Please remember that your answers must be returned + Please cle what source you used website, book, journal artic Please

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Please Remember That Your Answers Must Be Returned Please Cle What Source You Used Website Book Journal Artic Please 1 (48.28 KiB) Viewed 60 times

Please remember that your answers must be returned + Please cle what source you used website, book, journal artic Please be sure you use proper grammar, apeiting, and punctuation Remember that assignments are to be handed in an tima- NO EXCEPTIONS Whaley is a 65 year old man with a history of COPD who presents to fus prenary care provider's (PCP) office complaining Ta productive cough off and on for 2 years and shortness of tree for the last 3 days. He reports that he have had several chest colds in the last few years, but this time won't go wway. His wife says he has been leverth for a few days, but doesn't have a specific temperature to report. He reports smoking a pack of cigaretes a day for 25 years plus the occasional cigar Upon Nurther assessment, Mr. Whaley has crackles throughout the lower lobes of his lungs, with occasional expertory whezes throughout the lung felds. His vital signs are as follows • OP 142/86 mmHg HR 102 bpm RR 32 bpm Temp 102.3 5002 80% on room ar The nurse locates a portable coxygen tank and places the patient on 2 pm oxygen vis nasal cannula Based on these findings Mc Whaley's PCP decides to cal an ambulance to send Mr Whaley to the Emergency Department (ED) While waiting for the ambulance, the nurse repests the 502 and de Mr. Whaley's S02 is only 0% She increases his cygen to 4L/min, rechecks and notes an Sp02 of 95% The ambulance crew arrives, the nurse reports to them that the patient was short of breath and hypoxic, but saturation are now 95% and he is resting Per EMS, he is alent and oriented x3 Upon arrival to the ED, the RN finds Mr. Whaley is somnolent and difficult to arouse. He takes a set of vital signs and finds the following BP 138/78 mmHg HR 96 bpm RR 10 bpm Temp 38.4°C Sp02 90% on 4 L/min nasal cannula The provider weites the following orders Keep sats 88-92% . CXR 2004 Labs: ABG, CBC, BMP Insert peripheral V Albuterol nebulizer 2.5mg Budesonide-formoterol 1604.5 mcg The nurse immediately removes the supplemental oxygen from Mr. Whaley and attempts to stimulate him awake. Mr. Whaley is still quite drowsy, but is able to awake long enough to state his full name. The nurse inserts a peripheral IV and draws the CBC and BMP, while the Respiratory Therapist (RT) draws an arterial blood gas (ABG). Blood gas results are as follows: pH 7.301 . pCO2 58 mmHg .HCO3-30 mEq/L . p02 50 mmHg • Sa02 92% Mr. Whaley's chest x-ray shows consolidation in bilateral lower lobes. Mr. Whaley's condition improves after a bronchodilator and corticosteroid breathing treatment. His Sp02 remains 90% on room air and his shortness of breath has significantly decreased. He is still running a fever of 38.3°C. The ED provider orders broad spectrum antibiotics for a likely pneumonia. which may have caused this COPD exacerbation. The provider also orders two inhalers for Mr. Whale one bronchodilator and one corticosteroid. Satisfied with his quick improvement, the provider decides is safe for Mr. Whaley to recover at home with proper instructions for his medications and follow up fr his PCP. 1. What are the top 3 things you want to assess? 2. What does somnolence mean and why is the patient feeling this way? 3. What do the results of the ABG show? How did you reach your answer? 4. Why are albuterol and budesonide prescribed? Explain what the action of these medications a 5. List and explain 3 points of focus for his discharge teaching.