Answer Happy

Case study #3 Winifred Wilkerson A Winifred Wilkerson is a 76 year old female, admitted this morning through the Emergency Department to YTI Hospital. She has a history of COPD. She is alert and possibly confused. She is on the Med/Surg floor. She has an IV infusing normal saline. She appears to be in no respiratory distress. She is on 1 LPM nasal cannula. O Subjective: Patient states that she has been getting more short of breath over the last day or so. She also states that overnight last night the elves stole her socks and her feet are cold. Objective: She is a well-nourished female; able to speak in complete sentences. Nurse reports that the patient becomes tachypneic with minimal exertion. Patient lethargic and is having difficulty staying awake during your examination. Physical Findings: Heart rate 108 . Blood pressure 102/70 • Temp - 38.4C . • Respiratory rate - 22 . Breath sounds Decreased with rhonchi in the bases. . . Cough Annears to be productive but patient refuses to expectorate
the bases . Cough Appears to be productive but patient refuses to expectorate ABG on 1 LPM NC: pH 7.37/PCO2 60/PO2 46/HCO3 34/ Sa02 78% Hemoglobin - 16.4 WBC-14,600 Having left your RT cape at home, the physician has already written orders. Increase oxygen to 5 LPM NC Administer 2 puffs albuterol MDI Q4 Peak flow measurement BID Would you implement the order as it is written? What would you recommend in its place? Would you add or delete anything from this order?