Question

COPD Case Study

Day 1, 1330. Jim Lawson is a 64-year-old Caucasian male admitted to the hospital medical floor for a respiratory infection. Jim, a 2 pack-a-day smoker, has a history of chronic obstructive pulmonary disease (COPD). He awakened in the morning with increased shortness of breath and coughing with the production of green-brown sputum. Vital signs are BP 144/88. P94, R 30, temperature 100.2 orally. Physicians orders include: ABG’s stat, sputum for C & S then begin Ampicillin 500 mg IV q 6 hours, IV d5W 100cc/hr, Theo Dur 1 bid, Albuterol 3 mg per nebulizer qid and prn acute dyspnea, o2 1.5L/min.

1 Relate this clinical data to the diagnosis of COPD. What other symptoms would the nurse expect the client to exhibit?

2. What are the benefits and risks of O2 therapy in a client with COPD? Why was the O2 therapy limited to 1.5L/min?

3. What should be included in a teaching plan for a client with COPD?

Answer 1

Ans) 1. Other signs and symptoms of COPD may include:
- Shortness of breath, especially during physical activities.
- Wheezing.
- Chest tightness.
- Having to clear your throat first thing in the morning, due to excess mucus in your lungs.
- A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish.

2. Benefits of O2 therapy:

- Boost your energy and ability to exercise
- Help you focus better on tasks
- Improve your mood
- Improve sex
- Lower your chance of heart failure (when your heart doesn’t pump enough blood to your body)
- Perhaps prolong your life.

Risk:

- In individuals with chronic obstructive pulmonary disease and similar lung problems, the clinical features of oxygen toxicity are due to high carbon dioxide content in the blood (hypercapnia). This leads to drowsiness (narcosis), deranged acid-base balance due to respiratory acidosis, and death.

3. Teaching plan for a client with COPD:

-  Smoking and do not allow others to smoke around you.
- Stay active.
- Eat a healthy diet and maintain a normal weight.
- Educate yourself about your disease and treatment options.
- Take your medications.