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Tony is a 56-year-old, Hispanic male that presented to the Emergency Room with complaints of shortness of breath, which he has been experiencing for the past two days. He states “I haven’t felt good for about a week, but couldn’t afford to miss work.” He complains of a cough, fever, and feeling exhausted. Past medical history includes asthma, chronic obstructive pulmonary disease and diabetes. Upon physical examination, you notice that Tony is struggling to breathe, his respiratory rate is 36 breaths per minute and labored, heart rate 115 beats per minute, blood pressure 90/40 mm Hg, and his pulse oximetry is 84% on room air. You notify the MD. He orders oxygen at 2 L via NC and an arterial blood gas.
Tony’s ABG results:
pH 7.28
PaCO2 – 55 mm Hg
PaO2 – 70 mm Hg
HCO3 – 30 mEq/L
1) Describe possible causes of this condition(respiratory acidosis partially compensated)
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- Scenario Description: Juan Ferguson 50-year-old man with long-term emphysema who has become dyspneic and has been brought to the Emergency Department by paramedics and now is admitted to your floor for admission. He arrives alert and anxious, wheezing and still dyspneic. An IV has been started. Oxygen is started. What is my client’s primary and possible secondary diagnosis? What signs and symptoms would I expect to see with primary and secondary diagnosis? What do I need to assess? What is my top three priority assessments for this client? (Airway, breathing, circulation) What is my focused assessment for this patient and any nursing interventions I may need? What are the signs/symptoms that my client may exhibit if their condition is worsening? Give one or two reasons you would want to contact the healthcare provider?Tony is a 56-year-old, Hispanic male that presented to the Emergency Room with complaints of shortness of breath, which he has been experiencing for the past two days. He states “I haven’t felt good for about a week, but couldn’t afford to miss work.” He complains of a cough, fever, and feeling exhausted. Past medical history includes asthma, chronic obstructive pulmonary disease and diabetes. Upon physical examination, you notice that Tony is struggling to breathe, his respiratory rate is 36 breaths per minute and labored, heart rate 115 beats per minute, blood pressure 90/40 mm Hg, and his pulse oximetry is 84% on room air. You notify the MD. He orders oxygen at 2 L via NC and an arterial blood gas. Tony’s ABG results: pH 7.28 PaCO2 – 55 mm Hg PaO2 – 70 mm Hg HCO3 – 30 mEq/L 1)Determine Tony’s acid-base imbalance and Describe possible causes of the imbalanceGive typed full explanation A male client admitted with chronic pulmonary obstruction disease ( COPD ) exacerbation is receiving assisted ventilation with continuous positive airways pressure ( C PAP ) . His vital signs are temperature 98.8 F ( 3T , 1 degree * C ) heart rate 118 beats / minute blood pressure 176 / 96mm Hg46 BREATHS / MINUTE , while completing the pulmonary assessment , his oxygen saturation reading is 78 % and he is difficult to arouse . Which action should the nurse implement ? a)prepare for rapid sequence intubation b) increase oxygen delivery by 10% c) complete neurological assessment d) administer PRN nebulizer treatment
- JR is a 56 yo man with h/o asthma, HTN and hyperlipidemia. He presents to the ER today with h/o shortness of breath for 45 minutes at rest. He reports that he was feeling well and in his usual state of health until about an hour ago, when he smelled something burning. 20 minutes later, he began to feel short of breath and was wheezing. He tried using his albuterol inhaler without success, so he proceeded to the ER. Upon arrival, he was tachycardic, tachypneic, wheezing, using accessory muscles and hypertensive. His last admission for an asthma attack was 2 months ago. He denies a recent cold or URI and says the albuterol usually helps him when he feels an attack coming on and tends to use it on a daily basis. He generally has wheezing and shortness of breath on a daily basis. JR reports poor sleep due to waking about 2 times a week for shortness of breath. He has 2 cats, which sleep next to him on his pillow and he lives in an apartment complex. JR does not smoke, but his neighbor…CASE SCENARIOMr. Y is a 59-year-old Head of the Accounting Department in a certain Information and Technology Company. While having his breakfast at home, Mr. Y suddenly experienced slurring of speech, facial droop on the left side with weakness in left side of upper and lower limbs. His wife noted these sudden onset of symptoms and immediately called for help. Past health history revealed asthma which started at age 8. He was on prediabetes state 5 years ago and was diagnosed with Hypertension Stage 1 three years ago. He used to work for 50-60 hours per week as compared to his working hours during the pandemic which is recently reduced to 30 hours per week. Minimal change in lifestyle was done after he was diagnosed with hypertension, but remains a smoker for approximately 39 pack years. A social beer drinker about 10 standard drinks per week at 3-4 sessions. Outside work, he enjoys playing online games. Upon assessment patient was confused, with mild left sided neglect and altered…Background Patient name: Ngarla Kngwarreye Age: 62 Next of Kin: Son Gwoya and Daughter's Inala and Jenna Consultant: Dr Parry. Diagnosis: End Stage Chronic Obstructive Pulmonary Disease Patient notes Ngarla Kngwarreye is a 62 year old Anmatyerre woman from Urpuntia in Central Australia. 2 years ago Ngarla developed a Hospital Acquired Pneumonia during a hospital stay for exacerbation of her COPD. Since this time her lung function has continued to deteriorate until 6months ago she was admitted to hospital with respiratory failure and her conditioned was critical, at discharge her COPD was categorised as End-Stage. Three days ago Ngarala was again admitted with exacerbation of her COPD requiring extensive oxygen support, multiple antibiotics and high dose steroids to stabilise her. You are the nurse responsible for her care. Since admission, Ngarla's condition has failed to improve, her breathing has progressively worsened and she is now in the deteriorating palliative care phase…
- Background Patient name: Ngarla Kngwarreye Age: 62 Next of Kin: Son Gwoya and Daughter's Inala and Jenna Consultant: Dr Parry. Diagnosis: End Stage Chronic Obstructive Pulmonary Disease Patient notes Ngarla Kngwarreye is a 62 year old Anmatyerre woman from Urpuntia in Central Australia. 2 years ago Ngarla developed a Hospital Acquired Pneumonia during a hospital stay for exacerbation of her COPD. Since this time her lung function has continued to deteriorate until 6months ago she was admitted to hospital with respiratory failure and her conditioned was critical, at discharge her COPD was categorised as End-Stage. Three days ago Ngarala was again admitted with exacerbation of her COPD requiring extensive oxygen support, multiple antibiotics and high dose steroids to stabilise her. You are the nurse responsible for her care. Since admission, Ngarla's condition has failed to improve, her breathing has progressively worsened and she is now in the deteriorating palliative care phase…Background Patient name: Ngarla Kngwarreye Age: 62 Next of Kin: Son Gwoya and Daughter's Inala and Jenna Consultant: Dr Parry. Diagnosis: End Stage Chronic Obstructive Pulmonary Disease Patient notes Ngarla Kngwarreye is a 62 year old Anmatyerre woman from Urpuntia in Central Australia. 2 years ago Ngarla developed a Hospital Acquired Pneumonia during a hospital stay for exacerbation of her COPD. Since this time her lung function has continued to deteriorate until 6months ago she was admitted to hospital with respiratory failure and her conditioned was critical, at discharge her COPD was categorised as End-Stage. Three days ago Ngarala was again admitted with exacerbation of her COPD requiring extensive oxygen support, multiple antibiotics and high dose steroids to stabilise her. You are the nurse responsible for her care. Since admission, Ngarla's condition has failed to improve, her breathing has progressively worsened and she is now in the deteriorating palliative care phase…Background Patient name: Ngarla Kngwarreye Age: 62 Next of Kin: Son Gwoya and Daughter's Inala and Jenna Consultant: Dr Parry. Diagnosis: End Stage Chronic Obstructive Pulmonary Disease Patient notes Ngarla Kngwarreye is a 62 year old Anmatyerre woman from Urpuntia in Central Australia. 2 years ago Ngarla developed a Hospital Acquired Pneumonia during a hospital stay for exacerbation of her COPD. Since this time her lung function has continued to deteriorate until 6months ago she was admitted to hospital with respiratory failure and her conditioned was critical, at discharge her COPD was categorised as End-Stage. Three days ago Ngarala was again admitted with exacerbation of her COPD requiring extensive oxygen support, multiple antibiotics and high dose steroids to stabilise her. You are the nurse responsible for her care. Since admission, Ngarla's condition has failed to improve, her breathing has progressively worsened and she is now in the deteriorating palliative care phase…
- 4:24 al a @ ord-4.pearsonvue.com d © Time Remaining 00:14:25 113 of 125 B Calculator The nurse has taught a client with active pulmonary tuberculosis (TB). Which of the following statements by the client would indicate a correct understanding of the teaching? Select all that apply. 図1 回2 3. 4. 05. 6. "I should expectorate secretions into a disposable tissue and dispose of the tissue in a plastic bag. "will keep my dishes and eating utensils separate from those of other family members. "I should have a TB skin test again in 6 months." "I will receive prescribed medication for at least 6 months." "I should take the TB medication as long as the symptoms occur." "I will limit my daily activities until I am no longer feeling so tired.Answer Everything. Kindly skip if you're not interested to answer them. Read Chapter 12 of Egan’s Fundamental of Respiratory Care 11th edition by Kacmarek, R., Stoller, J., Heuer, A. and Chapter 6 of Cardiopulmonary Anatomy & Physiology Essentials by Respiratory Care 7 th edition by Terry des Jardins and answer the following questions. 5. Identify the amount of oxygen released when systemic arterial blood flows through tissues from hemoglobin. 6. Illustrate and explain the dissociation curve for oxygen-hemoglobin. 7. Determine the maximum quantity of oxygen that can be combined with blood hemoglobin. 8. Identify the amount of oxygen released when systemic arterial blood flows through tissues from hemoglobin. This is cardiopulmonary anaphy you can use this https://lens.csuandrews.net/pluginfile.php/175788/mod_resource/content/1/Pulmonary%20Ventilation.pdf as referenceJoe Ritter, a 74-year-old retired bricklayer, has a 40-pack-year tobacco history and a history of chronic obstructive pulmonary disease (COPD). Today, he presents to the emergency department with reports of shortness of breath and difficulty breathing. He in respiratory distress with retracting respirations of 26 breaths/min, BP is 154/76 mm Hg, pulse is 120 beats/min, and temperature is 37°C. His skin color is pale gray, his chest is barrel-shaped, and he uses accessory muscles to breathe; he appears anxious and is sitting in a tripod position. His nail beds are bluish in color; his oxygen saturation by pulse oximetry is 72%. Chest auscultation reveals wheezes and decreased-to-absent breath sounds in bilateral bases. Hyperresonance is noted upon chest wall percussion. Chest x-ray showed atelectasis bilaterally in the bases. Mr. Ritter coughs with minimal amounts of clear sputum. (Learning Objectives 5 and 8) Nursing Diagnosis 1: Goals: (Expected Outcome, long and short term)…
