Question

Ms. S is a 76-year-old female client who is admitted to the hospital with a diagnosis of pneumonia. Upon examination, you notice a barrel chest and diminished breath sounds in the bases. Her arterial CO2 is 55 mm Hg, and further questioning reveals that she has a history of chronic obstructive pulmonary disease (COPD). She has smoked two packs of cigarettes per day for the past 50 years. (Learning Objectives: 2, 3, 15, and 17)

1. How does her history of smoking increase her risk for pneumonia? 2. What findings make you suspect COPD? Why? 3. Ms. S has thick tenacious secretions that are blocking the airways. How will this impact her ventilation and perfusion? Why is this important? 4. Further lab testing reveals a low hematocrit and hemoglobin. How will this impact her respiratory status? 5. Write a paragraph about the determinants of airway resistance and the relationship between lung volume and airway resistance.

Answer 1

1. Smoking increases the risk of infection in any person and in COPD patient,smoking will doubled the risk for infection.

2. Patient has barrel chest and it is clinical manifestations of COPD. Patient also has diminished breath sounds and his CO2 is 55 mmHg and if it with compensated PH ,it indicate that patient is being a chronic CO2 retraner. Patient revealed that she had a history of COPD and chronic smoking increases the risk of COPD.

3. Ventilation and perfusion indicate the transport of air and blood to the alveoli. Thick tenacious secretions make this transport more difficult and it will resulted laboured breathing in patient.

4. Low hematocrit and low haemoglobin values indicate that the patient requires blood transfusion. Haemoglobin in RBC which carries oxygen to different parts of the body. Low haemoglobin levels causes decreased oxygen transportation and it leads to breathing difficulty and tissue hypoxia.