Can you help me answer some questions on COPD and respiratory status to better understand this disorder? Thanks!!!!!!!!
Mrs. Johnson is a 69-year-old retired waitress who has smoked since she was 12. She now has
severe emphysema and chronic obstructive pulmonary disease (COPD) and is admitted to the
nursing home where you work because she is widowed and has no family to care for her. She
uses oxygen 2 L per nasal cannula at all times.
1. What routine data should be collected to monitor Mrs. Johnson's respiratory status?
2. What are normal aging changes, in addition to her chronic lung disease, that affect Mrs.
3. You note that Mrs. Johnson's physician has documented that she has a barrel chest. What does
this mean, and what causes it?
4. Why is Mrs. Johnson on only 2 L of oxygen even though she is still sometimes short of breath?
5. You enter Mrs. Johnson's room one evening and find her with increased dyspnea. You check
her oxygen and find it is on at 2 L per minute as ordered. What questions can you ask to
further assess the severity of her problem?
6. You decide to check her oxygen saturation and find it is 85% on 2 L of oxygen. What do you
7. You page the physician. While you are waiting for her call, you sit with Mrs. Johnson and try
to calm her. What are some techniques that may help? What position will be most
effective for her?
Mar 10, '10
1. Is the COPD related to Asthma, Chronic Bronchitis or Emphysema: Cough present, productivity of cough, SOB, wheezing, chest tightness, cap refill, cyanosis, monitor vitals, monitor the level of fatigue before, during and after activities.
2. Lungs can lose elasticity
3. Inability to exhale completely, accessory muscle use
4. COPD'ers are use to a lower volume of O2 and and increased CO2 level too much O2 for a COPD patient can actually cause respiratory arrest.
5. Has she just completed an activity? Does the SOB decrease when she is sitting up?
6. Find out what her baseline O2 reading is some pts. with COPD can maintain a baseline SpO2 of 88%-89% and are considered stable. Try pursed lip breathing, cough, deep breath. If nothing works call the physician.
7. Pursed lip breathing, sitting up right, elevating the head of bed, try calming the anxiety.
Hope this helps!
Jan 6, '12
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