Reference no: EM133241814
CASE SCENARIO
John, a 50-year-old Caucasian man, comes to the emergency department with worsening dyspnea, fever, cough, and increased purulent sputum production. He is accompanied by his sister, who says John has been experiencing shortness of breath, feeling fatigued, and has not been thinking clearly.
His sister states that John has had a cold for the past three days, which he tried to manage with Tylenol.
According to past medical history, John has been a smoker for 30 years and has quit one year ago when he was diagnosed with stage II (moderate) chronic obstructive pulmonary disease. Since being diagnosed, John has been taking salbutamol PRN and tiotropium bromide (Spiriva) daily. He has no other medical conditions, and no known allergies.
Upon physical examination, the nurse notes John's vital signs are:
Blood pressure - 130/84
Respiratory rate - 28/min
Heart rate - 110/min
Oxygen saturation - 87%
Temperature - 38.1ºC
The client is using accessory muscles to breathe, has audible expiratory wheezing and inspiratory crackles, and diminished breath sounds in lower lobes upon auscultation.
Questions
- What is the potential cause for John coming to the ED?
- What body stance/position do you expect John to be in?
- What are some of the medications that John is likely to be given specific to his admission diagnosis?
- What are some of the nursing actions that will most likely be ordered?
- John asks the nurse, "I quit a year ago, how come this happened to me?" What would be the nurse's response?
- What client-teaching can the nurse implement when John is ready to be discharged?