The Differences And Similarities Of Pneumonia And — страница 3

  • Просмотров 305
  • Скачиваний 5
  • Размер файла 19

examination will occur. The doctor will listen to the patients chest for crackles. After that, tests such as the CBC blood test, x-rays, blood and sputum test, biopsy or a bronchoscopy can confirm an infection of the lungs. A tuberculosis specific test is the Mantoux test which is a skin test that confirms the presence of the TB bacteria in the patients system. A conservative treatment would include antibiotics such as penicillin and isoniazid (INH) that would treat the infection in the lungs. Or bronchodilators may be used to help keep the airways open. Other treatments may include a proper diet or bed rest. There are not many choices when it come to surgical management for pneumonia or tuberculosis. In fact there is usually only one that is often used. That surgery is

thoracentesis and it is used to remove the pleural effusion from the lungs. The Course The course of pneumonia and tuberculosis can vary from person to person. In general the course begins with the development of symptoms and the visit to the doctor. After the visit to the doctor tests and examinations will occur to confirm the presence of pneumonia or tuberculosis. Once the infection has been confirmed medication may be prescribed along with possible bed rest. A prompt recovery can occur if: 1. they are young, 2. their immune system is working well, 3. the disease is caught early and; 4. they are not suffering from other illnesses. Most patients will be able to respond to the treatments and begin to improve within a couple of weeks. Throughout the treatment medical evaluation,

drug monitoring and bacteriology is completed. They will check the sputum twice monthly for TB until the smear is negative and the patient is asymptomatic which usually occurs within the first three months (Galantino and Bishop, 1994). For both diseases they will also watch the patient for drug side effects, resistance and compliance. In Joan’s case the TB infection was caught too late to use preventive treatments but once it turned active it was discovered after two weeks. Bio-Psycho-Social Effects There are many secondary biological effects from pneumonia and tuberculosis. Tuberculosis and Bacterial Pneumonia can enter the body’s blood steam and cause damage or further infection to any part of the body, which includes the kidney, joints, bones, liver, brain, reproductive

organs or urinary tract. Other secondary problems that may arise from either disease include anemia, pleurisy, lung abscess, pulmonary edema, chronic interstitial pneumonia, acute respiratory failure, empyema, slowing of the intestines or hyponatremia which is low blood sodium (National Jewish Center for Immunology and Respiratory Medicine, 1989). The patient may also suffer from psychological and social problems throughout the course of the disease. In extreme cases patients may be unable to participate in physical, recreational, or normal day activities which may cause social deprivation or depression. However most patients can expect to keep their jobs, stay with their families throughout the treatment and lead normal lives. In Joan’s case she was hospitalized so had become

socially deprived and was becoming very depressed. This is in part due to the fact the her treatment was ineffective for the first three days from the misdiagnoses. Goals and Interventions for the Pneumonia or Tuberculosis Patient To facilitate the recovery of patients who have pneumonia or TB there will be interventions from the Physical Therapist, Respiratory Therapist and Social Worker. Each profession will have roles in motivating , supporting and increasing the functional capability of the patient. The most common objectives of treatment include: 1. to decrease discomfort, 2. to facilitate the exchange of oxygen and carbon dioxide in the lungs, 3. to prevent atrophy from the increased bed rest, and 4. to prevent social withdrawal. Rehabilitation Goals and Interventions 1.

Maintain or increase muscle strength during decreased activity -provide a progressive resistive exercise program -promote weight bearing activities, engage in recreational activities and self care activities 2. Maintain or increase mobility of soft tissue and joints during bed rest and decreased level of activity? – provide passive and active range of motion -recreational activities combining aerobic, stretching, and strengthening 3. Develop, improve, restore or maintain coordination – practice skills with walking, dressing, hygiene and standing 4. Promote psych-social adaptation to disability and prevent social withdrawal – educate to adapt lifestyle – get involved in support groups and social interactions – body positions that decrease discomfort – Social Worker may