Part 1

History, Signs, and Symptoms

Linda is a 54-year old woman who presents with the following signs and symptoms at Cebu
Doctors' University hospital upon admission.

- difficulty in breathing,
- heart rate of 110 bpm,
- respiratory rate of 32 bpm,
- blood pressure of 110/75 mmHg,
- temperature of 37.8 degrees Celsius,
- Pulse oximetry oxygen saturation (SPO2) of 92%.

Part 2

Client's Medical History

Client lives in Guadalupe, Cebu City, female, 54 years of age, non-smoker. She has no
history of any allergies, a non-alcoholic drinker, married with 3 kids. The client has no pre-
existing illness but with a familial history of Diabetes Type II maternal side and History of
Hypertension Paternal side. She has been admitted to the hospital once due to mild
pneumonia year 2018 and was diagnosed with COPD year 2021. Prior to admission, patient
had experience coughing for almost 5 days with sputum production, yellowish to light green
in color. Patient's relative verbalized a gradual loss of weight was observed.
Task 1. Study the physiology of Respiration.(Internal and External)

Respiration begins at the nose/mouth and the oxygenated air is brough down to the pharynx,
larynx and the trachea. Trachea has two bronchi which leads us to our 2 lungs. A smaller
bronchi is made into even smaller tubes called bronchioles. At th end of the bronchioles, we
have our air sacs called the alveoli where the gas exchange occurs.

Respiration includes 2 processes:

External Respiration is the exchange of gases between the alveoli and blood. The uptake of
O2 and excretion of CO2 in the lungs. The pulmonary artery carries deoxygenated blood into
the lungs from the heart, where it branches and eventually becomes the capillary network
composed of pulmonary capillaries. As the blood is pumped through this capillary network,
gas exchange occurs. External respiration occurs as a function of partial pressure
differences in oxygen and carbon dioxide between the alveoli and the blood in the pulmonary
capilalries.

Internal Respiration is the exchange of gases between the cells and capillary blood. Similar
to external respiration, it occurs as simple diffusion due to a partial pressure gradient. The
partial pressure of oxygen in tissue is low so in contrast, the partiap pressure of oxygen in
the blood is high. This creates a pressure gradient that causes the oxygen to dissociate from
hemoglobin, diffusing out from the blood, crossing the intersititial space and enter the
tissues.
Task 2. Discuss the effect of Certain Risk factors to Lung Volume and Lung Capacity.
Task 3. Provide a thorough Health Assessment of the client based on the history, signs
and symptoms and medical history of the patient

Task 4. Test yourself. Of the vital signs mentioned, which are abnormal?
Task 5. Enumerate possible diagnostic exams the client needs to undergo
 DIAGNOSTIC EXAM DESCRIPTION

Spirometry Test Spirometry is a simple test used to help

diagnose and monitor certain lung
conditions by measuring how much air you
can breathe out in one forced breath.
It's carried out using a device called a
spirometer, which is a small machine
attached by a cable to a mouthpiece.

Conditions that can be picked up and

monitored using spirometry include:

● asthma – a long-term condition

where the airways become
periodically inflamed (swollen) and
narrowed
● chronic obstructive pulmonary
disease (COPD) – a group of lung
conditions where the airways
become narrowed
● cystic fibrosis – a genetic condition
where the lungs and digestive
system become clogged with thick,
sticky mucus
● pulmonary fibrosis – scarring of the
lungs

Sputum Test A sputum test, also known as a sputum

culture, is a test that your doctor may order
when you have a respiratory tract infection
or other lung-related disorder to determine
what is growing in the lungs.
Task 6.
Formulate three (3) Nursing Diagnosis for our client Linda.
1. Ineffective airway clearance r/t bronchospasm as evidenced by verbalization of
difficulty breathing
2. Impaired gas exchange r/t altered oxygen supply as evidenced by abnormal vital
signs
3. Imbalanced nutrition : less than body requirements r/t dyspnea as evidenced by
gradual loss of weight
Task 7. Provide at least 5 nursing Interventions or actions to address the formulated Nursing
diagnoses with their corresponding rationales.
Task 8. Create a Health Teaching Plan for the patient and her significant others
Source:
Hinkle, J., Cheever, K., & Overbaugh, K. (2022). Brunner & Suddath’s Textbook of

Medical-Surgical Nursing (15th ed., Vol. 1). Wolters Kluwer.

LibGuides: BIO 140 - Human Biology I - Textbook: Chapter 30 - Gas Exchange.

(n.d.). LibGuides. Retrieved August 26, 2022, from

https://guides.hostos.cuny.edu/bio140/7-30#:%7E:text=External%20respiration%20is

%20the%20exchange,occurs%20due%20to%20simple%20diffusion.

The respiratory system review (article). (n.d.). Khan Academy. Retrieved August 26,

2022, from https://www.khanacademy.org/science/high-school-biology/hs-human-

body-systems/hs-the-circulatory-and-respiratory-systems/a/hs-the-respiratory-

system-review#:%7E:text=External%20respiration%2C%20also%20known

%20as,the%20cells%20and%20blood%20vessels.