Nursing care for patients with pneumonia and complications including septic shock at Kalasin Hospital : A case study.

Abstract

      This study compared two purposive case studies of pneumonia patients admitted to Kalasin Hospital between May and June 2025. Medical records were collected, and the FANCAS framework was used to identify problems and plan nursing interventions. Nursing outcomes were continuously summarized and evaluated.

      Results

      Case Study 1: A 55-year-old Thai female patient presented with high fever and vomiting one day prior to admission. Her medical history included uncontrolled diabetes, missed appointments, and medication non-adherence. She was diagnosed with pneumonia with sepsis and denied any underlying medical conditions. Complications upon admission included acute pyelonephritis, hyponatremia, hypomagnesemia, infected skin at the perineum, and urinary tract infection, along with hypoxia. She was treated with antibiotics and HHFNC oxygen therapy for four days. Her condition improved progressively, and she was discharged. A follow-up appointment with an internal medicine physician was scheduled for two weeks later.

      Case Study 2: A 54-year-old Thai female patient presented with shortness of breath 4 hours prior to admission. Her medical history included diabetes, hypertension, and hyperlipidemia, for which she was receiving ongoing medication at a community hospital. The diagnosis was pneumonia with sepsis and respiratory failure. Upon admission, complications included respiratory failure, acute kidney injury, metabolic acidosis, and metformin-associated lactic acidosis. She was treated with antibiotics and ventilator oxygen. She was able to be weaned off the ventilator, and complications decreased. After 4 days of treatment, her condition improved progressively. She was then transferred to a community hospital.