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Assignment 13.2: Community Acquired
Pneumonia Advanced Pharmacotherapeutics
Latest Update 2023
Assignment 13.2: Community Acquired Pneumonia For this week's assignment, I had taken care of Mrs. Anita Douglas who is a 72-year-old Black woman and came into the clinic with symptoms of Community Acquired Pneumonia. Mrs. Douglas stated that she been having cough, yellow to green nasal mucus discharges, and deep, dull chest pain on the lower right side since three days ago. Her chest pain is worsening when she coughs and with physical exertion. Rust-colored mucus production since two days ago. Mrs. Douglas also reported that she had been a fever since yesterday. She also complained of fatigue and muscle soreness. Mrs. Douglas has a medical history of hypertension and chronic kidney disease stage 2. Mrs. Douglas reported that her father also had hypertension. Mrs. Douglas currently takes 2 milligrams of trandolapril and 180 milligrams of verapamil combination daily and 500 milligrams of chlorothiazide twice a day. Mrs. Douglas also takes 325 milligrams of aspirin for her pain and fever. Instructed Mrs. Douglas to consult with a physician before taking aspirin for
pain and fever to reduce adverse outcomes. Mrs. Douglas also takes 1200 milligrams of Calcium and 15 micrograms of Vitamin D. She also tries to eat well, but usually eat pasta or salad and exercise lightly such as ten minute walks 2-3 times per week when she can to decrease her high blood pressure. Instructed Mrs. Douglas on the importance of maintaining regular exercises and proper healthy diet to decrease worsening her blood pressure. Mrs. Douglas had a pneumococcal vaccine approximately twelve years ago and received her flu shot annually. Instructed Mrs. Douglas of importance receiving pneumococcal vaccine every five to ten years after the initial vaccine to protect against the bacteria that are most commonly causing pneumonia. Mrs. Douglas was prescribed a five-day course of doxycycline antibiotics to treat the community acquired
erythromycin or doxycycline is a preferred treatment therapy (Harnett, 2017). For the patient with comorbidities and recent use of antibiotic therapy, either fluoroquinolone (moxifloxacin, gemifloxacin, or levofloxacinor), or beta lactam such as high dose of amoxicillin or amoxicillin- clavulanate plus macrolides or doxycycline is preferred (Harnett, 2017). It is important to ensure patient follow up within 48-72 hours of initial treatment to determine the clinical response to antibiotic therapy (Harnett, 2017). Antibiotics should be given for at least 5 days, and longer durations may be needed in immunocompromised patients or pulmonary complication patients (Harnett, 2017). As a future nurse practitioner, it is important to know these treatments so that appropriate decision processes and care plans could be provided to prevent worsening the illness and hospitalizations of the patient.
References Correa, R. A., Costa, A. N., Lundgren, F., Michelin, L., Figueiredo, M. R., Holanda, M., Gomes, M., Teixeira, P., Martins, R., Silva, R., Athanazio, R. A., Silva, R., & Pereira, M. C. (2018). 2018 recommendations for the management of community acquired pneumonia. Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia , 44 (5), 405–423. https://doi.org/10.1590/S1806- 37562018000000130 Harnett G. (2017). Treatment of Community-Acquired Pneumonia: A Case Report and Current Treatment Dilemmas. Case reports in emergency medicine , 2017 , 5045087, 1-7. https://doi.org/10.1155/2017/ Niederman, M. S., Mandell, L. A., Anzueto, A., Bass, J. B., Broughton, W. A., Campbell, G. D., Dean, N., File, T., Fine, M. J., Gross, P. A., Martinez, F., Marrie, T. J., Plouffe, J. F., Ramirez, J., Sarosi, G. A., Torres, A., Wilson, R., & Yu, V. L. (2001). Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention. American Journal of Respiratory and Critical Care Medicine , 163 (7), 1730– Lutfiyya, M. N., Henley, E., Chang, L. F., & Reyburn, S. W. (2006). Diagnosis and treatment of community-acquired pneumonia. American Family Physician , 73 (3):442-450.
