Acute Obstructive Pulmonary Disorder ( Copd ) Essay

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Scenario I
I had a patient with Chronic Obstructive Pulmonary Disorder (COPD) that was receiving albuterol treatments every four hours. The patient was significantly agitated and restless. I knew this patient and this behavior was uncharacteristic of the patient. Before administering the ordered dose of albuterol, I obtained vital signs and noted the patient 's heart rate was significantly higher than the patient 's baseline. The patient 's heart rate was 125 beats per minute, the pulse oximetry was stable at 92% on 2 liters of oxygen. Knowing something was not right, I called the physician. I used the SBAR tool to convey my findings to the physician;
 Situation: the patient is a 78 year old male, with chronic obstructive pulmonary disease, demonstrating restlessness, agitation with a rapid heart rate, tachycardia.
 Background: the patient was admitted two days ago for a COPD exacerbation, and receiving albuterol every four hours via nebulizer.
 Assessment: the patient 's vital signs are 108/68, 125 beats per minute, respirations, even and non-labored at 14 breaths per minute, 92% on 2 liters of oxygen via nasal cannula, afebrile 98.5 F.
 Recommendations: 1. Discontinue the standing albuterol, and making it every 6 hours, as needed (prn). 2. STAT electrocardiogram (EKG) to rule out cardiac ideologies. The physician agreed with my recommendations and gave new orders to change the albuterol to as needed and ordered a STAT EKG.
The next day I found out the patient
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