AUBREY ROSE A.

VIDON September 15, 2020

BSN 3Y1 – 2 NCMB312 LAB

COURSE UNIT TASK #3

Create a conceptual map using the case scenarios as guide. Conceptual map should include
pathophysiology, medical diagnosis, signs and symptoms, and risk factors, if any. Nursing diagnosis,
nursing interventions, medical management (medical and procedures), expected outcomes.

A 78-years-old was admitted with pneumonia hyponatremia. Plasma Na concentration was

initially 129 meq/L, decreasing within 3 days to 118-120 meq/L despite fluid restriction to 1 liter/day. A
chest CT scan revealed a right 2.8x 1.6 cm infrahilar mass and post obstructive pneumonia. The patient
was active smoker. Past medical history was notable for laryngeal carcinoma treated 15 years prior with
radiation therapy, renal carcinoma, peripheral vascular disease, and hypothyroidism. On review of
system, he denied headache, nausea and vomiting. He had chronic hip pain, manage with
acetaminophen. Other medication including cilostasol, amoxicillin, digoxin, diltiazem, and thyroxine. He
was euvolemic on examination, with no lymphadenopathy and a normal chest examination.

Laboratory Results:

 Na – 120
 K – 4.3
 Cl – 89
 Bun – 8
 Crea – 1.0
 Glucose – 93
 Mg – 2.0
 Phos – 2.8
 Ca – 8.9
 Alb – 31
 TSH – 2.6
 Uric Acid – 2.7 md/dl

The patient was treated with furosemide 20 mg PO BID and salt tablets. The plasma Na
concentration increased to Na meq/L with this therapy: How ever the patient developed orthostatic
hypotension and dizziness. He was stated on demeclocycline, 600 mg po in the morning and 300 mg in
the evening, just before discharge from hospital. Plasma concentration increase to 140 meq/L with bun
of 23 and crea of 1.4 at which point democlocycline was reduced to 300 mg PO bid. Bronchoscopic
biopsy eventually showed small lung cancer. The patient declined chemotherapy and was discharge.
 CONCEPTUAL MAP Bacterial Pneumonia

 Inflammation in
the lung due to
bacterial infection
Pathophysiology
Signs and Symptoms
 Bacterial Pneumonia: this Viral Pneumonia
 Chest pain when you breath or infection triggers alveolar
cough inflammation and edema.
 Confusion or changes in
 Viral Pneumonia: this virus  It is a lung
first attacks bronchiolar infection
mental awareness epithelial cells and causes
 Cough, which may produce caused by a
interstitial inflammation and
phlegm desquamation. virus.
 Fatigue  Aspirational Pneumonia:
 Fever, sweating and shaking inhalation of gastric juices or
hydrocarbon inflammatory
chills Aspirational Pneumonia
changes and in activates
 Lower than body temperature
surfactant over a large area.
 Nausea and vomiting or
diarrhea  Is a type of lung
infection that is due
 Shortness of breath to a relatively large
amount of material
from the stomach
PNEUMONIA
Laboratory Result or mouth entering
the lungs.
HYPONATREMIA
 Na – 120
Being hospitalized - You’re at  K – 4.3
greater risk of pneumonia if  Cl – 89
you’re in a hospital intensive  Bun – 8
care unit, especially if you’re  Crea – 1.0
on a machine that helps you
Risk Factors  Glucose – 93
breath.
 Mg – 2.0
Chronic Disease – You’re  Children who are 2 years old or  Phos – 2.8
more likely to get younger.  Ca – 8.9
pneumonia if you have  People who are age 65 or older  Alb – 31
asthma, chronic  TSH – 2.6
obstructive pulmonary Other risk factors:  Uric Acid – 2.7 md/dl
disease (COPD) or heart
disease  Being hospitalized
 Chronic disease
 Smoking

Smoking – it  Weakened or suppressed

damages your immune system
body’s natural Weakened or suppressed
defenses against immune system – people
the bacteria and who have HIV/AIDS, who’ve
viruses that causes had an organ transplant, or
pneumonia who receive chemotherapy
or long-term steroids are at
risk
Nursing Diagnosis Nursing Interventions Medical Management Expected Outcomes

 Chronic hip pain  The patient was  CT Scan  Plasma concentration

 Infrahilar Mass treated with  Chest examination increase to 140 meq/L
 Post obstructive furosemide 20 mg  Bronchoscopic with bun of 23 and
pneumonia PO BID and salt Biopsy crea of 1.4 at which
tablets. point democlocycline
 Chronic hip pain, was reduced to 300
manage with mg PO bid.
acetaminophen.
Other medication
including
cilostasol,
amoxicillin,
digoxin, diltiazem,
and thyroxine
 Plasma Na
Concentration
Therapy