Question

you as a nurse are caring for 62 year old Male patient in the hospital who has an exacerbation of his emphysema. the patient currently takes the following medications lorazepam, xanax, cardizem, flonase, prednisone, advair, aspirin and uses 2 L of 02 via NC. based off these medications what medical conditions do you think he has? how do these medical conditions impact this patient's emphysema?. what diagnostics would you want to see on this patient and why? what nursing interventions would you implement for this patient and why? if you can, please relate to situations you have witnessed/experience in your clinical/ work experience

Answer 1

1- As he is administering Lorazapam and xanax, which contain Alprazolam, is a medication for anxiety and other depressive symptom. So patient might be suffering from anxiety

He also takes Cardizem and aspirin which means that he may be suffering from cardiovascular disease like high blood pressure and seems to have high risk of blood clots.

Advair, Flunase and prednisome might be prescribed for this patients since he have the history of pulmonory disorder and allergy.

2- As the patient is known to have cardiovascular disease, it can have impact on emphysema. The patient with cardiac problems cannot pump enough blood or may have difficulty to pump the blood.So this patient can breath easily at rest but with activity, as the blood flow increases, the blood start to pump harder and faster. This makes the heart to keep up the blood leading to blood back up into the lungs causing fluid congestion then to shortness of breath.

3- Diagnosis with cardiac troponase will be a indicator for this patient.

Acute excerbations of pulmonary disease is associated with rise in troponin. Cardiac troponin T is considered as the better prognostic indicator in pulmonory diseased patients with cardiovascular disorders.

A test fo C-Reactive protein has to be done. The inflammatory markers such as fibrinogen, interleukines will be in higher levels in the blood of these patients. These findings can suggest whether the inflammation is only pulmonary or systamically.

Also other routine test for the Emphysema is also recommended in this patient.

4- Nursing intervention.

• Ausculating the lung sounds of the patient, if wheezy then breathing treatment has to be done
• Blood pressure levels of the patient has to be taken in a perticular interval of time.
• The blood gas level has to be checked inorder to detect any respiratory acidosis is there.
• Blood cholestrol level has to be taken and encourage to have a healthy weight. Access weight in patient decrease the space to expand in the patient.
• A healthy nutritious diet has to be recommented. Food rich in cholestrol and trans fats has to be avoided.
• Plan a oxygen monitoring guidline with the concerned physician.
• If the patient still feels very difficult to breath inform the respiratory therapist and immediatly have a airway cart.
• Breathing tratment and the medications prescribed by the doctor has to be administered and evaluated the results and changes you might notice in the patient.
• Preventive vaccination has to be taken inorder to prevent inflenza and pneumoicoccal infections because the patient's lungs are already working harder to keep the body balanced with oxygen and carbondioxide.