Competency: Select nursing interventions for clients with complex disorders.
Instructions:
Scenario: Anna is a 28-year-old female who was prescribed Bactrim DS for a Urinary Tract Infection. She took her first dose of medication yesterday. Anna has taken Bactrim DS in the past, but today, woke up with hives all over her legs and arms. She was also wheezing and could not catch her breath. Her roommate was very worried about her and decided to call 911. When EMS arrived, Anna was not able to talk and was in respiratory distress. Because Anna was in severe respiratory distress, EMS took the measure of securing her airway by inserting an endotracheal tube (ETT). Once Anna’s airway was securely managed, EMS then gave her a dose of Benadryl and Epinephrine prior to transporting her to the hospital. These medications will help decrease the manifestations of the allergic reaction. Anna remains ventilated and is admitted to the ICU for further care.
Answer the following questions related to this scenario:

1. Why are ventilated clients at risk for pneumonia? Explain your response.
2. What nursing interventions can be taken to prevent pneumonia? Explain the rationale for your response.
3. The patient most likely had an allergic reaction to the Bactrim DS that she was taking. Why did the reaction occur even though Anna has taken this medication before without any problems?
4. The patient has multiple intravenous lines. One of the intravenous IV sites is red and the patient winces in pain when the nurse palpates around the site. The site is slightly swollen. What complication does the nurse suspect? What action should the nurse take to prevent further complication at the compromised site?
5. The patient has a full recovery and is ready for discharge. What discharge instructions would you provide to the patient regarding future administration of Bactrim DS?