Reference no: EM133983141

Question

Exacerbation of his Chronic Obstructive Pulmonary Disease (COPD). Alfred has a history of smoking since he was 12 years of age but finally managed to quit 5 years ago when he was diagnosed with COPD. Alfred had noticed he had been coughing more and his sputum had turned a thick yellow colour. He has also reported that he had not eaten or drank much in the past week before his admission to hospital as "I just haven't felt well". John's weight is 55 kgs and his height is 180cms.

He is currently receiving 4th hourly nebulised ventolin and is on 2L/min of oxygen via nasal prongs. His observations are: heart rate is 98 beats/min, respiratory rate is 28 breaths/min, oxygen saturation is 92% on room air and temperature is 37.8 oC. He has an intravenous cannula (IV) insitu and his medical chart shows that he is prescribed IV antibiotics. When you enter the room you notice Alfred is sitting up on the side of his bed leaning over his bedside table, coughing and trying to breath. He is pale and seems to be using his accessory muscles to assist his breathing. As you listen to his chest with the stethoscope you can hear coarse crepitations and there seems to be decreased air entry in both lower lobes. He responds that "I am struggling to get my breath and I can't seem to cough this stuff up."

1. Identify two nursing problems Alfred is experiencing?

2. Briefly discuss two nursing interventions to address each nursing problem identified in question 4 (a) (these may be independent or collaborative).

3. Identify the rationale for each selected nursing intervention?

4. There is a high incidence of depression among patients with COPD. List two factors that may increase the risk for depression in COPD patients and explain briefly why they are considered to increase this risk?