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The Treatment of the Patient with Exacerbation of Chronic Obstructive Pulmonary Disease
Vincent Brody
67 years old. Has a 50-year history of smoking 2 packs a day. Admitted with exacerbation of chronic obstructive pulmonary disease (COPD).
Related to stress and pain experienced as a result of COPD exacerbation
Priority Nsg Diagnosis # 1
Risk for respiratory distress symptoms:
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Subjective data: This cough is killing
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Objective data: No improvements in oxygen saturation levels;
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Resp: 23;
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SpO2: 94%;
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Elevated HCO3 and PCO2.
Current information
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Medical diagnosis: respiratory alkelosis
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Risk factors: COPD, old age, smoking, prior history of respiratory conditions
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Diagnostic tests: Chest X-ray, lung pulmonary function test, ABGs, CT scan
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Treatments: administration of opioid pain relieve medicine, providing a sufficient amount of oxygen to stop hyperventilation
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Medications: oxycodone, codeine, or morphine
Nsg interventions
Nursing interventions:
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Increase inspired carbon dioxide (rebreathing)
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Relieve pain and limit the sources of anxiety
Short-term goal: stop hyperventilation:
Long-term goal: limit the impact of the underlying condition (COPD) on alkelosis
Contributed to heightened anxiety and hyperventilation
Priority Nsg Diagnosis # 2
Emotional Distress:
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Subjective data: audible chest wheezes, shortness of breath
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Objective data: Difficulty breathing;
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Chest pain;
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HR-21;
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BP: 198/80
Current information
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Medical diagnosis: sinus tachycardia
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Risk factors: COPD, old age, excessive nicotine consumption, prior history of respiratory conditions
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Diagnostic tests: ECG, thyroid function tests
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Treatments: administration of the necessary medicine
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Medications: calcium channel blockers, ivabradine
Nsg interventions
Nursing interventions:
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Administering anti-arrhythmic medication
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Preventing cardiac emergencies
Short-term goal: slow the heart rate, stabilize the patient
Long-term goal: ensure there is no need for invasive therapy such as catheter ablation
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