Reference no: EM133598065

A 65 year old Cuban male comes to the ED because of shortness of breath. He notes that over the last 2-3 years he has had gradual worsening of his ability to exert himself without feeling out of breath, and it has been acutely worse for the past week, including a worsening productive cough. On questioning, he reveals that he coughs almost every morning as well, and this has been going on for even longer, perhaps 4-5 years. The cough is now productive of yellowish-brownish sputum. He denies chest pain. He has no history of lower extremity edema. He currently smokes. He states he has lost 15 lbs in the last year.

On exam, his BP is 144/88 mmHg, HR is 98, respiratory rate is 28 breaths per minute. His temp is 97.6. Oxygen saturation was 89% on RA and increased to 93% on 2 L. You find him sitting up, leaning forward. He appears uncomfortable with labored breathing and prolonged expiration and his lips are bluish. No JVD or carotid bruits noted . Chest exam shows mild intercostal retractions seen around the anterolateral costal margins and barrel chest. Wheezes present bilaterally but diminished BS without crackles. Heart exam is unremarkable, though the heart sounds are distant. Lower extremities show no cyanosis, clubbing or edema.

Name at least 4 risk factors for COPD evident in this client. What is the biggest risk factor?

What are six physical assessment findings this client has that are significant for COPD ?

Mr. Reyes has a FEV1 that was 30-50 % predicted. Explain to the family member the significance of the finding. and what GOLDs class would the client be in ?

Mr Reyes has an arterial blood gas drawn. PH 7.21 PaO2 58 PaCO2 72 and HC03 35 O2 sat 86 %. ?Analyze this ABG

The client continues to be SOB state interventions the nurse can do to assist then client. Include four interventions.

The HCP has prescribed a short acting beta 2 agonist and a corticosteriod. Explain to the client what each medication does and give two side effects for each medication.

The client has had a ten lb weight loss in the last month. Explain this to the clients family member and suggest dietary changes they can make to increase nutritional status .

Mr Reyes has stated he is interested in smoking cessation. What education can the nurse do to assist the client in this?

The client will be discharging on home O2. Educate the client on the advantages of home O2 therapy. Educate the client on the precautions needed when on home O2

The client and his family member express concern on how to know when to seek medical attention or call healthcare provider. "I am short of breath all the time, when would they actually need to know?". What is the nurse's best response to this question? Please include at least 5 concerning symptoms in your education.