Questions
1. Identify the likely acute pulmonary complication the patient is experiencing.
2. Explain the underlying pathophysiology (aka. cellular/tissue changes) and relate it to abnormal examination and diagnostic findings.
3. Identify bundled prevention care strategies that should have been initiated upon admission to prevent this specific healthcare-associated pulmonary complication. Hint: See implemental materials in weekly module.
4. Explain additional diagnostic testing, medical treatment, and nursing care to treat the patient and/or prevent future complications.
Scenario:
A 47-year-old male was struck by a car while crossing the street. Upon admission to the emergency department, he was alert and oriented. His injuries included pelvic fractures and open fractures of the left extremities with significant blood loss. He required immediate orthopedic surgery and transfusion of blood products.
The patient has history of hypertension and was taking Lisinopril/hydrochlorothiazide daily. He has no recent antibiotic use within the past year prior to hospitalization.
The patient has been intubated and since his surgery 6 days ago. This morning, the nurse notes he has had new onset of large amounts of purulent yellow/green pulmonary secretions.
