Kelly Gore

1. Explain what Mucor is and how a patient is likely to become infected with Mucor. Describe the pathophysiologic

progression of the infection into pneumonia and at least two medical/nursing interventions that would be helpful in treating the patient.

Pulmonary Mucormycosis is a fungal infection that is caused by breathing in fungi spores from mucormycetes, which is found in organic matter such as soil (CDC. 2015). Mucormycosis can develop in  many areas of the body, but for this question we are focusing on pulmonary
mucormycosis. “Pulmonary mucormycosis is the most common type of mucormycosis in people with cancer and in people who have had an organ transplant or a stem
cell transplant (CDC.2015.p.3)”. Mucormycosis can be contracted by anyone but usually affects people with weakened immune systems (CDC. 2015).  Once the spores are inhaled or enter the body via another means, the progression of this disease can be rapid and diagnosis prolonged due to some nonspecific clinical manifestations (Petrikkas, et al. 2012).

Two nursing interventions that would be helpful in treating this patient population would be close monitoring
of respiratory system and other vital signs and also giving antifungal medications as ordered. Education regarding the disease, treatment, transmission, and
prognosis is imperative for patients to understand the severity of this disease.

2. Examine the laboratory blood test results and arterial blood gases provided in “Discussion Question Resource: Laboratory Blood Test Results.” What laboratory values are considered abnormal? Explain each abnormality and discuss the probable causes from a pathophysiologic perspective.

WBC 15.2: Increased due to
Lymphocytes 10%: Decreased due to
pH 7.50: Patient is alkalotic and
PaO2 59: Patient is hypoxic due to
infection and needs O2
PaCO2 25: Patient’s CO2 levels are
low most likely due to rapid respiratory rate from infection

3. What medications and medical treatments are likely to be prescribed by the attending physician on this case? List at least three medications and three treatments. Provide rationale for each of the medications and  treatments you suggest.

Ampho B: Binds to ergosterol altering cell
membrane permeability in susceptible fungi and causing leakage of cell
components with subsequent cell death. Proposed mechanism suggests that
amphotericin causes an oxidation-dependent stimulation of macrophages (Lexicomp,
nd). Ampho B is used to treat life-threatening fungal infections.

Acetaminophen: Used as a premedication for Ampho B (Lexicomp. nd.)

Benadryl: Used as a premedication for Ampho B (Lexicomp. nd)

Posaconazole: Used to treat refractory fungal infections (Lexicomp, nd). Only certain physicians can order this medication (Lexicomp, nd).

Isavuconazole: Used for treatment of mucormycosis in adults (Lexicomp, nd)

O2: Patients with pulmonary fungal infections will generally use supplemental O2 due to suppression of respiratory system

Educating patient on need to protect self from environment: fungal infections are most often contracted from areas that produce a lot of dust in which spores are
found. Avoiding areas such as construction sites can help decrease the risk for contracting this infection (CDC. 2015).

Wear proper clothing when doing work outside that involves the soil, such as gardening. By wearing items like gloves, the risk of getting these spores on your skin which can
then be transmitted to your lungs, will be decreased (CDC. 2015)

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