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Read the following case studies and answer the questions that follow James White James White, a patient with an exacerbation of COPD, is on your medical-surgical unit. You need to obtain his vital signs and give him a bath. His vital signs at 8 am were as follows: temperature, 98.4°F; pulse, 86 beats/minute and regular; respirations, 18/minute; blood pressure, 130/68 mm Hg. The physical therapist who is working with this patient on conditioning therapy has just brought him back from his exercises. You notice that his breathing is labored, with audible expiratory wheezes. While you are obtaining his oral temperature and vital signs, you continue to hear audible expiratory wheezing. His vital signs now are as follows: temperature, 96.8°F; pulse, 106 beats/minute and irregular; respirations, 26/minute; blood pressure, 140/74 mm Hg. Medical orders Daily physical therapy for conditioning Oxygen at 2 L via nasal prongs prn for pulse oximetry <90% Developing Clinical Reasoning I . Did you take the second set of vital signs at the most appropriate time? Why or why not? • Describe the timing and type of bath you think Mr. White requires and the degree of assistance he will need. Explain your rationale. Vital signs q 4 bc Oxygen saturation levels via pulse oximeter every shift and prn • How have Mr. White’s exercises affected the accuracy of his vital signs? • What would be your course of action in response to his labored breathing?
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