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Discussion

should I have noticed something?

Hi All. I am a CNA working in home care, and I am taking care of a client that recently went to the hospital with pneumonia. It took me back a little because I was just with them 24 hours prior and i noticed nothing unusual. no coughing or wheezing or acting like they were sick at all. I only have a 2 hour shift with them, but still I feel guilty that maybe I should have caught some sort of sign that they were sick with something so dangerous. Is there some things to watch out for that I might have missed. Just want to be the best CNA I can be and be able to detect better and faster if something like this happens again if I can.

Oh theydid seem a little bit more confused then normal, But they also have dementia pretty bad and everyone knows they can have their good days and bad days so i did not see that as a sign of sickness but maybe I should have.

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    Doesn't sound like there was anything jumping out to say "Hey, I'm sick!"

    Symptoms of pneumonia can include coughing, wheezing, labored breathing, fever. But sometimes, there's really nothing "wrong" except an abnormal chest xray or lab work.

    If this was a aspiration pneumonia, you may not see anything a whole day before. Once they aspirate, they can get sick/show symptoms really quickly.

    Observing the patient's behavior is often the most helpful tool in someone with Alzheimer's or dementia. But just being there for 2 hours probably isn't enough to really tell.

    If you do notice a change in behavior, or that s/he's more sleepy or won't eat well or has a change in bathroom habits, tell the nurse. A good observant CNA (and you seem to be that) is so very important to a nurse!

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    It's hard when you are only there for a short period of time. It is also easy to look back and say oh I should have noticed this or that. Continue to watch your patients for any change, even subtle ones. With aspiration pneumonia they can become ill very quickly so don't beat yourself up.

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    I agree, don't beat yourself up. You don't have x ray vision. However, confusion can be a sign of infection in elderly adults, so maybe next time you notice an elder more confused than baseline, notify the nurse. It may or may not be significant, but you can rest more assured that you did your part.

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