KERRY A 68 Y.O. FEMALE WEIGHING 76 KG,IS ADMITTED

Kerry a 68 y.o. female weighing 76 kg,is admitted to the Intensive Care Unit w/ Community Acquired Pneumonia.

Kerry a 68 y.o. female weighing 76 kg,is admitted to the Intensive Care Unit w/ Community Acquired Pneumonia.

QUESTION: A)Outline the rationale for the conclusion to intubate and mechanically ventilate.

Referring to Kerry 68 and her admission to the emergency care acordingly this essay will discuss the types of susceptible patients to infections and the most common micro-organisms associated with nosocomial infections. Including, how implications of effective handwashing, wearing of protective attire and appropriate disposal of wastes linen and sharps are strategies and methods used by nursing staff in preventing, controlling and reducing nosocomial infections.

Plus the importance of screening patients and how this minimises cross infection. This essay will lastly discuss factors contributing to an infection outbreak and the role and impact that health professionals have in these procedures. Different groups of patients are at higher risk of developing a nosocomial infection, undeniably certain factors contribute to susceptibility. Although, immunocompetent hosts are susceptible, in particular the elderly and immunocompromised patients are vulnerable to nosocomial infections due to reduced or impaired host defenses in resisting infection (Duffy 2002). (Rice & Eckstein 1995).

Potential sources of infection may be either exogenous or endogenous. Endogenous is the patients own internal microbial flora and exogenous organisms are external environmental factors including equipment, linen, visitors, hospital staff and other patients (Black 2002). Arelated condition, healthcare-associated pneumonia (HCAP), has furthermore been described where pathogens are associated with recent hospitalisation and/or antimicrobial therapy. HCAP has been defined as pneumonia happening in a patient who has: been admitted to hospital for 2 or more days within previous 90 days been resident in a nursing home or long term care facility attended a hospital within previous 30 days received IV antibiotic therapy, chemotherapy or wound care within the previous 30 days. (Guidelines for the management of HAP in the UK: Report of the Working Party on HAP of the British Society for Antimicrobial Chemotherapy. Journal of Antimicrobial Chemotherapy. 2008; 62: 5-34.) 2. Whead covering are the expected pathogens? Early onset: Often caused by community organisms such as Streptococcus pneumoniae or Haemophilus influenzae. Late onset: (or HCAP) The longer the patient is in hospital, the wider the spectrum of likely pathogens they have been exposed to and the more likely the organisms are to be resistant used to treat early onset pneumonia. Gram negative organisms such as Pseudomonas aeruginosa, Escherichia coli, Klebsiella spp., Enterobacter spp. and Serratia spp. may be implicated as can MRSA, MSSA, and anaerobes. Empirical antibiotic therapy should take into account these factors. 3. empirical therapy would you suggest for early onset HAP with no risk factors? Amoxicillin in addition to metronidazole or co-amoxiclav oral/IV depending on severity. May add gentamicin if severe to give increased gram-negative cover. Intravenous therapy is recommended where there are symptoms of infection (sweats, chills, rigors etc.) PLUS 2 of the following: Temp >38oC or < 36oC ...