Case Study Emphysema JZ, a 65-year-old man, is admitted to Kaiser due to an exacerbation of emphysema. (COPD) He has a p

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Case Study Emphysema Jz A 65 Year Old Man Is Admitted To Kaiser Due To An Exacerbation Of Emphysema Copd He Has A P 1 (65.19 KiB) Viewed 37 times

Case Study Emphysema JZ, a 65-year-old man, is admitted to Kaiser due to an exacerbation of emphysema. (COPD) He has a past medical History of HTN, which has been well controlled on ( ---) for the last 8 years. He is a thin, poorly nourished man who is experiencing SOB. H complained of coughing spells with thick yellow sputum. JZ seems irritable and anxious when he admits to having been a 2-pack a day smoker for 36 years. He says he sleeps poorly and lately feels very tired most of the time. His VS are 164/86, 124,36, 102 F, SpO2 89%. His admitting diagnosis is chronic emphysema with an acute exacerbation. His admitting orders are as follows: diet as tolerated, OOB with assistance, O2 a 21/L via N/C, IV DSW at Soml/h; sputum C&S x3; ABGs in am; CBC. CXR in am: prednisone 40 mg PO tid, cefuroxime (Zinacef) 18 IVPB theophylline (Theo-Dur) 300mg PO tid, albuterol 2.5 mg (0.5ml) in 3ml NS 96h enalapril (Vasotec) 10 mg PO 4 am. 1. What is the pathophysiology of emphysema? 2. Discuss the Vs for Z 3. Identify nursing measures to improve oxygenation 4. explain the purpose of the following classes od drugs: Antibiotics, bronchodilators, and corticosteroids. 5. What are the most common side effects of bronchodilators 6. JZ comments how hungry he is when you bring his tray. You notice he rapidly eats his mashed potatoes but nothing else. When you pick up the tray he says "I don't understand, I can be so hungry but when I start to eat, I have trouble breathing and have to stop. Explain the phenomenon based on your knowledge of the breakdown on carbohydrates. 7. Identify strategies that might improve his caloric intake 8. Identify expected outcomes of his treatment. 9. JZ asks for a carton of milk. Is this a good choice for him? 10. Later you notice he has a box of dark chocolate. Why might he have a craving for chocolate. 11. How can you address dietary and nutritional teaching needs with JZ and his wife. 12. What education topics should you explore with JZ