Question

Case Studies

1. You are a nurse caring for your newest admission, a 68-year-old retired teacher who has a 50 pack-year history of smoking, which resulted in emphysema. She attends exercise classes at her local gym seeking to maximize her oxygenation. Recently, the patient has begun to contemplate the use of portable oxygen to decrease her workload to breathe.

What respiratory accommodations would you expect to observe in your patient due to her COPD?

How do the effects of emphysema increase respiratory workload?

As her condition becomes chronic, what effects would you expect to develop?

Considering her medical history, for which illnesses is she at greater risk?

Describe the lung sounds you would anticipate auscultating.

How would your patient’s COPD impact her dietary needs?

Outline measures that would promote your patient’s comfort.

Why would it be helpful to encourage adequate fluid intake?

What exhalation technique would be helpful to your patient? What are its benefits?

How could abdominal breathing assist your patient in oxygenation?

Why is it important to monitor the oxygen flow rate in patients with COPD?

Answer 1

1) Breathing may be assisted by pursed lips and use of accesory respiratory muscle. Patient may adopt the tripod sitting position. The chest may be hyperresonant and wheezing may be heard

2) As you breath in air, the alveoli stretch, drawing oxygen in and transporting it to the blood. When you exhale, the alveoli shrink, forcing carbon dioxide out to the body. Emphesma destroys the wall between the alveoli. This leads the lungs less able to absorb oxygen into the bloodstream and remove carbon dioxide from the blood. Lung tissue also loses its resilience which prevents it from stretching and Contracting properly. As result the respiratory work load of the patient will increase.

3) COPD can cause many complications including ;

* Lung infection

- flu

- whooping cough

* Collapsed lung ( pneumothorax)

* Poor gas exchange

* Heart problems

* Depression and anxiety

4) she is at the greater risk of respiratory failure.

5) Ascultation finding are hyper inflation, prolonged exhalation, wheezing, rhonchi, crackles.