Bilateral Pneumonia in a 69-Year-Old Female Patient

Topic: Pulmonology
Words: 603 Pages: 2


In the case under analysis, the patient, Sarah, is a 69-year-old female with shortness of breath as her major complaint. She has a history of heart failure and chronic obstructive pulmonary disease (COPD). The measurement of the level of oxygen in the blood (pulse oximetry) shows 82%, which is lower than normal levels of at least 95%. The body’s pH level is slightly low (7.30), as well as PaCO2 (58 mm Hg), while her PaO2 (78 mm Hg) and HCO3 (26 mEq/L) are within a normal range. Addressing these findings and the requirement of oxygen 2 L via nasal cannula, the nurse should evaluate the patient’s potential problems, provide multidimensional care, and examine the role of other departments for treatment.

Potential Problems

A low pH level proves a poor acidic-water balance in the body. The patient’s decreased pH, together with normal PaO2 and HCO3 levels and increased PaCO2, is a major sign of respiratory acidosis (Jung et al., 2019). This condition may provoke additional health risks for an older adult patient if it is poorly treated or misdiagnosed. Thus, the nurse should focus on potential problems like seizures, intracranial pressure, and organ failure. The patient may also report a reduction of heart muscle function and heart rhythm changes, which makes the nurse responsible for controlling arrhythmia symptoms. In addition to respiratory and cardiovascular problems, the patient is exposed to kidney damage (Jung et al., 2019). Therefore, the level of fluids in the body has to be regularly monitored during all care processes.

Multidimensional Care

In the patient, there are several areas of concern for nurses, which explains the importance of promoting a multidimensional care approach. In the past, Sarah had heart failure and COPD, and the nurse should follow such recommendations as appropriate breathing and relaxation techniques, oxygenation, and airway clearness. Her x-ray shows bilateral pneumonia, so it is important to follow acute respiratory distress syndrome signs and apply supportive and protective ventilation (Morris, 2018). The goal is to obtain high-quality respiratory secretions for sputum culture. Antibiotic therapy is also obligatory to manage bacteria in the organism. All these steps introduce the required critical elements of multidimensional care that can be offered to the patient with such present and past medical history.

Cooperation with Other Departments

In addition to the care that a nurse gives on a general medical floor, several departments should be included in developing Sarah’s treatment plan. The work of the respiratory and radiology departments is critical in this case. The patient has breathing problems, and it is important to evaluate Sarah’s capacity to breathe and respond to the therapy offered. A radiologist makes and interprets radiographic findings, and any x-ray changes prove the effectiveness or inappropriateness of the chosen course. The information from the department of geriatric care should also be included in Sarah’s treatment because of her age and past medical history. Such problems as chronic pain or medication side effects cannot be ignored, and a geriatrician is aware of these basics. Finally, the woman has to cooperate with a psychiatrist to predict the progress of mental health disorders like depression, insomnia, isolation, and anxiety about long-term pneumonia effects.


In general, Sarah’s case helps to understand the basics of multidimensional care and the worth of interpreting the patient lab results. It is not enough to examine and diagnose the patient but to offer an effective care plan and include as many healthcare providers from different departments as possible. Older adults require special care and management of their health problems, and if a nurse fails to notice something, there has to be another person for additional control.


Jung, B., Martinez, M., Claessens, Y. E., Darmon, M., Klouche, K., Lautrette, A., Levraut, J., Maury, E., Oberlin, M., Terzi, N., Viblino, D., Yordanov, Y., Claret, P. G., & Bigé, N. (2019). Diagnosis and management of metabolic acidosis: Guidelines from a French expert panel. Annals of Intensive Care, 9(1). Web.

Morris, A. C. (2018). Management of pneumonia in intensive care. Journal of Emergency and Critical Care Medicine, 2. Web.

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