Question

A 50 year old patient is admitted to the medical-surgical floor from the emergency department with severe abdominal pain thought to be from acute pancreatitis. He case a history of drinking at least a case of beer a day. He also smokes and appears cachectic. His old chart indicates a history of COPD, but he does not take drugs for this. He does have a new productive cough. At chage of shift, the nurse finds the patient dyspneic and slight confused. Lung sounds have wheezes, and he is mildly febrile. Pulse is 120 beats per minute, respirations are 32 breaths per minute, and blood pressure is 118/64. Oximetry shows a SpO2 of 91%. • What risk factors for ARDS does this patient have? • Explain the relationship between the lung sounds and the oximetry reading • What diagnostic testing should you be prepared to obtain? Two hours after applying oxygen at 3 liters/nasal cannula, the patient’s Spo2 is now 89%4. What additional measures do you anticipate for this patient?

Answer 1

Risk factors are

1.cigerrette smoking

2.alcohol consumption

For this patient

Lung sounds indicate patient have bronchitis or COPD.In this case saturation level 90 to 92 is considered as normal.

Chest x ray should be done to find out hyperinflated lungs as well as flattened appearance of diaphragm.

Oxygen should be kept on 1-2 litre

Teach the patient pursed lip breathing exercise

Tripod position can be given..sit upright and leaning forward to cardiac table.

Encourage the patient to take 2-3 litere per day..