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Pneumonia Case Study
The general statistics and facts about the patient are as follows. The patient is a Caucasian whit e email that is 52 years old. She was admitted to St. Mary's hospital on 12/12/2012. She stood a bit over five feet tall and weighed around 128 pounds. She was married with two grown children and lives in a small camping trailer as opposed to a conventional home or apartment/room.
Both the patient herself and the spouse of the patient are of disabled status. Advanced directives for the patient were in force as of the date of admission of the patient, again that being 12/12/2012. The purpose of the admission on 12/12/2012 was for a pneumonectomy. The patient was prior-diagnosed with necrotizing pneumonia in August 2012 and she hoad a lobectomy in Sepbemter. However, the necrotizing pneumonia destroyed the rest of the patient's lung.
The patient in question had had a number of surgeries over her life numbering well into the double digits. These surgeries including a hysterectomy, a cervical laminectomy, a C-section, tubal ligation, breast reduction and knee surgery. The total surgery count stood at 18 in her lifetime. She was in the hospital for a total of 65 days, eventually being discharged on 2/14/2013. Overall health was greatly improved due to the surgery and the ensuing therapy and other treatment.
Functional Health Patterns
The functional health patterns for the patient were assessed on the 57th and 58th day of the patient's hospitalization, those days being 2/5/2013 and 2/6/2013. The sources of the information gathered for this report include the patient, the husband of the patient and the hospital staff.
Nutrition-Metabolic
As far as nutrition/metabolic information, the patient has the following general pattern of meals
Breakfast
Yogurt
Coffee
Lunch
Chicken
Salad
Dinner
One of any variety of soups
General Fluid Intake at any time
Water
Gatorade
Coffee
The patient said the following things about her appetite
Weight went from 128 pounds upon admission to nearly 100 pounds after the surgery
She gained about 20 pounds back after leaving ICU
No allergies
No trouble chewing
No difficulty swallowing
No difficulty chewing
Was 121 pounds upon discharge, only seven pounds lower than what she was upon admission.
Physical Assessment
Had the following skin/health issues beyond what has been mentioned already
Dry itchy skin
Bruising
Skin graft necessary for right thigh
No signs of infection from the thigh wound
Wound on right...
Just taking pills and the like
Able to fall asleep? Yes
Able to stay asleep? No
Cognitive & Perceptual
Able to read and write? Yes.
Languages spoken? Only English
How do you learn best? Reading
Do you learn new things well? Yes.
Do you wear glasses? Only for reading
Last visual exam: July 2012
Dizziness issues? No
Sensitivity to Cold/Heat? Yes
Pain with cold/heat sensitivity? Yes
Self-perception/self-concept terms? Thankful, happy for support.
Changes in perception? Near-death experience has shaped my perceptions a lot.
Biggest concern? Getting another infection
Lots of anger/anxiety, depression or fear? Depressed a lot and concerned about health.
Role/relationship: I life with my husband
Roles in the family? My role is limited due to my health
Health Perception/Health Management
The 53-year-old patient presented a chief compliant of a consistent and purulent yet productive cough. She also showed a failure to thrive and leukocytosis. The patient discussed her health history over the last few months. She said she was…
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