solution

Mrs. A.H. has had an acute episode of influenza A, complicated by pneumococcal pneumonia. She lives in a seniors’ apartment building, where a number of residents have had influenza in the past month.

1. State the cause of influenza and describe briefly how it affects the lungs.

2. Describe the normal mechanisms that defend against infection in the respiratory tract.

3. Explain why it can be expected that a number of residents in such a building would be affected by influenza.

4. What precautions could be taken by the residents to avoid the infection?

5. What precautions could you take in your particular profession to reduce the risk of respiratory infection for yourself, your colleagues, and your patients?

6. Explain why antibacterial drugs are not directly effective in cases of influenza. Why may they be prescribed?

7. Explain why Mrs. A.H. is predisposed to develop pneumonia

Mrs. H. was admitted to the hospital after she developed severe chest pain and appeared confused to friends. Pneumococcal pneumonia was suspected.

8. Describe the appropriate diagnostic tests that would be used for Mrs. A.H. and give the rationale for each.

9. Mrs. A.H. indicates that the chest pain increases on inspiration or coughing. Explain the probable cause of this chest pain and her confusion.

10. Describe how other signs and symptoms would probably change as pneumonia develops and give the reason for each (include the relevant respiratory and systemic signs).

11. Predict the values of arterial blood gases in Mrs. A.H. in the early stage of pneumococcal pneumonia and in the advanced stage if two lobes are involved. (Use general descriptions such as increased slightly or greatly, not specific figures.)

12. Explain how Mrs. A.H. can compensate to maintain a normal serum pH.

13. List several reasons why Mrs. A.H. may become dehydrated.

14. Explain several ways in which dehydration could complicate Mrs. A.H.’s status.

15. Describe several treatment measures that would be helpful in this case.