Describe how concept would inform your nursing care

Reference no: EM133444223

Mr. Park is a 70-year-old retired man who was admitted to Sterling College Hospital last night with a diagnosis of COPDE and pneumonia.

Social History
Mr. Park emigrated from South Korea to Canada in 1980 with his wife. Together they ran a successful realty and property management business from 1982 to 2012. He is now retired and living with his daughter in Burnaby, B.C. He is financially secure. Sadly, his wife died two years ago after 45 years of marriage. Mr. Park used to be very involved with the local Korean business association and was a pillar of the
community. He now enjoys playing cards with his friends and watching sports but has been less involved with these activities for the last few months. He is not very physically active. Lately his daughter has noticed that he has a poor appetite.

Medical History
Mr. Park was diagnosed with COPD and HTN in 2011 and was started on antihypertensive medications
and bronchodilators. He has used tobacco since he was a young man. Since his diagnosis, he has cut down his smoking to significantly. In 2014 he was treated for atrial fibrillation with an ablation procedure; however, this was not successful. He was put on a beta blocker for rate control. In the last few years, he has struggled with insomnia, and usually sleeps in his chair watching TV. He occasionally
takes Zopiclone but doesn't like the way it makes him feel in the morning.
Over the last 2 weeks he has been experiencing increased SOBOE, fatigue, and a loss of appetite. Yesterday, his daughter noticed he was struggling to breathe while sitting in his chair and that he seemed disoriented. She brought him to the ER where his vital signs were:
BP 145/85 HR 70 Temp 37.5 Sp02 86% RR 26
GCS = 14
After a CXR he was diagnosed with COPDE and pneumonia. He was admitted to the medical ward.

Night shift report:
Mr. Park remains very SOB, increased upon exertion. Requiring 3-4L 02 via NP.
Wheezes throughout lung fields. Coarse crackles to mid-upper fields. Thick yellow
sputum. Please encourage coughing. Required 3 x rescue inhaler treatments.
BP remains elevated at 154/88. HR: 67 irreg. Temp: 38.0. Sp02: 89% on 3-4L 02 via
NP. RR: 28. Slept very poorly but didn't want to take Zopiclone. Flat affect. Minimal fluid intake overnight. Voiding qs per urinal, but urine is concentrated. CXR scheduled
for this morning at 0830. Blood samples were drawn at 0630 for ordered lab tests.
Daughter says will visit today after work. She wants him to stop smoking before he
comes home.

Patient Assessment Data
General Appearance : Increased WOB , Use of accessory muscles/uncomfortable/dishevelled , Flat affect , Answering questions with only a few words/broken sentences due to SOB
Context : Wife died 2 years ago , Daughter wants you to quit smoking. You believe it is too late.

Subjective Data :
CNS : Alert and oriented x 3. You speak in short phrases. No pain. You are
uncomfortable and restless.
RESP : Your breathing is still hard and you are very tired.
You didn't sleep well. So much coughing.
It's difficult to take too many deep breaths.
CVS : No chest pain or palpitations.
Some numbness and dull pain in feet bilaterally.
No alterations in your hands.
GI : You don't feel like eating or drinking. LBM two days ago - normal.
No problems with bowel movements in the past.
GU : You are using a urinal. No problems with voiding.

Objective Data
Vital signs BP 150/90
HR 88 beats/min IRREGULAR
Temp = 37.2
RR = 26/min
Sp02 Sat 86% on 2L via nasal prongs
Sp02 increases to 89% on 4L
Sp02 increases to 93% on >5L
IV Site free from redness and swelling
CNS : PERRL at 3mm; face movements are symmetrical
RESP : Wheezes throughout lung fields bilaterally. Increased WOB and accessory muscle
use noted. Cough is moderately effective; producing yellow sputum.
CVS ARMS: CWMS satisfactory. Cap refill 3 secs. Peripheral pulses palpable. Moderate
and equal handgrips.
FEET: Feet cool, dry, cap refill 4 secs; pedal pulses not palpable
GI Abdomen is flat and soft. Bowel sounds hypoactive.
MSK Moderate and equal strength in limbs bilaterally
SKIN Mouth: lips, tongue dry

Questions

1. Identify ONE BCCNM Professional Standards. OR Entry-Level CompetencyLinks to an external site. that applies to this case study. Describe how the standard guides nursing care for Mr. Park.

2. Choose ONE of the health concepts below. Describe how this concept would inform your nursing care of Mr. Park. (NOTE: If you would like to address a health concept not listed, you are welcome to do so. Please discuss this first with your instructor.)

Grief
Chronic Illness
Living at Risk/Choice
Health Promotion OR Prevention
Aging

Reference no: EM133444223

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