Reference no: EM133852388

Question

Oxygen Administration Case Study Mr. Jin is a 55-year-old Chinese man. Mr. Jin is hospitalized for pneumonia. Mr. Jin tells you that, for the past few days, he has been experiencing shortness of breath, wheezing, and fatigue. He is coughing up copious amounts of thick yellow/green colored sputum. He denies chest pain. He is tired and does not have much of an appetite. He has smoked cigarettes for 49 years and has no intention of stopping or decreasing the amount he smokes. He thinks he smokes 2 packs a day, but doesn't really keep count. For the past several years, he has had "breathing problems". Past medical history: Congestive heart failure and COPD Medications: Hydrochlorothiazide, Proventil (albuterol) and Advair inhalers. When his lungs get "really bad", he takes prednisone. Allergies: Sulfa and penicillin. Vital signs: Temperature 38.0°C (oral), pulse 102 beats per minute, respirations 24 breaths per minute, blood pressure 156/78, O2 sats (oxygen saturation) 89%. Alert and oriented. General impression: Patient sitting in chair with increased respiratory effort. Nasal flaring and pursed lip breathing. Needs to pause to breathe in the middle of sentences. Skin: Color pale, lips are bluish in color. Clubbing present in fingers. Respiratory: Using neck muscles to breathe, no intercostal retractions. Coughing up moderate amounts of thick, yellow sputum. Increased dyspnea and respirations increase to 32 breaths per minute when ambulating in the hall. Percussion: Right base dull to percussion. Auscultation: Coarse expiratory wheezes throughout all lung fields bilaterally. Decreased breath sounds throughout. Coarse crackles in right lower lung field. Current Medical Diagnosis: Pneumonia and COPD exacerbation Physician Orders: O2 per nasal cannula at 2LPM to keep O2 saturation at 90% Erythromycin 500mg po Q 8 hours for pneumonia Check VS including O2 saturation Q 4 hours

1. Identify the subjective and objective data included in this case study

2. What is COPD?

3. Why only have your patient on oxygen 2 LPM and why not bring his O2 saturation up to at least 95%?

4. Why is a nasal cannula ordered instead of a mask?

5. Give an example of worsening respiratory status when you would call the provider

6. Identify 2 nursing diagnoses/patient problems for your patient, and why.

7. Create a SOAP note for your highest priority RESPIRATORY nursing diagnosis/patient problem. S) O) A) P)