Reference no: EM133396647
Case: Mr. Cohen is a 75 year old male is admitted to the general medical floor today with an exacerbation of chronic obstructive pulmonary disease (emphysema). He does NOT use oxygen at home. He has been keeping the head of the bed up for most of the day and night to facilitate his breathing which has resulted in lower back pain. Tylenol has not been effective in reducing his pain, so his physician has prescribed oxycodone/acetaminophen (Percocet) 1-2 tabs po every 4-6 hours as needed for pain. Mr. Cohen is on 2 liters of oxygen by nasal cannula. He can receive respiratory nebulisation treatments of albuterol every 4-6 hours prn. He needs someone to walk with beside him when he ambulates because he has an unsteady gait and often needs to stop to catch his breath.
You check his SaO2 one more time and is 91%. You obtain a portable oxygen cylinder, and take a short walk of 50 feet to the nurses station. He states he needs to rest at the nurses station because he is feeling SOB. You check his SaO2 and the reading is now 86% with a heart rate that correlates with the oximeter at 98 bpm.
What is your primary concern right now (think A-B-C's)
After a couple of moments of resting his SaO2 reads at 91%. You went back to his room where he sits in the chair waiting for lunch. You reassess his lungs and he now has expiratory wheezes bilaterally throughout both lung fields. SaO2 is now 88%. You decide that respiratory therapy should be called to administer an albuterol via nebuliser.
What is the rationale for the albuterol nebuliser?
Based on the time-action-profile of albuterol nebuliser, what timeframe would be the BEST to reassess the patient's response to the medication?
Are you moving in the right direction? What assessment findings support this?
Are Mr. Cohen's oxygen saturation readings normal? Explain