Question: Vincent Brody Is A 67-year-old Male Admitted Directly From The Provider’s Office For Exacerbation Of Chronic Obstructive Pulmonary Disease (COPD). During The Last Year He Has Had Two Exacerbations. Physical Findings Include Barrel Chest And Clubbed Fingers. He Has Been Assisted Into A Patient Own And Is In The Hospital Bed. He Is Hunched Forward In …

Vincent Brody is a 67-year-old male admitted directly from the provider’s office for exacerbation of chronic obstructive pulmonary disease (COPD). During the last year he has had two exacerbations. Physical findings include barrel chest and clubbed fingers. He has been assisted into a patient own and is in the hospital bed. He is hunched forward in apparent respiratory distress. The provider has written orders and blood samples have been drawn and sent to the lab but the results are not available yet. His wife is very attentive at his side. Initial Vital Signs Temperature 379 “CHeart Rate 92 bpm Respiration Rate 28 rpm Blood Pressure 142/84 mmHg SpO2 835 Past Medical History Patient has a 30-year history of smoking 2 packs a day and has continued to smoke despite health care providers recommendations to quit During the last year he has had two COPD exacerbations. Provider’s Orders . . . 0 Diet: regular, encourage fluids Activity: up as tolerated Continuous Spo, monitoring and vital signs every 5 minutos x 1 hour, then every 4 hours Oxygen per nasal cannula at 2 L/min, titrate to keep Spo, greater than 90% IV: DS normal saline with 20 mEq KCL at 100 mL/hour Incentive spirometry every 2 hours Meds: Albuterol 2.5 mg in 3 ml, normal saline via nebulizer every 4 hours Methylprednisolone 125 mg IV xl now Prednisone 20 mg PO three times per day, first dose tomorrow Labs CBC BMP BNP Troponin CK.MB ABG Chest x-ray portable (PA) . 0 o O 0 O O EBP: What concerning signs and symptoms did the patient exhibit? . . EBP: What assessments did you complete based on the signs and symptoms? Explain your thinking EBP: Discuss factors that lead to acute respiratory failure in COPD. PCC: How did you communicate with the patient? PCC: What specific issues would you want to take into consideration to provide for this patient’s unique care needs? PCC: For the wife: How did the nurse attend to your unique needs? PCC: Discuss the impact of timeliness of your interventions as it relates to this patient’s care situation. EBP: Discuss the importance of the cardiac labs ordered in relationship to Mr. Brody’s COPD diagnosis. EBP: Discuss the interventions you implemented as a result of your assessment. S: What measures did you implement to ensure safe patient care? . . . .