Ramon Victor G. Roxas Jr.

SLMC GC Nursing Trainee Take Home Workshop Group 1 Case #1 62 y/o female with progressive DOB over the past 48 PMH 40 pack year smoking history On home O2 Some type of lung problem v/s O2 sat 78% O2 2L RR 26 Temp. 98.1

Assessment: -

Obvious Risk factors: Cigarette Smoking ( most important) Possible long respiratory infections Possible allergens Possible Diagnosis of Emphysema ( pink Puffer) breakdown of the elasticity of the lungs, decreased lung recoil, overdistention of the lungs Possible Barrel chest Possible Diagnosis of Chronic Bronchitis ( Blue Bloater), inflammation of the bronchi, hypersecretion of mucus, productive cough, crackles, obstruction of airways, increased airway resistance. O2 sat 78% O2 2L RR 26 Temp. 98.1 There is possible impaired gas exchange Possible Signs and symptoms: -Cyanosis, -respiratory acidosis ( high CO2), -Cardiac dysrhythmias, -low O2 sat, -orthopnea -Prolonged expiration -pulmonary hypertension - decreased vital capacity -dyspnea -decrease in weight

- use of accessory muscles for breathing, hypertrophy of muscles. Possible Management: -Stop Cigarette Smoking -chest Physiotherapy -Corticosteroids for inflammation - Clearing the Secretion for suction -Cough Suppresant -Oxygen Therapy ( low flow rate: 2-3 Lpm - offer fluids 3L/day - oral hygiene -Proper positioning ( orthopneic/ high fowlers) - Pursed lip breathing to eliminate CO2 - Postural drainage - Diet ( high calorie, high protein, low carbohydrates) -decrease oxygen demand ( bed rest) - dilate the bronchi by giving bronchodilatorss