MISSION

“MABINI COLLEGES provides quality

VISION MABINI COLLEGES instruction, research and extension service
“MABINI COLLEGES INCORPORATED programs at all educational levels as its
monumental contribution to national and
shall cultivate a Governor Panotes Avenue, global growth and development.
Specifically, it transforms students into:
CULTURE of Daet, Camarines Norte 1. God – fearing;
EXCELLENCE in Tel. no. (054) 721-1281 local 109 2. Nation – loving;
education.” Email: mabinicollege@hotmail.com
3. Law abiding;
4. Earth caring;
5. Productive; and
6. Locally and Globally
competitive persons

I. INTRODUCTION

What is Pneumonia/Community Acquired Pneumonia?

Community-acquired pneumonia (CAP) is a prevalent respiratory infection

characterized by inflammation of the lung tissue caused by various infectious agents
acquired outside of healthcare facilities. CAP can affect individuals of all ages, from
infants to the elderly, and its symptoms can vary widely in severity. Patients may
experience a range of respiratory symptoms, including cough, fever, chest pain, and
difficulty breathing. The cough associated with CAP can produce sputum that may
be greenish, yellow, or rust-colored. Fever is a common symptom and is often
accompanied by chills and sweats. Chest pain, which may worsen with breathing or
coughing, can occur due to inflammation of the pleura (the lining around the lungs)
or from muscle strain associated with persistent coughing. Additionally, difficulty
breathing, or dyspnea, can range from mild to severe and may be exacerbated by
physical activity or lying flat.

The symptoms of CAP can manifest in a spectrum of severity, ranging from

mild respiratory discomfort to life-threatening respiratory failure. Common clinical
manifestations include cough, often productive with sputum that may be purulent
or blood-tinged, fever with or without chills, chest pain exacerbated by breathing or
coughing, and dyspnea, which may be exacerbated by exertion or lying flat. These
symptoms can significantly impair an individual's quality of life, leading to
functional limitations and decreased overall well-being. Given the diverse range of
symptoms and potential severity, timely recognition and management of CAP are
essential to mitigate its impact on patients and prevent complications.

Prompt initiation of appropriate antimicrobial therapy is crucial for reducing

morbidity and mortality associated with CAP, although the choice of antibiotics may
vary depending on suspected pathogens and individual patient factors. Additionally,
supportive measures, including hydration, oxygen therapy, and respiratory support,
may be necessary to manage severe cases. By understanding the complex interplay
of pathogens, clinical presentations, and diagnostic approaches associated with CAP,
healthcare providers can effectively diagnose, treat, and prevent this prevalent
respiratory infection in community settings.
 MISSION
“MABINI COLLEGES provides quality
VISION MABINI COLLEGES instruction, research and extension service
“MABINI COLLEGES INCORPORATED programs at all educational levels as its
monumental contribution to national and
shall cultivate a Governor Panotes Avenue, global growth and development.
Specifically, it transforms students into:
CULTURE of Daet, Camarines Norte 1. God – fearing;
EXCELLENCE in Tel. no. (054) 721-1281 local 109 2. Nation – loving;
education.” Email: mabinicollege@hotmail.com
3. Law abiding;
4. Earth caring;
5. Productive; and
6. Locally and Globally
competitive persons

Abstract of the Patient

Name: Penaflor, Felix
Age: 75
Sex: Male
Address: Libmanan, Camarines Sur

Local and Global Incidences

Projected estimates indicate that community-acquired pneumonia (CAP) will
continue to pose a considerable health burden in the Philippines. Factors such as rapid
urbanization, air pollution, and limited healthcare access are expected to contribute to
varying local incidence rates. Globally, the Philippines is projected to face challenges in
reducing CAP prevalence due to socioeconomic disparities and healthcare infrastructure
gaps. Vulnerable populations, particularly children and the elderly, are projected to
remain at heightened risk. Effective interventions, including expanded vaccination
programs and improved healthcare services, are crucial for addressing CAP and reducing
its impact in the Philippines.

Reason and Objective of the Student

I have chosen the Community Acquired Pneumonia in order to understand the
disease's complication, treatments, and other possible factors that would affect the
patient's health so that the knowledge would enable me to counter or alleviate the
suffering of my patients, additionally to prepare myself if one of my relatives or
myself caught the extremely dangerous disease which is Community Acquired
Pneumonia. My objective is to gather if not enough information/knowledge
regarding the disease to improve my understanding of the disease and to help the
patient cope with the treatments.

II. ASSESSMENT
A. Nursing History
● Personal Data:
Name of Patient: Penaflor, Felix
Age:75
Sex: Male
Date of Birth: July 29, 1948
 MISSION
“MABINI COLLEGES provides quality
VISION MABINI COLLEGES instruction, research and extension service
“MABINI COLLEGES INCORPORATED programs at all educational levels as its
monumental contribution to national and
shall cultivate a Governor Panotes Avenue, global growth and development.
Specifically, it transforms students into:
CULTURE of Daet, Camarines Norte 1. God – fearing;
EXCELLENCE in Tel. no. (054) 721-1281 local 109 2. Nation – loving;
education.” Email: mabinicollege@hotmail.com
3. Law abiding;
4. Earth caring;
5. Productive; and
6. Locally and Globally
competitive persons

Religion: Catholic
Citizenship: Filipino
Civil Status: Married
Address: Bahao Libmanan, Camarines Sur
Chief Complaint
Difficulty of Breathing
History of Present Illness
Patient is 1 week Prior to Admission he is noted has an productive cough
associated with intermittent dyspnea sought consult at Emergency Room and given
unremarked medications, few hours prior to admission patient noted to have
worsening dyspnea he was brought back to Emergency Room and was then
admitted.
Past Medical History
1. 2019 - Pulmonary Tuberculosis
2. 2022 – COPD Chronic obstructive pulmonary disease

B. Physical Assessment

Body Part Normal Findings Actual Findings Analysis &

Interpretation

General Alert and Patient appears Manifestations of

Appearance oriented, no fatigued, lethargic, CAP, reflecting the

distress and body's response to

uncomfortable. infection.

Vital Signs Temperature: 36.5- Temperature: 37.9°C Elevated

37.5°C (97.7-99.5°F) Pulse: 118bpm temperature,

Pulse: 60-100 bpm Respiratory Rate: 28 increased heart rate,

Respiratory Rate: 12- breaths /min and respiratory rate

20 breaths/min Blood Pressure: are typical findings

Blood Pressure: 90/60 - 150/80 in CAP due to the

90/60 - 120/80 mmHg body's inflammatory

mmHg response.

Chest Symmetric chest Decreased breath Abnormal breath

expansion, clear sounds, crackles or sounds and chest

 MISSION
“MABINI COLLEGES provides quality
VISION MABINI COLLEGES instruction, research and extension service
“MABINI COLLEGES INCORPORATED programs at all educational levels as its
monumental contribution to national and
shall cultivate a Governor Panotes Avenue, global growth and development.
Specifically, it transforms students into:
CULTURE of Daet, Camarines Norte 1. God – fearing;
EXCELLENCE in Tel. no. (054) 721-1281 local 109 2. Nation – loving;
education.” Email: mabinicollege@hotmail.com
3. Law abiding;
4. Earth caring;
5. Productive; and
breath sounds wheezing heard on pain are indicative of 6. Locally and Globally
competitive persons

bilaterally, no chest auscultation, patient lung involvement.

pain or discomfort reports chest pain
when breathing
deeply

C. Diagnostics

Diagnostic Tests Findings Nursing

Responsibilities

Chest X-ray ( March 14, Consolidation, infiltrates in Ensure patient is properly

2024 ) lung fields positioned for the X-ray

procedure - Assist with
patient comfort and safety
during the test.

Monitor for any adverse

reactions.

Complete Blood Count Elevated white blood cell Collect blood sample using

(CBC) (March 14, 2024 ) count (leukocytosis) aseptic technique.

Ensure timely delivery of

sample to the laboratory for
analysis.

Monitor patient for signs of

infection or bleeding during
blood collection.

Pulse Oximetry Decreased oxygen Apply the pulse oximeter

saturation levels (SpO2) probe correctly to the

patient's finger.

Monitor oxygen saturation

continuously, especially
 MISSION
“MABINI COLLEGES provides quality
VISION MABINI COLLEGES instruction, research and extension service
“MABINI COLLEGES INCORPORATED programs at all educational levels as its
monumental contribution to national and
shall cultivate a Governor Panotes Avenue, global growth and development.
Specifically, it transforms students into:
CULTURE of Daet, Camarines Norte 1. God – fearing;
EXCELLENCE in Tel. no. (054) 721-1281 local 109 2. Nation – loving;
education.” Email: mabinicollege@hotmail.com
3. Law abiding;
4. Earth caring;
5. Productive; and
during periods of activity or 6. Locally and Globally
competitive persons

changes in respiratory
status.

Take appropriate action if

oxygen saturation falls
below target levels.

Arterial Blood Gas (ABG) Hypoxemia (low oxygen

levels), Respiratory Alkalosis Monitor patient for signs of
(low CO2 levels, elevated bleeding or hematoma
pH) formation post-procedure.

Ensure accurate
documentation of ABG
results and notify the
healthcare provider of any
abnormal findings.

III. ANATOMY AND PHYSIOLOGY

Community-acquired pneumonia (CAP) is a respiratory infection that affects the
lungs and is acquired outside of healthcare facilities. Community Acquired Pneumonia
affects the ff:
 MISSION
“MABINI COLLEGES provides quality
VISION MABINI COLLEGES instruction, research and extension service
“MABINI COLLEGES INCORPORATED programs at all educational levels as its
monumental contribution to national and
shall cultivate a Governor Panotes Avenue, global growth and development.
Specifically, it transforms students into:
CULTURE of Daet, Camarines Norte 1. God – fearing;
EXCELLENCE in Tel. no. (054) 721-1281 local 109 2. Nation – loving;
education.” Email: mabinicollege@hotmail.com
3. Law abiding;
4. Earth caring;
Respiratory System: CAP primarily affects the lungs and airways. The infection 5. Productive; and
6. Locally and Globally
competitive persons

leads to inflammation of the bronchioles, bronchi, and alveoli, impairing their function.
Inflammatory changes result in the accumulation of fluid and cellular debris within the
alveoli, leading to consolidation.
Immune System: CAP triggers an immune response aimed at neutralizing the
invading pathogens. Immune cells, such as neutrophils and macrophages, migrate to the
site of infection to engulf and destroy the pathogens. This immune response contributes
to the inflammatory process in the lungs, leading to tissue damage and further
impairment of respiratory function.
Central Nervous System: CAP can affect the central nervous system through
systemic effects of inflammation and hypoxemia. Fever associated with CAP can lead to
altered mental status, confusion, and delirium, particularly in older adults.

IV. PATHOPHYSIOLOGY
Community-Acquired Pneumonia (CAP) initiates when infectious agents, including
bacteria like Streptococcus pneumoniae or viruses such as influenza virus, are inhaled
into the respiratory tract. Following inhalation, these pathogens adhere to and colonize
the mucosal surfaces of the upper respiratory tract, including the nasal passages and
bronchial epithelium. Once attached, the pathogens evade the host's initial defense
mechanisms, such as mucociliary clearance and local immune responses. They then
proliferate within the respiratory epithelium, leading to local inflammation and tissue
damage. As the infection progresses, the pathogens can breach the mucosal barrier and
invade deeper into the lower respiratory tract, including the bronchioles and alveoli. This
invasion triggers a robust inflammatory response, characterized by the release of pro-
inflammatory cytokines and recruitment of immune cells, such as neutrophils and
macrophages, to the site of infection. Inflammatory mediators further amplify the
immune response, leading to vascular leakage, interstitial edema, and alveolar
consolidation. The consolidation, visible as areas of opacity on imaging studies like chest

X-rays, impairs gas exchange, and leads to clinical symptoms such as cough, dyspnea,
chest pain, and systemic manifestations like fever and malaise.

VIII. HEALTH EDUCATION/TEACHINGS

Medications:
 MISSION
“MABINI COLLEGES provides quality
VISION MABINI COLLEGES instruction, research and extension service
“MABINI COLLEGES INCORPORATED programs at all educational levels as its
monumental contribution to national and
shall cultivate a Governor Panotes Avenue, global growth and development.
Specifically, it transforms students into:
CULTURE of Daet, Camarines Norte 1. God – fearing;
EXCELLENCE in Tel. no. (054) 721-1281 local 109 2. Nation – loving;
education.” Email: mabinicollege@hotmail.com
3. Law abiding;
4. Earth caring;
Explanation of Medications: Provided a clear and understandable 5. Productive; and
6. Locally and Globally
competitive persons

explanation of each medication completing the full course of antibiotics as

prescribed by the healthcare provider to ensure complete eradication of the
infection and prevent recurrence or antibiotic resistance.
Dosage and Administration: Clearly explained the prescribed dosage
and administration schedule for each medication. Discussed whether the
medication should be taken with or without food and if there are any specific
instructions regarding timing.
Importance of Adherence: Emphasized the critical importance of
adhering to the prescribed medication regimen. Discussed potential
consequences of missed doses and the impact on treatment effectiveness.
Exercise:
Gentle Exercise: Encourage light physical activity, such as walking or
stretching, as tolerated, to promote circulation, maintain muscle strength, and
prevent deconditioning during illness recovery. Remind individuals to listen to their
bodies and avoid overexertion.
Bed Exercises: Encouraged simple bed exercises that can be
performed while lying down, such as ankle circles, leg lifts, and gentle arm
stretches. Isometric exercises, where the patient contracts and releases
muscles without joint movement, to maintain strength.
Treatment:
Rest and Fluids: Encourage adequate rest and hydration to support the
body's immune response and facilitate recovery. Suggest consuming clear fluids,
such as water, broth, or herbal tea, to stay hydrated and help loosen mucus.

Respiratory Support: In severe cases, respiratory support measures like

oxygen therapy or mechanical ventilation may be necessary. Explain these
interventions and reassure patients and caregivers about their importance in
ensuring adequate oxygenation.
Hygiene:
Hand Hygiene: Stress the importance of frequent handwashing with soap
and water or alcohol-based hand sanitizer to prevent the spread of respiratory
infections, including CAP.
Respiratory Etiquette: Educate individuals on covering their mouth and nose
with a tissue or their elbow when coughing or sneezing to reduce the transmission
of respiratory droplets containing infectious agents.

Out-Patient Follow up:

 MISSION
“MABINI COLLEGES provides quality
VISION MABINI COLLEGES instruction, research and extension service
“MABINI COLLEGES INCORPORATED programs at all educational levels as its
monumental contribution to national and
shall cultivate a Governor Panotes Avenue, global growth and development.
Specifically, it transforms students into:
CULTURE of Daet, Camarines Norte 1. God – fearing;
EXCELLENCE in Tel. no. (054) 721-1281 local 109 2. Nation – loving;
education.” Email: mabinicollege@hotmail.com
3. Law abiding;
4. Earth caring;
Follow-Up Appointments: Encourage patients to attend scheduled follow-up 5. Productive; and
6. Locally and Globally
competitive persons
appointments with their healthcare provider to monitor their recovery progress,
assess treatment effectiveness, and address any concerns or complications
promptly.
Nutrition and Physical Activity: Discussed the role of nutrition in
supporting overall health and managing treatment-related side effects.
Provided guidance on maintaining a balanced diet and staying hydrated.
Encouraged appropriate physical activity based on the patient's abilities and
medical condition.
Medication Adherence: Emphasized the importance of adhering to
prescribed medications and maintaining open communication with
healthcare providers about any challenges or concerns related to
medications.
Patient Empowerment: Empowered the patient to actively participate
in their care, ask questions, and advocate for their needs. Encourage a
proactive approach to self-care and communication with the healthcare
team.
Diet:
Nutritious Diet: Advocate for a balanced diet rich in fruits, vegetables, lean
protein, and whole grains to support the immune system and promote recovery.
Encourage small, frequent meals to prevent fatigue and maintain energy levels.

Hydration: Stress the importance of staying well-hydrated, especially during

and after cancer treatment. Encourage the patient to drink water, herbal teas, and
other hydrating fluids while limiting caffeinated and sugary beverages.
Spiritual/ Safety & Security:
Coping Mechanisms: Discussed various coping mechanisms that
incorporate spirituality, such as prayer, meditation, or mindfulness.
Encouraged the patient to engage in activities that bring comfort and a sense
of spiritual connection.
Home Safety: Discuss strategies for maintaining a safe home environment,
including removing tripping hazards, ensuring adequate lighting, and using assistive
devices, if necessary, to prevent falls and injuries during illness recovery.

IX. EVALUATION
 MISSION
“MABINI COLLEGES provides quality
VISION MABINI COLLEGES instruction, research and extension service
“MABINI COLLEGES INCORPORATED programs at all educational levels as its
monumental contribution to national and
shall cultivate a Governor Panotes Avenue, global growth and development.
Specifically, it transforms students into:
CULTURE of Daet, Camarines Norte 1. God – fearing;
EXCELLENCE in Tel. no. (054) 721-1281 local 109 2. Nation – loving;
education.” Email: mabinicollege@hotmail.com
3. Law abiding;
4. Earth caring;
In the time span of making this case study of a patient who has an 5. Productive; and
6. Locally and Globally
competitive persons

Community Acquired Pneumonia, I have assessed my objectives to be fruitful for I

am able to gather information as well as added interventions to heighten my
knowledge regarding the dangerous disease that the patient is fighting, I have
learned through this case study more about the care for CAP patients. I recommend
focusing on providing relief from the symptoms and stress of the patients who have
Community Acquired Pneumonia. As for supportive care, management of symptoms
and side effects, such as pain, difficulty of breathing, and nausea, is crucial. This may
involve medications, lifestyle changes, and supportive therapies. Additionally, it is
also important to give emotional and psychological support for both the patient and
their caregivers or watchers, including counselling and support groups.
 MISSION
“MABINI COLLEGES provides quality
VISION MABINI COLLEGES instruction, research and extension service
“MABINI COLLEGES INCORPORATED programs at all educational levels as its
monumental contribution to national and
shall cultivate a Governor Panotes Avenue, global growth and development.
Specifically, it transforms students into:
CULTURE of Daet, Camarines Norte 1. God – fearing;
EXCELLENCE in Tel. no. (054) 721-1281 local 109 2. Nation – loving;
education.” Email: mabinicollege@hotmail.com
3. Law abiding;
4. Earth caring;
BRGH-GMC Affiliation Reflection 5. Productive; and
6. Locally and Globally
competitive persons

In our time during the BRGH-GMC. New challenges have risen, bonds to form, and
experience to be had. And with us, a fun and acknowledging clinical instructor.

I'd say it is productive, challenging yet productive. Studying with the group was all
the fun to be had it is not just the laughs, but it comes with knowledge from my
amazing group and clinical instructor. We were also told the history of the BRGH-
GMC while walking it was brief but amazing to some extent. After our time in the
OPD and Geriatric Ward, we have gone up to the activity lounge of the geriatric ward
and plan for the activity we will conduct but before that we were given patients to
have a discussion on with their own respective cases. Cases that vary such as
Myocardial Infarction, Community Acquired Pneumonia and Etc.. A very detailed
discussion has taken place and hours have passed discussing different aspects of
care for the different cases presented. Additionally, the shared knowledge of our
clinical instructor has heightened my understanding of the different purposes of
medications that our clinical instructor discussed.

However, another challenge has occurred, a quiz. This is to assess our learnings in
that said time span of discussion. Although I didn’t get the high score at the quiz, I
deem it positive because of the rationale that my groupmates along with our clinical
instructor made, it made me understand my mistakes and I hope I learned from it.

Edilberto G. Era, RN, MNCS

Clinical Instructor

Dana G. Labuson
Student