Pharmacology (Anti-infective Drugs)
In the contemporary medical world, fully recovered elderly individuals from an illness are likely to have a readmission. That is the case given the weak nature of their immune system, which predisposes them to other infections. A case in point is the elderly patient brought by Ms. Webb to the clinic with different clinical manifestations after fully recovering from pyelonephritis. In essence, this paper aims to analyze this case study to its practical details for the establishment of the most likely primary diagnosis, laboratory tests for its confirmation, and treatment.
Primarily, the patient’s most likely primary diagnosis is pneumonia going by the presenting signs and symptoms. The pneumonia is the community-acquired type to be more specific since this individual develops this condition while staying in the community. Winkelman, Workman, and Ignatavicius, (2013) are of the opinion that pneumonia patients will present clinically with manifestations such as fever, tachypnea, crackles on auscultation and signs of lung consolidation. As such, going by this description of pneumonia, it is apparent that the patient’s presentation in this case study befits that of an individual with a diagnosis of pneumonia. However, there is a need for further testing through the diagnostic tests to confirm this diagnosis.
Central to the confirmation of this diagnosis are several diagnostic tests ranging from radiological to laboratory tests that are worth noting. Of particular interest among the radiological tests is the chest X-ray. Chest X-ray for this patient will enable one to establish the presence of pulmonary infiltrate, which is a classic sign of bacterial pneumonia (Buttaro, Trybulski, Polgar-Bailey, & Sandberg-Cook, 2013). On the other hand, laboratory tests that are of utmost significance to this case scenario are sputum test and complete blood count. The patient’s sputum is necessary for culture and sensitivity, which will determine the specific bacteria causing pneumonia. As for the full blood count, its significance to the confirmation of this diagnosis is that an increased neutrophil count is suggestive of bacterial pneumonia (Copstead-Kirkhorn & Banasik, 2014). Evidently, with such tests, it is beyond doubt that one will be able to confirm this diagnosis.
Finally, the management of this patient also entails various treatment strategies that are of utmost importance in this discussion. At the heart of the management of this patient are the pharmacologic agents that will aid in the relief of his signs and symptoms. The pharmacologic agents of interest are the antibiotics, particularly the broad-spectrum antibiotics such as macrolides and cephalosporins before the confirmation of the specific causative agent. The macrolides such as erythromycin utilize a mechanism of action that entails inhibiting the protein synthesis and formation of the initiation complex (Woo, & Robinson, 2016). On the other hand, cephalosporins such as ceftriaxone have the mechanism of action of interfering with the cell wall synthesis of the bacteria. The dosages that are suitable for this patient’s condition include Ceftriaxone 1-2g for every 24 hours and Erythromycin 500mg QID x 7-14 days. One can use these drugs singly if the patient’s case is not severe or in a combined therapy if the condition is severe. One ought to change to a narrow spectrum antibiotic such as amoxicillin upon getting laboratory results of the specific causative agent. Amoxicillin has the mechanism of action of interfering with the bacterial cell wall synthesis causing cell lysis. Its dosage for the elderly is 500mg TID x 7-14 days (Woo, & Robinson, 2016). Based on the mechanism of action of these agents, it is beyond doubt that the patient’s condition will improve significantly.
In closure, this paper aimed at analyzing a case study involving a patient with classic signs of pneumonia to its practical details. Indeed, this discussion has largely achieved this objective by establishing the laboratory tests necessary for the confirmation of the primary diagnosis, and the likely treatment for the improvement of the patient’s condition. An implication drawn from the analysis is the need for laboratory testing for the confirmation of the primary diagnosis rather than relying on clinical manifestations. As such, going into the future, healthcare professionals must consider this implication if they are to improve their practice.
References
Buttaro, T., Trybulski, J., Polgar-Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed.). St. Louis, Mo.: Elsevier Health Sciences.
Copstead-Kirkhorn, L., & Banasik, J. L., (2014). Pathophysiology (5th ed.).
Winkelman, C., Workman, M., & Ignatavicius, D. (2013). Clinical companion, Ignatavicius Workman, Medical-surgical nursing (1st ed.). St. Louis, MO: Elsevier Saunders.
Woo, T. M., &Robinson, M. V. (2016). Pharmacotherapeutics for advance practice nurse prescribers. Philadelphia: F.A. Davis Company
