Harry Ware is a 45-year-old gentleman who has recently visited his General Practitioner (GP) complaining of a ‘chest infection’. He was admitted immediately to your ward where he was diagnosed as suffering from acute bronchopneumonia. On admission, he had a productive cough and complained of general pain in his chest when breathing deeply, felt lethargic and tired.
Ward baseline Observations
Oxygen saturations 85% on 2 litres (24%)
Temp 390C
Blood Pressure 110/60mm Hg
Pulse 125 beats per minute
Respiratory rate 32 breaths per minute
Medications as per drug chart;
Oxygen 2 litres continual via nasal or mask
Amoxicillin 500mg IV tds (three times a day)
Paracetamol 1g qds (four times a day)
Six hours after admission, Harry’s condition deteriorated, and he became pyrexia and was sweating. His breathing was noisy and rapid, with a faint expiratory wheeze. His tachycardia was increasing, and his pulse felt weaker than it did earlier (and his respiration rate was increasing). Harry was also more lethargic than he was on admission.
Discuss Harry’s acute management and nursing care in the first 24 hours following the deterioration with reference to the relevant pathophysiology.
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