Copd Case Study Essay

2780 Words Dec 5th, 2015 12 Pages
Airway/Breathing (Oxygenation) Pneumonia/Chronic Obstructive Pulmonary Disease Clinical Reasoning Case Study
STUDENT Worksheet

JoAnn Walker, 84 years old

Overview

This case study incorporates a common presentation seen by the nurse in clinical practice: community acquired pneumonia with a history of COPD causing an acute exacerbation. Principles of spiritual care are also naturally situated in this scenario to provide rich discussion of “how to” practically incorporate this into the nurse’s practice.

Concepts (in order of emphasis)

I. Gas Exchange II. Infection III. Acid-Base Balance
IV. Thermoregulation V. Clinical Judgment VI. Pain VII. Patient Education VIII. Communication IX. Collaboration

I.
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| This is important because we need to look at the relevant data and realize that she seems to be in distress and first take care of that. Also realize that she seems to have an infection. With this information we are able to prioritize | RELEVANT Data from Social History: | Clinical Significance: | She was widowed 6 months ago after being married for 64 years, and she feels like it is the beginning of the end for her. | This is important because when caring for her we need to keep in mind her age, stressors in her life and any limitations |

What is the RELATIONSHIP of your patient’s past medical history (PMH) and current meds?
(Which medication treats which condition? Draw lines to connect)

PMH: | Home Meds: | Pharm. Classification: | Expected Outcome: |  COPD/asthma Hypertension Hyperlipidemia Cor-pulmonale Anxiety disorder 1ppd smoker x40 years. Quit 10 years ago | 1. Fluticasone/salmeterol(Advair) diskus 1 puff every12 hours2. Albuterol (Ventolin) MDI2 puffs every 4 hours prn3. Lisinopril (Prinivil) 10 mg po daily4. Gemfribrozil (Lopid) 600mg po bid5. Diazepam (Valium) 2.5 mg po every 6 hours asneeded6. Triamterene-HCTZ (Dyazide) 1 tab daily | 1. corticosteroid 2. bronchodilator 3. ACE inhibitor4. cholesterol 5. benzodiazepine 6. potassium sparing diuretic | 1. improve breathing2. open up airway in the lungs3. decrease

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