla
B C A
B C A
38
PATHOPHYSIOLOGY
Production of
lactic acid Increased RR
MUSCLE PAIN
39
DIAGNOSTIC PROCEDURES
Date: 10-11-2016
DIFFERENTIAL COUNT
Segmented 72.4 45-55 HIGH Neutrophil are the
Neutrophils (%) primary white blood
cells that respond to
bacterial infection.It is
increased to
phagocytize the
bacteria that are present
in the body of patient
which causes an
infection. The body
40
DIAGNOSTIC PROCEDURES
uses it to fight
infections.
(Reference:Nader D
Nader, MD, PhD,
FCCP.,Neutrophilia.,
Retrieved from
:http://emedicine.medsc
ape.com/article/208576
-overview)
RDW-SD - 37-54 - -
URINALYSIS
Date: 10-14-16
Cells
Bacteria Few Bacteria in urine can
suggest infection due
to vascular
permeability
SOURCE:
www..ncbi.nlm.nih.gov
Epithelial - - - -
Cells
Crystals AMORPHOUS
PHOSPHATES
CastS - - - -
Others - - - -
43
DIAGNOSTIC PROCEDURES
Radiologic Findings
10-12-16
No hilar fullness
IMPRESSION
IMPLICATION
A lower lobe infiltrate is a medical situation where an X -Ray of the lungs shows a gray
shadow on the left lobe is a build up bacterial infection that you can see to the x- ray result.
Source: www.reference.com
44
DIAGNOSTIC PROCEDURES
ORDER
pages 380)
Secure
TPR q4 &
The vital signs are body temperature,
record
pulse respiration and blood pressure,
NPO
NPO status is used to help prevent
temporarily
aspiration pneumonia
(https;//bellinosc.com/2014/09/09me
dical-terminology-deciphered-npo)
TVF:
and electrolytes.(reference:
http://www.answer.com/Q.
PHARMACY)
LABS:
https://www.ncbi.nlm.gov)
handbook)
Q4
Oxygen is a drug, so medication
possible.((foundation of basic
med. centre
last Sept.r 27
to Oct. 4
inhibiting crosslinking pf
Q12
64mg q12
(https://dailymed.nlm.nih.gov/
or medication can be
administered(https://dailymed.nlm.ni
h.gov/, http://medical-
dictionary.thefreeditionary.com/kvo
medication/
(http://www.medschat.com/yopics/im
muzinc-action)
Immuzincgtts
1,0 ml O.D
(https://www.m.webmd.com/a-to-z-
stat. (https://www.m.webmd.com/a-to-z-
guides/tc/pneumonia-exam-and-test)
or medication can be
administered(https://dailymed.nlm.ni
h.gov/, http://medical-
dictionary.thefreeditionary.com/kvo
8th edition)
54
DIAGNOSTIC PROCEDURES
Continue
meds.
or medication can be
administered(https://dailymed.nlm.ni
h.gov/, http://medical-
dictionary.thefreeditionary.com/kvo
8th edition)
Continue
transfer.(https://www.ndrugs.com/?
q6
Continue
salbutamol
D5 IMB 1L (https://dailymed.nlm.nih.gov/
8th edition)
Cont. meds
(https://dailymed.nlm.nih.gov/
TF: D5 IMB
500 ml X
(https:www.verywell.com/how-to-do-
chest-physical-herapy-child-under-
Chest five-998313)
clapping
KVO administered(https://dailymed.nlm.ni
h.gov/, http://medical-
dictionary.thefreeditionary.com/kvo)
Decreased
nebulizerq8
https://www.ncbi.nlm.gov
D/C
hydrocortiso
ne
Increase
or medication can be
TF: D5 IMB
administered(https://dailymed.nlm.ni
500 ml x kvo
h.gov/, http://medical-
dictionary.thefreeditionary.com/kvo
8th edition)
or medication can be
\ administered(https://dailymed.nlm.ni
h.gov/, http://medical-
X KVO
8th edition)
https://www.ncbi.nlm.gov)
Resume
Cont.
Montelukast is a leukotriene receptor
nebulizer q4
antagonist used as an alternative to anti-
65
DIAGNOSTIC PROCEDURES
bronchospasm (EIB)
(https://www.drugbank.ca/drugs/DB004
71)
milk
medication receptors.
66
DIAGNOSTIC PROCEDURES
1.0 ml BID
(6am-6pm)
be
dictionary.thefreeditionary.com/kvo)
67
DIAGNOSTIC PROCEDURES
8th edition)
8th edition)
be
KVO dictionary.thefreeditionary.com/kvo
facility.
OPD 8 hours
my after 1wk
70
DIAGNOSTIC PROCEDURES
References:
PPDS. Nursing Drug Guide, Philippines copyright 2007 by Malan press, INC p. 540
Nurses Drug Handbook by Jones & Bartlett Learning copyright 2011 10th edition, p. 507-509
name: 85 mg IV q4 for > Indication: Decreases fever by GI: Nausea, Assess patien
mol 37.8 To reduce fever acting directly on the hepatotoxicity,
hypothalamic heat vomiting. Assess allerg
ame: Contraindication: regulating center to reactions; rash
Hypersensitivity; cause sweating and HEME: Hemolytic urticarial; if th
intolerance to tartrazine, vasodilation which help anemia, leukopenia, occur, drug ma
ation: table sugar, saccharin. to dissipate heat. neutropenia, to be discontin
etic pancytopenia.
Assess
at: SKIN: Pruritus hepatotoxicity:
rash, urticarial urine, clay-col
jaundice, blisters stools, yellowi
skin and sclera
ous
Check input a
output ratio; de
output may ind
renal failure
Assess for ch
poisoning: rap
pulse; dyspnea
clammy extrem
report immedia
prescriber.
References: Nurses Drug Handbook by Jones & Bartlett Learning copyright 2011 10 th edition, p. 23-
25; PPDS. Nursing Drug Guide, Philippines copyright 2007 by Malan press, INC p. 32-33
Assess bowel pa
of dehydration: if
occurs, drug shou
72
DIAGNOSTIC PROCEDURES
discontinued.
Reference: PPDS. Nursing Drug Guide, Philippines copyright 2007 by Malan press, INC p. 75-76
Generic Name: 200 mg TIV Indication: Interferes with bacterial CNS: Chills,
Ceftriaxone q 12 To treat infections of the cell wall synthesis by reversible
lower respiratory inhibiting cross-linking of hyperactivity,
Brand name: infections. peptidoglycan strands. seizures, fever
Forgram Peptidoglycan makes the
Contraindication: cell membrane rigid and EENT: stomat
Classification: Contraindicated to protective. Without it, glossitis
3rd generation patient with bacterial cells rupture and
cephalosporin hypersensitivity to die CV: Edema
cephalosporin and
Ordered at: penicillin. GU: Elevated
10/12/16 level, renal fail
SKIN: Allergi
dermatitis, rash
urticarial.
References: PPDSNursing Drug Guide, Philippines copyright 2007 by Malan press, INC p. 107-108
Nurses Drug Handbook by Jones & Bartlett Learning copyright 2011 10th edition p. 208-
73
DIAGNOSTIC PROCEDURES
ic name: 4mg 1tab Indication: Antagonizes receptors for CNS: asthenia, Monitor patient
lukast 6pm mix Treatment of exercise cysteinylleukotrienes, fatigue, fever, adverse reactions
with ml induced produced by arachidonic acid insomnia, as cardiac and
d name: bronchoconstriction in metabolism and released from restlessness, tremor. pulmonary condi
air pediatric patients. mast cells, eosinophils and in patient, notify
other cells. When CV: Palpitations prescriber if suc
fication: Contraindication: cysteinylleukotrienes bind to reactions occur
triene receptor Hypersensitivity to any receptors in bronchial airways, EENT: Nasal
nist components acute they increase endothelial congestion, Assess patients
asthma attacks status membrane permeability, which pharyngitis, underlying condi
ed at: asthmaticus. lead to airway edema, smooth- sinusitis. before therapy an
16 muscle contraction, and altered regularly thereaf
activity of cells in asthmas GI: hepatotoxicity, monitor drug
: Oral inflammatory process, indigestion. effectiveness.
montelukast blocks these
: 24 hrs. effects. GU:Pyuria Assess respirati
auscultate bilater
24 hrs. RESP: Cough, lung fields: rate a
upper respiratory rhythm
ion: 24hrs. tract infection
References: Nurses Drug Handbook by Jones & Bartlett Learning copyright 2011 10 th edition p. 696-
698PPDSNursing Drug Guide, Philippines copyright 2007 by Malan press, INC p. 604-605
74
DIAGNOSTIC PROCEDURES
eric Name: 1.0 mL BID Indication: Competes with CNS: fever, Assess for allergy
rizine (6am-6pm) To treat histamine for H1 insomnia, fatigue. symptoms: rhinitis,
hypersensitivity. Receptor sites on pruritus, urticarial,
nd name: effector cells in GI CV: edema, watering eyes, befo
rkid Contraindication: tract, blood vessels, palpitation, and periodically du
Hypersensitivity to respiratory tract. tachycardia treatment
ssification: cetirizine or to any of its
histamine ingredients or EENT: Dry mouth. Assess respiratory
hydroxyzine, Severe status and increase
ered at: renal insufficiency. GI: Nausea, bronchial secretions
1/16 vomiting, increase wheezing.
appetite
te:
GU: urinary
retention.
et:
60 mins. RESP: Cough
k: SKIN:
Fixed drug eruption,
rash, pruritus
ation:
o 24 hrs.
References:
PPDS. Nursing Drug Guide, Philippines copyright 2007 by Malan press, INC p. 43-44
75
DIAGNOSTIC PROCEDURES
SKIN: Pallor,
flushing, rash
References: Nurses Drug Handbook by Jones & Bartlett Learning copyright 2011 10 th edition p. 37-
38 PPDSNursing Drug Guide, Philippines copyright 2007 by Malan press, INC p. 606
4. Imbalance Nutrition less than Body Requirements related inability to ingest food due to
Problem Prioritization
To relax
respirat
emascu
airway
Administer Hydro
mobiliz
cortisone 43mg. IV
secretio
q6 as ordered.
(Refere
NANDA
edition
Anti-
inflamm
medica
normal
respons
Administer (Refere
Amikacin 64 mg IV handbo
q 8 as ordered
it work
inhibiti
produc
bacteria
which c
bacteria
death
(Refere
handbo
pg.1522
Bronch
selectiv
B2agon
providi
Acting
Bronch
with a f
Nebulize 1 nebule (within
q15 minute q 4 in rever
78
DIAGNOSTIC PROCEDURES
airway
Obst
(Ref
Drug
hand
pg.2
Precipit
allergic
respirat
reaction
With oxygen trigger
inhalation via nasal acute ep
cannula 5Lpm (Refere
A 13th e
pg.88)
To mini
dust, sm
Instruct the mother feather,
to keep the accordi
environment individu
Allergen free. situatio
79
DIAGNOSTIC PROCEDURES
Subjective:
Nahihirapan Impaired Gas After 4 hours of
huminga ang aking Exchange related nursing Monitor vital sign all vital signs are
anak dahil sa to Alveolar Intervention, the cardiac rhythm and by changes of ox
sipon As capillary patient will assess patients (Reference :NAN
verbalize by the membrane demonstrate condition. edition pg. 423)
mother of the changes improved
patient. ventilation, and
adequate
Objectives: oxygenation by Auscultate lungs for In this nursing di
decrease crackles, ventilator effort i
Restless symptoms of consolidation and insufficient amou
respiratory pleura friction rub. dioxide. Abnorm
Irritability distress sounds are indica
numerous proble
Capillary refill (Reference: NAN
of more than 3 edition pg. 423)
seconds
Provide insight i
abnormal skin of breathing and
Observe skin color alveolar ventilati
color (pale) and capillary refill (Reference: NAN
edition pg. 422)
Vital sign
Temperature:
38.6C Pulse: Help limit oxyg
133 bpm consumption.(Re
NANDA 13th ed
Encourage the
Resp. Rate: 52 424)
mother of the patient
cpm to take adequate rest
and activities to
within client
tolerance
Promote optimal
Instruct the mother to expansion , mob
perform chest secretion and ox
physiotherapy after diffusion do back
nebulization.
80
DIAGNOSTIC PROCEDURES
(Reference NAND
Collaborative: edition pg. 424)
Administer oxygen
as ordered.
Improve Gas exc
decrease work
of breathing(Refe
DA 13th edition
81
DIAGNOSTIC PROCEDURES
Most fluid co
body through
water in food
Monitor fluid status
formed by ox
in relation to dietary
foods. Verifyi
intake.
patient is on a
restraint is ne
(Reference :N
edition pg,134
For rehydrati
and help wash
to reduce airw
and mobilize
Administer fluids
(reference: NA
and electrolytes as
edition pg. 88
indicated (D5IMB x
500cc to run for 8
Anti-inflamm
82
DIAGNOSTIC PROCEDURES
Administer inflammation
Hydrocortisone 43 to lessen the e
mg IV q6 as ordered
(reference: dru
pg 1522)
83
DIAGNOSTIC PROCEDURES
4. Imbalance Nutrition less than Body Requirement related to Inability to Ingest Food
Weak in
appearance instruct mother to To rep
provide a high nutrie
Had only 2 calorie, high protein high c
crackers in diet consisting of high p
the shift. soft , easy -to -eat diet).
foods.( high calorie (Refer
Body weight protein e.gchicken, NAND
9.5 chocolate, soy milk, Editio
kilograms. egg, cheese )
(normal11.2
kg. For 1 yr 5
months)
Prevent Unpleasant To pro
odor. good.
(Refer
NAND
editio
To av
Instruct the Mother spread
of patient on good micro
oral hygiene before (Refer
and after feedings. NAND
editio
84
DIAGNOSTIC PROCEDURES
85
DIAGNOSTIC PROCEDURES
To our co-student:
This study will help you to fully understand how pneumonia III high risks occurs,
what are the symptoms and management to be given to patient with his type ofdisease. You
will also learn how risk factors such as people living or traveling to tropical areas. This will
To faulty members:
This study will help you to recall all your knowledge and refreshes your idea about
pneumonia III risk factor. This may be helpful in teaching lessons of the faculty members
especially those who handle third year nursing students. We hope that this would be a great
To our beloved readers who are curious about pneumonia III risk factor. This will be
very helpful to you because all the contents of this study were focused on the said disease.
Diet medication and other health management to prevent occurrence of the disease are also
included.
87
SUMMARY OF DISCHARGE
Medication
No medication
Exercise
No exercise
Treatment
No treatment
Health Teaching
Instruct the mother to provide warm water rather than cold water.
Rationale: To soften the childs mucus that clog in his/her nose and throat.
Instructthe mother to give foods that are easy to digest such as fruits like orange,
banana and grapes. Vegetables like mash potato and puree squash.
Instructthe mother to let the child rest and sleep as much as possible.
Rationale: To conserve the energy and to help your childs body to heal.
Instructthe mother to take child's temperature at least once each morning and once
each evening.
Instruct the mother to not let anyone smoke around your child.
Rationale: To prevent child from coughing and breathing worse that is cause by
smoke.
88
SUMMARY OF DISCHARGE
Instruct the mother to wash her hands and her child's hands often.
Instruct the mother to not let her child share personal items with others.
Instruct the mother of the child to keep his head elevated to breathe better.
Instructthe mother to offer the child high-calorie food and drinks such as whole milk
and juice.
Rationale: To supply the essential nutrients which is common found in milk and dairy
products.
Out-Patient Department
Spiritual
Encourage the mother to maintain her spiritual needs and advise to never lose hope in
Source:
Electronics .
https://www.drugs.com/cg/pneumonia-in-children-discharge-care.html
http://www.livestrong.com/article/544124-diet-for-children-with-pneumonia/6
89
SUMMARY OF DISCHARGE
90
BIBLIOGRAPHY
Wongs Nursing Care of Infants and Children 1st Philippine edition Hockenberry/wilson
http://www.wpro.who.int/philippines/typhoon_haiyan/media/Pneumonia.pdf?ua=1
(references: medical-surgical nursing 5th edition by Lewis, Heitkemper and Dirksen Chapter
(wongs Nursing Care of Infants and children 1st Philippine edition Hockenberry/ Wilson
volume 2)
(https;//bellinosc.com/2014/09/09medical-terminology-deciphered-npo)
( references: jones and Bartlett nurses drug hand book 2015 (hydrocortisone page 256
andhttps://www.ncbi.nlm.gov)
Pediatric Nursing care for children and their families second edition)
(reference: Jones and Barlett Nursing Drug handbook 2015 (ceftriaxone page 223)
(https://dailymed.nlm.nih.gov/
91
BIBLIOGRAPHY
(https://dailymed.nlm.nih.gov/, http://medical-dictionary.thefreeditionary.com/kvo
(http://www.medschat.com/yopics/immuzinc-action
(https://dailymed.nlm.nih.gov/, http://medical-dictionary.thefreeditionary.com/kvo
(https://dailymed.nlm.nih.gov/, http://medical-dictionary.thefreeditionary.com/kvo
(https://www.ndrugs.com/?s=neozep%20forte)
(https://dailymed.nlm.nih.gov/
(https://dailymed.nlm.nih.gov/
(https:www.verywell.com/how-to-do-chest-physical-herapy-child-under-five-998313)
(https://dailymed.nlm.nih.gov/, http://medical-dictionary.thefreeditionary.com/kvo)
(https://dailymed.nlm.nih.gov/, http://medical-dictionary.thefreeditionary.com/kvo
https://dailymed.nlm.nih.gov/, http://medical-dictionary.thefreeditionary.com/kvo
( references: jones and Bartlett nurses drug hand book 2015 (hydrocortisone page 256 and
https://www.ncbi.nlm.gov)
(https://www.drugbank.ca/drugs/DB00471)
(https://dailymed.nlm.nih.gov/, http://medical-dictionary.thefreeditionary.com/kvo
(https://dailymed.nlm.nih.gov/, http://medical-dictionary.thefreeditionary.com/kvo
https://www.healthtap.com/user_questions/20857-why-does-pneumonia-decrease-
hemoglobin-levels
:http://emedicine.medscape.com/article/208576-overview23)
93
BIBLIOGRAPHY
https://www.healthtap.com/user_questions/1013250
https://en.wikipedia.org/wiki/Pulmonary
http://umm.edu/health/medical/reports/articles/pneumonia
https://www.drugs.com/cg/pneumonia-in-children-discharge-care.html
http://www.livestrong.com/article/544124-diet-for-children-with-pneumonia/6