Nursing care for a patient with drug-resistant pneumonia with acute respiratory failure : A case study.

Abstract

     This case study aimed to nursing care for a patient with drug-resistant pneumonia with acute respiratory failure. The subject was a 55-year-old Thai male laborer with underlying conditions including diabetes mellitus, hypertension, and hyperlipidemia. He was admitted to the hospital on April 17, 2024, presenting with acute shortness of breath following a one-week history of fever, nasal discharge, and persistent cough. Data were analyzed by content analysis.

     Result : Diagnostic tests confirmed a lung infection caused by E. coli ESCR, with chest X-ray showing bilateral pulmonary infiltration. Laboratory results revealed anemia and hypokalemia. Key nursing problems identified included: impaired breathing, risk of transmission of multidrug-resistant organisms, inadequate nutrition, discomfort from fever, reduced ability to perform daily activities, patient and family anxiety, and lack of knowledge regarding self-care after discharge. The nursing approach focused on respiratory support, administration of the antibiotic Meropenem based on culture results, fluid and nutritional management, fever reduction, assistance with daily living activities, physical rehabilitation, and discharge preparation using the D-METHOD framework. Caregiver education and community referral coordination were also provided. After three days of treatment, the patient's condition improved steadily: breathing normalized, fever subsided, oral intake resumed, and follow-up lab results and chest X-rays showed signs of recovery. The patient was discharged with a follow-up care plan. Both the patient and family demonstrated understanding of home care instructions. The total length of hospital stay was three days.