Chronic Obstructive Pulmonary Disease with Exacerbation.
Use the Sherpath case study for the patient with chronic obstructive pulmonary disease with exacerbation to answer the following questions.
Review the client profile, subjective date, objective data and diagnostic studies to complete the case study in Sherpath. After completing the case study, use the information to answer the discussion question.
What in the client’s history is commonly associated with pulmonary disease?
Interpret the client’s arterial blood gasses.
What is the likely medical diagnosis for this client? Explain the pathophysiology?
What assessment data and diagnostic study results led you to this diagnosis?
What would you want to teach this patient about his disease process?
What treatment and nursing management would you provide for this patient? Be sure to follow the nursing process in your discussion and include two priority nursing interventions.
Answer the questions and format in an essay style paper. Introduce the client prior to answering the questions. It is required that you use APA format for your essay and references. The essay should be at minimum 1000-1250 words. Do not use “I” in the essay, make sure to use proper nursing interventions and teaching that specifically pertain to the patient.
Assignment Expectations
Structure: Include a title page and reference page in APA style. These do not count towards the minimal word amount for this assignment.
Mr. Artuso is a 63-year-old electrician who came to the emergency department complaining of shortness of breath, morning cough, and swelling in his lower extremities.
Subjective Data
Has smoked one pack of cigarettes daily for over 30 years
Has difficulty breathing when he walks
Has been sleeping in a recliner to make it easier to breathe
His shoes are tight at the end of the day
Objective Data
Physical Examination
Blood pressure 125/90, pulse 90, temperature 98.4° F, respirations 32
Increased anterior-posterior diameter
Breath sounds diminished with prolonged expiration
2+ peripheral edema bilateral lower extremities
Thin with muscle wasting
Respirations labored
Diagnostic Studies
Arterial blood gases: pH 7.32, SaO2 86%, PaCO2 55 mm Hg, PaO2 70 mm Hg
Chest x-ray shows hyperinflation of lungs
FEV1 65%
Question 1
What in Mr. Artuso’s history is commonly associated with pulmonary problems?
Question 2
Interpret Mr. Artuso’s arterial blood gases.
Question 3
What is a likely medical diagnosis for Mr. Artuso?
Question 4
What assessment data and diagnostic study results led you to this diagnosis?
Question 5
What complication associated with this diagnosis does Mr. Artuso also have? What clinical manifestation led you to that and what is the cause of it?
Question 6
What are the priority nursing diagnoses for Mr. Artuso at this time?
Question 7
What interventions are indicated for Mr. Artuso and what outcome is expected for each intervention?
Question 8
As part of patient teaching, is it “too late” to encourage Mr. Artuso to stop smoking? Why?
Question 9
What other teaching needs would you review with Mr. Artuso while he is hospitalized?
Review with Mr. Artuso measures to use at home to reduce the risk of his acquiring an infection, such as hand washing and avoiding those with cold or flu symptoms; the importance of yearly flu vaccinations and 5-year pneumonia vaccinations; specific instructions regarding any prescribed medications, energy conservation techniques, measures to ensure adequate sleep, and participation in sexual activity; and when to seek medical attention, focusing on the manifestations of heart failure and infection.
Rationale
