Hypoxia and pneumonia

Hypoxia and pneumonia:

Explaining the underlying physiology and the symptoms associated with hypoxia and pneumonia with describe the symptoms, explaining the process of carrying out the clinical assessment

Relevance and definition of hypoxia and pneumonia:

Pneumonia can be defined as the acute respiratory illness of infection which poses adverse impact on the functioning of lungs. In case of normal people, the air sacs are filled with the air (oxygen) thereby assisting the person to perform the inhalation and exhalation easily. In case of person suffering from pneumonia, the alveoli or air sacs are inflamed dur to which the sac are filled with pus and fluid. The fluid’s restrict the movement of oxygen through these sacs and also reduces the spaces for oxygen thereby causing severe breathing difficulties in patients.

More than 1 in each 1000 adults is affected by the pneumonia in the UK in each year. This disease is one of the most common disease in the winter and autumn [NHS, Choice, 2014]. Being an adult nurse, I need to have the clear knowledge about the management and prevention of pneumonia.

Pneumonia leads to cause hypoxia in patients. Due to the insufficient oxygen supply to the cells ATP is produces anaerobically. Body follows the glycolysis pathways to transform to glucose to the 2 pyruvic acids molecules. In case of people suffering from pneumonia, due to insufficient oxygen in the cells the pyruvic acids cannot enters into the Kreb’s cycles thereby producing the lactic acid as a by-products which then increase the overall ph values of the blood thereby making blood more acidic. This changes then sensed by chemoreceptors located in the medulla oblongata which then causes the stimulation of diaphragm thereby enhancing the overall breathing rate in terms of inhaling the more oxygen and exhaling the CO2 and reducing the blood pH level ((Marieb and Hoehn, 2014).)

ABCDE assessment:

First, I am going to assess the different areas of safety and then call for the medal support

I will ask sets of simple question to patients such as ‘How are You?’

If the patient is able to answer the questions normally without showing any symptom then it points out that the patients has patent airways

If the patient speaks little then it points out that the patients may have the partial respiratory distress

If no response can be gathered from the patients the it will point out the fact that the patients suffer from the serious breathing issues that need immediate clinical support

Then I will carry out the checking of the oxygen saturation level of patient by using pulse oximeter ad ECG

Airways:

Three kinds of airways are there including:

• Patent or safe
• Partially occluded or risk airways
• Fully occluded or blocked airways

During the process I check the airways of the patient I am going to use the look, listen and feel process

Here I will look for symptoms in the patients like vomit, blood, swelling, abnormal saw and see movement, paradoxical chest movement, foreign bodies in the mouth and central cyanosis.

I will listen to the noises such as wheezing, snoring, rattling, stridor and gurgling. If the patient has fully occluded airways then there will be no sound of breathing. On the other hand, in case of patient with partially occluded airways there will be diminished entry of air.

I am going to feel the airway through the nose as well as the mouth of the patient.

If there is airways obstruction in the patient I will call for the immediate medical support

Most of the health and nursing professionals use the simple methods such as insertion of the airway adjunct and airways suction in terms of treating the airways obstruction.

While treating the pneumonia patient I will expect the symptoms like difficulties of patients in speaking, heavy cough and pain. Depending on the brain perfusion that the patient has there may the altered and different level of the consciousness. May be there is no foreign bodies in the mouth of the patient but may be there green sputum, which I will remove through using the airways suction process of the patients faces difficulties in removing the sputum himself or herself. Then I will place the patient uprights and carry out the application of the high concentration of oxygen by using the mask with the oxygen reservoir containing a flow of 11-15 litters.

Breathing:

Here also I am going to use the look listen and feel approach.

I will look for the signs such as sweating, respiratory difficulties, chest pain, chest tightness, abnormal breathing, central cyanosis and wheezing.

I will listen to the noise such as wheezing, rattling, snoring

I would feel the position of the trachea and the chest movement

I will expect that the patients will show severe respiratory difficulties with high respiratory rate on more than 30 with unequal chest expansion and the shallow breath. Patients will also use the accessory chest muscles to take the oxygen and exhale the CO2 due to the poor lung activity, which point out the possible symptoms of cyanosis.

Circulation:

During the assessment, I will check the colour of patient’s hand, feet and fingers to determine whether there is any chances of cyanosis. I will check that whether the body parts are blue, pale, mottled or pink. I will also determine that whether these body parts of patients is warm or cool

I will check patient’s pulse in terms of determining its rate, rhythm, quality, regularity and equality.

I will check the heart rate (rhythm and amplitude) , blood pressure ( diastolic and systolic)

I will also check that whether the patient shows any other additional signs such as lower urine formation (less than 50 ml per hour) and lack of consciousness

I will insert 16G intravenous cannula.

I will take patient’s body for carrying out the routine investigation I will also carry out the cross-matching blood transfusion

I will reassess the BP regularly.

While treating patents I will expect that the hands hand and feet of the patient will be felt hot. This is because of the temperature increase due to the lung infection and inflammation of alveoli I will also expect the capillary refill at slower rate in the patient with the sign of tachycardia. The patient will also have sign of hypertension with lower urine production as well as less output (less than 50 ml per hour)

Disability:

I will assess the Glasglow Coma Scale or GCS and AVPU (Alert, responds to Voice, responds to Pain, Unresponsive)

I will also determine whether the patient has Hypertension or hypoxia

I will examine the blood sugar level and will determines the pupil size and PEARL

I expect that the patient will show a sign of altered consciousness due to the increase level of CO2 ad less O2. The patients will also have the increased blood sugar level

Exposure:

I will examine whether there is any rashes, swelling, bleeding and fracture in patient’s body

I will determine he patient’s autonomy and dignity are maintained throughout the care process

If the patient has pneumonia then her f she will not have an rashes , fracture or bleeding.

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