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:
- Subjective data: “This cough is killing”
- Objective data: No improvements in oxygen saturation levels;
- Resp: 23;
- SpO2: 94%;
- Elevated HCO3 and PCO2.
Current information
- Medical diagnosis: respiratory alkelosis
- Risk factors: COPD, old age, smoking, prior history of respiratory conditions
- Diagnostic tests: Chest X-ray, lung pulmonary function test, ABGs, CT scan
- Treatments: administration of opioid pain relieve medicine, providing a sufficient amount of oxygen to stop hyperventilation
- Medications: oxycodone, codeine, or morphine
Nsg interventions
Nursing interventions:
- Increase inspired carbon dioxide (rebreathing)
- 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:
- Subjective data: audible chest wheezes, shortness of breath
- Objective data: Difficulty breathing;
- Chest pain;
- HR-21;
- BP: 198/80
Current information
- Medical diagnosis: sinus tachycardia
- Risk factors: COPD, old age, excessive nicotine consumption, prior history of respiratory conditions
- Diagnostic tests: ECG, thyroid function tests
- Treatments: administration of the necessary medicine
- Medications: calcium channel blockers, ivabradine
Nsg interventions
Nursing interventions:
- Administering anti-arrhythmic medication
- 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