Question

B. Your second patient is 64 years old with chronic obstructive pulmonary disease (COPD). He caught a cold a week ago and presents to the clinic with areen sputum and increased shortness of breath. He had a fever at the beginning of the cold. but does not have a fever today. Current medications are Symbicort (budesonide/formoterol) and lisinopril. On examination, he is afebrile, with respiratory rate 18, heart rate 104, blood pressure 135/70 mm Hg, and SaO2 93 %. Lung auscultation reveals decreased breath sounds and diffuse inspiratory and expiratory wheezes and no crackles. 1. What is the plan of care for John? Discuss medication and treatment changes as necessary. What will you look for as as a sign(s) of improvement in his condition? he need? Be specific and include rationale for this. 2. What education does

Answer 1

1.The chief plan of care includes

• To treat his dyspnea and ensure a nirmal breathing
• To treat the underlying cause of dyspnea (secretions )

Th patient is need of a

• bronchodialtor to relieve breathing difficulty
• To and thin and cough out the thick respiratory secretion by nebulization
• To prevent relapse of infection (fever ) administer antibiotics as per order
• The patient can be administered a nasal cannula oxygenation at 0.5 to 2L/min to normalize oxygen saturation

The signs of improvement will be

• Palpitation reduced
• Able to breath without breathing difficulties
• No usage of accessory muscles while breathing
• Oxygen saturation near to normal

2.The following education is necessary for this patient

• Health educate about the disease condition and its progress
• Breathing exercise ,to improve his lung function
• Report immediately in case of fever because it is a sign of infection
• Follow cough etiquette
• Not to skip medication
• No alcohol or OTC
• Mild activities can be done
• Avoid triggers causing difficult to breath
• Have a regular follow up