Question

Paragraph Case Study Joe Ritter, a 74-year-old retired bricklayer, has a 40-pack-year tobacco history and a history of chronic obstructive pulmonary disease (COPD). Today, he presents to the emergency department in respiratory distress with shortness of breath, retracting respirations of 26 breaths/min, BP is 154/76 mm Hg, pulse is 140 beats/min, rapid and irregular and temperature is 37°C. He also complains of chest discomfort and left leg pain (8 on 0-to-10 scale). His skin color is pale gray, his chest is barrel-shaped, and he uses accessory muscles to breathe, he appears anxious and is sitting in a tripod position. His nail beds are bluish in color: his oxygen saturation by pulse oximetry is 86%. Chest auscultation reveals wheezes and decreased-to-absent breath sounds in bilateral bases. Hyperresonance is noted upon chest wall percussion. Chest x-ray showed atelectasis bilaterally in the bases. Mr. Ritter coughs with minimal amounts of clear sputum. A 12-lead ECG recorded his heart rate as 140 beats/min, rapid, and irregular with an interpretation by the physician as atrial fibrillation. Upon further exam the left lower extremity is edematous warm and tender to touch. 1. What subjective and objective data can the nurse gather from the information available about Mr. Ritter in the given scenario? 2. What questions would you ask Mr. Ritter during the interview portion of the health assessment related to his symptoms, SOB, chest pain, cardiac rate and rhythm? 3. What findings from the given scenario represent abnormal objective data? D Focus o - SP e

Answer 1

Answer: The subjective data includes the patient' s experience. Here the patient feels:

1. Chest discomfort
2. Pain in left leg
3. Cough

The objective data are those can be observed and measurable:

1. Respiration rate 26 breathes/ min
2. Blood pressure is 154/76mmHg.
3. Pulse rate 140bpm
4. Skin color pale grey
5. Anxious