Question

Wallace Peterson is a 69-year-old male with a 6-year history of chronic obstructive pulmonary disease who presented to the emergency department at 0100 on Tuesday morning with moderate respiratory distress, a productive cough, and a fever. He was admitted to the inpatient medical-surgical unit for treatment of pneumonia.

Questions 1: What are the early signs and symptoms of inadequate oxygenation?

2: Is maintaining oxygen saturation greater than 88% adequate for this patient?

3: What type of pneumonia does this patient have?

Maurice Arviso is a 60-year-old Native American male directly admitted from his provider's office to the inpatient medical unit with community-acquired pneumonia. Maurice is determined to maintain his independence and dignity and refuses assistance with personal care, even though he experiences shortness of breath with any exertion. Just before the scenario begins, Maurice attempts to use the urinal independently and spills urine on the bed and floor.

1: Mr. Arviso states, "I am short of breath." What assessment findings should the nurse o

2: What questions would be appropriate for a nurse to ask when gathering subjective data for Mr. Arviso?

3: List objective manifestations associated with dyspnea? 1 point Growth & Development Why does Mr. Peterson's age predispose him to pneumonia?

Growth & Development

What developmental (Erikson) stage is Mr. Arviso, and how does his current situation contribute to this stage of development?

Culture & Diversity

What are some cultural risk factors for pneumonia?

Answer 1

1.Early signs and symptoms of inadequate oxygen are

• confusion
• Headache
• Changes in the level of consciousness
• breathing difficulty
• cough
• changes in the vital signs (i.e: rapid heart rate)
• Bluish discoloration of the skin and mucus membrane

2. oxygen saturation of 88% is adequate for the COPD Patients. The aim of this type of patients may be 88- 92% which is to little low than for the normal people. Because this type of patients also known as CO2 retainer. They can have effective exhalation. Low level O2 helps to stimulate effective breathing depth and rate. If oxygen is an adequate means, there is slow and shallow breathing which may induces co2 trapping leads to hypercapnia.

3. This patient may have bacterial pneumonia which is most common than other type. Because of mucus production may be favourable environment for the bacteria to grow.

Mr. arviso scenario

1. Nurses assessment for shortness of breath:

• Breath rate
• chest movement
• oxygen saturation
• Level of consciousness, confusion
• bluish discoloration of the skin and mucus membrane.

2.The nurse may ask

• Are you difficult to breath?
• When you gets breathing difficulty on rest or while activity?
• Are resting period do you feel better to breath?

3. Objective manifestation of dyspnea:

1. Shortness of breath
2. Nasal flaring
3. Confusion
4. Increased and shallow breath
5. Bluish discoloration of skin and mucous membrane
6. Rapid heart rate

Mr. Peterson is an old age person, it may be predisposition factor along COPD for the occurance of pneumonia.

As old age people have weaken immune status - less ability to fight against pathogens.

Mr.Arviso is under the erik erikson's stage of generavity Vs stagnation. He may in stagnation.

Generavity means making a positive image on wards me by participating in the community activity, being productive in life . His illness makes him unable to do his activity efficiently. This may leads to negative outcome.

Cultural factors for pneumonia:

Smoking - is for lifestyle