Mucor is a fungus which can cause an infection called Mucormycosis, week4 discussion help

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1. Mucor is a fungus which can cause an infection called Mucormycosis. This fungus like many other fungi lives outdoors in old barns, gardens, in soil, moss or manure piles, compost piles and piles of dead leaves (CDC, 2015). A person becomes infected with Mucor by coming into contact with the fungus spores. These can enter the body many ways. Our patient may have inhaled spores or developed a sinus Mucor infection and inhaled some of the pus from his sinuses. Per the CDC a patient is more likely to develop a fungal infection if they are immunocompromised (AIDS, HIV or organ transplant patients on immunosuppressant drugs). Nursing interventions which would be effective in the treatment and diagnosis of this patient: 1) Accurate history to help with diagnosis of Mucor vs. bacterial pneumonia. Include underlying illnesses which might make the patient vulnerable to a fungal infection. Include hobbies, lifestyle, etc. 2) Medication list including any devices they use and herbals they take. Include essential oils, humidifiers.
2. The lab values reveal an abnormal ABG.
3. pH 7.5 is elevated (7.35-7.45 is norm) revealing alkalosis, PaO2 59 is low (80-85 norm), PaCO2 is 25 which is low (35-45 is normal), these all reveal a Metabolic alkalosis which is characterized by pH above 7.40 with decreased PaCO2, this may have been caused by hypoxemia, pain and anxiety in our patient with acute pneumonia (Copstead-Kirkhorn, Banasik, 2014). The elevated bicarb is compensatory. Electrolytes are mostly normal except the Calcium which is slightly low which might be caused by the bodies attempt to compensate for the respiratory issues. The Glucose is elevated for a fasting glucose which should be 70-100. This could be a clue that the patient is diabetic or that he is under stress. He may also have taken a glucosteroid for treatment of this inflammatory process causing the elevation. The H&H is normal. The WBC is slightly elevated but the Lymphocyte count is low at 10% (normal 20-40). This might give us a clue as to the patient’s vulnerability to this Mucor infection. He may be immunocompromised.
4. If the patient is not hospitalized they should be. Once the diagnosis of Mucor is made an antifungal will be diagnosed. Per the CDC website (2015) Amphotericin B is the antifungal of choice for this infection. Side effects of this medication are numerous but include kidney damage, nausea and vomiting, swelling of hands and feet, dry mouth, muscle cramps and many more (PubMed, 2016). Robitussin will help liquefy pulmonary secretions and help the patient expectorate them (Mayo Clinic, 2016). Immediately oxygen would be indicated to bring up the patients PaO2 into the normal range, prevent air hunger, and support the brain and other organs. It should be delivered with EtCo2 monitoring (Krause, Silvestri, 2016). IV fluids are indicated to support the patient’s hydration during this illness. Treatments would include nebulizer treatments with bronchodilators, chest percussion, and incentive spirometer. Follow-up ABG’s, Electrolytes, CBC after 24 hours of antibiotic therapy and chest x-ray after 72 hours. Ambulation QID, DVT prophylaxis and diet as wanted and tolerated.

Mucor is a fungus which can cause an infection called Mucormycosis. This fungus like many other fungi lives outdoors in old barns, gardens, in soil, moss or manure piles, compost piles and piles of dead leaves (CDC, 2015). A person becomes infected with Mucor by coming into contact with the fungus spores. These can enter the body many ways. Our patient may have inhaled spores or developed a sinus Mucor infection and inhaled some of the pus from his sinuses. Per the CDC a patient is more likely to develop a fungal infection if they are immunocompromised (AIDS, HIV or organ transplant patients on immunosuppressant drugs). Nursing interventions which would be effective in the treatment and diagnosis of this patient: 1) Accurate history to help with diagnosis of Mucor vs. bacterial pneumonia. Include underlying illnesses which might make the patient vulnerable to a fungal infection. Include hobbies, lifestyle, etc. 2) Medication list including any devices they use and herbals they take. Include essential oils, humidifiers.
2.The lab values reveal an abnormal ABG.

pH 7.5 is elevated (7.35-7.45 is norm) revealing alkalosis, PaO2 59 is low (80-85 norm), PaCO2 is 25 which is low (35-45 is normal), these all reveal a Metabolic alkalosis which is characterized by pH above 7.40 with decreased PaCO2, this may have been caused by hypoxemia, pain and anxiety in our patient with acute pneumonia (Copstead-Kirkhorn, Banasik, 2014). The elevated bicarb is compensatory. Electrolytes are mostly normal except the Calcium which is slightly low which might be caused by the bodies attempt to compensate for the respiratory issues. The Glucose is elevated for a fasting glucose which should be 70-100. This could be a clue that the patient is diabetic or that he is under stress. He may also have taken a glucosteroid for treatment of this inflammatory process causing the elevation. The H&H is normal. The WBC is slightly elevated but the Lymphocyte count is low at 10% (normal 20-40). This might give us a clue as to the patient’s vulnerability to this Mucor infection. He may be immunocompromised.
1.If the patient is not hospitalized they should be. Once the diagnosis of Mucor is made an antifungal will be diagnosed. Per the CDC website (2015) Amphotericin B is the antifungal of choice for this infection. Side effects of this medication are numerous but include kidney damage, nausea and vomiting, swelling of hands and feet, dry mouth, muscle cramps and many more (PubMed, 2016). Robitussin will help liquefy pulmonary secretions and help the patient expectorate them (Mayo Clinic, 2016). Immediately oxygen would be indicated to bring up the patients PaO2 into the normal range, prevent air hunger, and support the brain and other organs. It should be delivered with EtCo2 monitoring (Krause, Silvestri, 2016). IV fluids are indicated to support the patient’s hydration during this illness. Treatments would include nebulizer treatments with bronchodilators, chest percussion, and incentive spirometer. Follow-up ABG’s, Electrolytes, CBC after 24 hours of antibiotic therapy and chest x-ray after 72 hours. Ambulation QID, DVT prophylaxis and diet as wanted and tolerated.