Question

CASE STUDY: Respiratory

Med-Surg. Respiratory Case studies

#1 Patient Profile: A 62-year-old female client with a history of COPD is admitted to the hospital with an acute exacerbation and left-sided pneumonia. The nurse observes increased anterior-posterior diameter of the chest, reddish-blue skin tone, and prolonged expiratory phase when breathing. Admission vital signs: temperature 101.5 F (oral), blood pressure 154/92, heart rate 110, and respiratory rate 26 breaths/minute.

Critical Thinking Questions: Answer each question thoroughly and with details:

1. What nursing diagnosis is the priority for this patient and why?
2. During the initial physical assessment of the patient, the patient exhibits a frequent cough with copious purulent secretions expectorated. This assessment finding is compatible with which etiology of pneumonia? What type of nursing care would you then provide?
3. What should the nutritional plan for this patient include? Explain why?
4. To optimize oxygenation for this patient with left-side pneumonia, what body position should be encouraged and why? What positive is contraindicated for this patient?
5. The patient says that she is beginning to feel slightly “short of breath”. What is the appropriate choice in initiating supplemental oxygen in this patient? Explain your rationale.

Answer 1

1.Ineffective airway clearance related to infection in lungs as evidenced by prolonged expiratory phase,fever,tachypnea,cough, reddish blue skin tone

2.The copious purulent secretion is indicative of long term infection if lung happening in pneumonia .This can be caused by bacterial infection like pneumococcal pneumoniae, streptococcus.The nursing care to be provided are

• Administer antibiotics to treat infection
• Teach cough etiquette
• Send sputum for culture sensitivity test as oer order
• Teach breathing exercises

3.The patient should be provided with high protein diet .This has a properly to tear the inflammatory process ,it can repair the tissues which are damaged due to pneumonia.

4.The patient can be orovide proper up position or right lateral position. Supine position has to be avoided because this can risk the patient for reflux aspiration, and left lateral can also increase aspiration because of stomach contents