265 Med Surg Hesi Case Study
Exam Questions and Answers
You review the rationale for Mr. Hannigan's nursing care. What is the underlying pathophysiology of
pneumonia? - Correct Answers: inflammation and/or infection of the lung
The pathophysiology of pneumonia involves excess fluid in the lungs associated with an acute
inflammatory process that is usually a result of infection. Microorganisms (bacteria, viruses, fungi,
parasites) gain entry into the respiratory tract either by inhalation (from airborne transmission with
talking, sneezing, coughing) or aspiration (secretions from the oropharynx or nasopharynx). The
organisms are not successfully cleared, and they become established.
You are making room assignments for several new admissions. How do you decide which room to assign
to Mr. Hannigan?
Which considerations are critical for the nurse to make when assigning a room to a client with
community acquired pneumonia (CAP)? - Correct Answers: Mr. Hannigan's confusion
Mr. Hannigan's confusion is an important consideration for room assignment. The fact that Mr.
Hannigan is confused places him at risk for injury. An initial assessment found Mr. Hannigan to be
disoriented to time, place, and person. Bed placement as close to the nurses' station as possible is
important.
Infection control
Infection control is an important consideration for room assignment. Mr. Hannigan has pneumonia,
although the specific organism responsible for infection is not known at this time. The means of
transmission is not yet known. To decrease risk for hospital-acquired pneumonia or other nosocomial
infections in other clients, Mr. Hannigan was assigned to a private room.
Community-acquired pneumonia (CAP) is often caused by the bacterium Streptococcus pneumonia
(typical pneumonia). This type of pneumonia is most common among older persons and among very
young children. Streptococcal pneumonia is one of the most common infectious causes of illness and
death among the elderly. That is why it is recommended that older adults, ages 65 and older receive the
pneumococcal vaccine.In adults, typical pneumonia is caused by streptococcus, Haemophilus
influenza,Staphylococcus aureus, Group A streptococcus or Moraxella catarrhalis. Atypical is caused by
Legionella, mycoplasma pneumonia, or chlamydia pneumoniae.
, There are different types of bacterial pneumonia (community acquired, hospital acquired, ventilator
associate, healthcare associated) and each have a period of communicability, means of transmission,
and type of isolation required. These vary depending on the infecting agent.The incubati - Correct
Answers: Standard Precautions
Centers for Disease Control (CDC) Guidelines for Isolation Precautions in Hospitals require that Standard
Precautions be used with all hospitalized persons, regardless of diagnosis or presumed diagnosis.
Droplet Precautions
Centers for Disease Control (CDC) Guidelines for Isolation Precautions in Hospitals require that Droplet
Precautions be used with persons who have suspected or known infections that are transmitted by large
particle droplets, including some pneumonias. These pneumonias are contagious with coughing,
sneezing, talking, and procedures requiring close contact. Usually transmission is by
nasopharyngeal/respiratory secretions and/or sometimes saliva. It is possible that Mr. Hannigan has a
pneumonia that will not require Droplet Precautions. However, it is prudent that Droplet Precautions be
instituted to prevent transmission of infection until such time that a diagnosis suggesting otherwise is
determined.
Contact Precautions
Centers for Disease Control (CDC) Guidelines for Isolation Precautions in Hospitals require that Contact
Precautions be used with persons who have suspected or known infections that can be transmitted by
direct (personal) or indirect (environmental surfaces) contact. Some pneumonias spread easily through
direct contact with infected persons or indirect contact with contaminated objects or surfaces. For these
pneumonias, transmission is usually by nasopharyngeal/respiratory secretions. It is possible that Mr.
Hannigan has a pneumonia that will not require Contact Precautions. However, it is prudent that
Contact Precautions be instituted to prevent transmission of infection until such time that a diagnosis
suggesting otherwise is determined.
For clients on droplet precautions and/or contact precautions, a private room is recommended. Clients
known to have infection with the same organism may share a room (cohorting), if a private room is not
possible.Given the availability of a private room close to the nurses' station, it was assigned to Mr.
Hannigan.
Standard precautions, droplet precautions, and contact precautions apply for Mr. Hannigan. Besides a
private room, which of the following infection control requirements are indicated? - Correct Answers:
Wear a mask with close contact
When providing close-contact (within three feet) direct care with clients on droplet precautions, the
health care provider should wear a face mask. Often, this means wearing a mask when in the client's
room.
Wear a gown when assisting Mr. Hannigan with bathing
Exam Questions and Answers
You review the rationale for Mr. Hannigan's nursing care. What is the underlying pathophysiology of
pneumonia? - Correct Answers: inflammation and/or infection of the lung
The pathophysiology of pneumonia involves excess fluid in the lungs associated with an acute
inflammatory process that is usually a result of infection. Microorganisms (bacteria, viruses, fungi,
parasites) gain entry into the respiratory tract either by inhalation (from airborne transmission with
talking, sneezing, coughing) or aspiration (secretions from the oropharynx or nasopharynx). The
organisms are not successfully cleared, and they become established.
You are making room assignments for several new admissions. How do you decide which room to assign
to Mr. Hannigan?
Which considerations are critical for the nurse to make when assigning a room to a client with
community acquired pneumonia (CAP)? - Correct Answers: Mr. Hannigan's confusion
Mr. Hannigan's confusion is an important consideration for room assignment. The fact that Mr.
Hannigan is confused places him at risk for injury. An initial assessment found Mr. Hannigan to be
disoriented to time, place, and person. Bed placement as close to the nurses' station as possible is
important.
Infection control
Infection control is an important consideration for room assignment. Mr. Hannigan has pneumonia,
although the specific organism responsible for infection is not known at this time. The means of
transmission is not yet known. To decrease risk for hospital-acquired pneumonia or other nosocomial
infections in other clients, Mr. Hannigan was assigned to a private room.
Community-acquired pneumonia (CAP) is often caused by the bacterium Streptococcus pneumonia
(typical pneumonia). This type of pneumonia is most common among older persons and among very
young children. Streptococcal pneumonia is one of the most common infectious causes of illness and
death among the elderly. That is why it is recommended that older adults, ages 65 and older receive the
pneumococcal vaccine.In adults, typical pneumonia is caused by streptococcus, Haemophilus
influenza,Staphylococcus aureus, Group A streptococcus or Moraxella catarrhalis. Atypical is caused by
Legionella, mycoplasma pneumonia, or chlamydia pneumoniae.
, There are different types of bacterial pneumonia (community acquired, hospital acquired, ventilator
associate, healthcare associated) and each have a period of communicability, means of transmission,
and type of isolation required. These vary depending on the infecting agent.The incubati - Correct
Answers: Standard Precautions
Centers for Disease Control (CDC) Guidelines for Isolation Precautions in Hospitals require that Standard
Precautions be used with all hospitalized persons, regardless of diagnosis or presumed diagnosis.
Droplet Precautions
Centers for Disease Control (CDC) Guidelines for Isolation Precautions in Hospitals require that Droplet
Precautions be used with persons who have suspected or known infections that are transmitted by large
particle droplets, including some pneumonias. These pneumonias are contagious with coughing,
sneezing, talking, and procedures requiring close contact. Usually transmission is by
nasopharyngeal/respiratory secretions and/or sometimes saliva. It is possible that Mr. Hannigan has a
pneumonia that will not require Droplet Precautions. However, it is prudent that Droplet Precautions be
instituted to prevent transmission of infection until such time that a diagnosis suggesting otherwise is
determined.
Contact Precautions
Centers for Disease Control (CDC) Guidelines for Isolation Precautions in Hospitals require that Contact
Precautions be used with persons who have suspected or known infections that can be transmitted by
direct (personal) or indirect (environmental surfaces) contact. Some pneumonias spread easily through
direct contact with infected persons or indirect contact with contaminated objects or surfaces. For these
pneumonias, transmission is usually by nasopharyngeal/respiratory secretions. It is possible that Mr.
Hannigan has a pneumonia that will not require Contact Precautions. However, it is prudent that
Contact Precautions be instituted to prevent transmission of infection until such time that a diagnosis
suggesting otherwise is determined.
For clients on droplet precautions and/or contact precautions, a private room is recommended. Clients
known to have infection with the same organism may share a room (cohorting), if a private room is not
possible.Given the availability of a private room close to the nurses' station, it was assigned to Mr.
Hannigan.
Standard precautions, droplet precautions, and contact precautions apply for Mr. Hannigan. Besides a
private room, which of the following infection control requirements are indicated? - Correct Answers:
Wear a mask with close contact
When providing close-contact (within three feet) direct care with clients on droplet precautions, the
health care provider should wear a face mask. Often, this means wearing a mask when in the client's
room.
Wear a gown when assisting Mr. Hannigan with bathing
