Pneumonia
Pneumonia
Order Instructions
Read the following articles:
Lisy, K. (2014). Chest physiotherapy for pneumonia in children. The American Journal of Nursing, 114(5), 16. doi:10.1097/01.NAJ.0000446761.33589.70
Makic, M., Rauen, C., Jones, K. and Fisk, A. (2015) Continuing to challenge practice to be evidence based. Critical Care Nurse, 35(2), 39-50. doi:10.4037/ccn2015693
Certain practice habits continue to be used despite the availability of research and other forms of evidence that should be implemented to guide practice interventions. CPT is often prescribed for children with pneumonia, asthma, bronchiolitis, and atelectasis following surgery or mechanical ventilation.
Initial Discussin Post::
What is the expected outcome when implementing CPT?
What are the risks of performing CPT? Do the risks outweigh the benefits?
Is the practice of CPT supported by evidence? Are there safe, alternative interventions that the RN can implement to achieve the same outcome as performing CPT? If so, identify at least one.
Base your initial post on your readings and research of this topic.
*FORMATTING AND STYLE FOR WRITTEN ASSIGNMENTS:
*APA style is required for the writing assignments.
The body of your initial post to the discussion question must:
Contain a minimum of 250 words. References, citations, and repeating the question do not count towards the 250 word minimum.
• Contain at least one (1) current professional nursing reference.
o A current professional nursing reference is from current (five [5] years old or less) professional sources published in the United States.
o Sources such as Wikipedia, Medicine Net, nursing blogs etc. are not professional nursing resources and do not count towards the one (1)reference minimum.
Required:
Textbooks for this paper:
Brunner and Suddarth’s textbook of medical-surgical nursing**
• Chapter 23: Management of Patients with Chest and Lower Respiratory Tract Disorders (sections on “Atelectasis”, “Acute Tracheobronchitis” , “Pneumonia”, “Aspiration”, “Pleurisy” and “Pleural Effusion”, “Acute Respiratory Failure”,” Acute Respiratory Distress Syndrome” and “Chest Trauma”)
• Chapter 24: Management of Patients with Chronic Pulmonary Disease (sections on “Chronic Obstructive Pulmonary Disease” and “Plan of Nursing Care – Care of the Patient with COPD” )
Pharmacology**
• Chapter 41: Drugs for Lower Respiratory Disorders
Nursing Diagnosis Guidebook
• Use your chosen Nursing Diagnosis Guidebook to review the nursing diagnoses specific to the content covered in this module
Maternal and child health nursing**
• Chapter 40: Nursing Care of a Family When a Child has a Respiratory Disorder(sections on “Aspiration”, “Bronchial Obstruction”, “Bronchiolitis”, “Pneumonia”, “Atelectasis” and “Pneumothorax” only)
Web Based and Other Professional Resources:
• Chest physiotherapy for pneumonia in children (2014)**
• Continuing to challenge practice to be evidence based (2015)
• CDC guidelines for the pneumococcal vaccine
***Required Materials and text book for Nursing 211 course.
Textbooks (Chapter numbers and titles may differ in subsequent editions of a given textbook. If your edition is different, use the Table of Contents in the textbook to locate the appropriate chapters to read):
Hinkle, J., & Cheever, K. (2014). Brunner and Suddarth’s textbook of medical-surgical nursing (13th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Kee, J., Hayes, E., & McCuistion, L. (2015). Pharmacology: A patient-centered nursing process approach (8th ed.). St. Louis, MO: Elsevier.
Nursing Diagnosis Guidebook
A pocket-size nursing diagnosis guidebook of your choice that is no more than one edition old, that includes NANDA International-approved nursing diagnoses, definitions, defining characteristics, and possible nursing Interventions.
Pillitteri,A. (2014). Maternal and child health nursing: Care of the childbearing & childrearing family (7th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Web Based and Other Professional Resources:
American Heart Association. (2014). American Heart Association issues e-cigarettes recommendations.
Jenerette, C. M., Brewer, C. A., & Ataga, K. I. (2014). Care seeking for pain in young adults with sickle cell disease. Pain Management Nursing, 15(1), 324-330 7p. doi:10.1016/j.pmn.2012.10.007
Johnson, M. and Pennington, N. (2014). Adolescent use of electronic cigarettes: An emergent health concern for pediatric nurses. Journal of Pediatric Nursing. doi:10.1016/j.pedn2014.11.006
Lisy, K. (2014). Chest physiotherapy for pneumonia in children. The American Journal of Nursing, 114(5), 16. doi:10.1097/01.NAJ.0000446761.33589.70
Mahon, S. Screening for breast cancer: Evidence and recommendations. (2012). Clinical Journal of Oncology Nursing, 16 (6), 567-571. doi10.1188/12.CJON.567-571
Makic, M., Rauen, C., Jones, K. and Fisk, A. (2015) Continuing to challenge practice to be evidence based. Critical Care Nurse, 35(2), 39-50. doi:10.4037/ccn2015693
Mayer, D. K. (2012). Anatomy of a drug shortage. Clinical Journal of Oncology Nursing, 16(2), 107-108.
McKeever, A. E., Bloch, J. R., & Bratic, A. (2013). Drug shortages and the burden of access to care: A critical issue affecting patients with cancer. Clinical Journal of Oncology Nursing, 17(5), 490-495. doi:10.1188/13.CJON.490-495
Purbaugh, T. (2014). Alarm fatigue: A roadmap for mitigating the cacophony of beeps. Dimensions of Critical Care Nursing; 33 (1), 4-7.
Stevens, S. (2015). Preventing 30-day Readmissions. Nursing Clinics of North America, 50 (Transformational Tool Kit for Front Line Nurses), 123-137. doi:10.1016/j.cnur.2014.10.010
Wilson, B. H., & Nelson, J. (2015). Sickle cell disease pain management in adolescents: A literature review. Pain Management Nursing, 16, 146-151. doi:10.1016/j.pmn.2014.05.015
American Cancer Society
CDC guidelines for the pneumococcal vaccine
Drug Shortages page of the Food and Drug Administration website
Pulmonary Hypertension Association
SAMPLE ANSWER
Question 1
Chest Physical Therapy (CPT) is a technique that helps patients breathe more freely and receive more body oxygen. It is based on the theory that when particular back and chest parts are percussed, transmission of shock waves occurs through the chest wall. This in turn loosens the airway secretions. CPT has been used commonly in children with pneumonia. In a well-positioned, the secretions flow into the upper airways and then cleared through deep breathing techniques and coughing. The outcomes of CPT implementation include improved respiratory efficiency, elimination of respiratory secretions, changes in breath sounds, increased blood oxygenation as measured by ABG sampling, and improved chest X-ray findings.
Question 2
Some of the risk factors that have been associated with CPT include pulmonary hemorrhage, vomiting and aspiration, injury or pain to the ribs, spine or muscles, dysrhythmias, bronchospasms, and occasions of acute hypotension in some patients. CPT does more harm than go to the patient.
Question 3
There is no evidence that supports the use of CPT in evacuating mucus from the peripheral lung regions. Registered nurses have been challenged to evaluate their practice and embrace clinical practices that are evidence-based into their daily practice. Newer and safer interventions have been introduced in clinical practice to aid in curbing the adverse effects of CPT (Lisy, 2014). The interventions include Active Cycle of Breathing Technique (ACBT), autogenic drainage, forced expiratory technique (FET), and positive expiratory pressure (PEP). An interview like ACBT aids patients with respiratory conditions in clearing sputum by loosening and moving the sputum from the airways. Conversely, in PEP patients breathe against a resistance to force air behind the mucus and help it move from the air walls.
Reference
Lisy, K. (2014). Chest physiotherapy for pneumonia in children. The American Journal of Nursing, 114(5), 16. doi:10.1097/01.NAJ.0000446761.33589.70
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