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COLLEGE OF NURSING
Mr. Budoy 55 years old, a 10 wheeler driver, normotensive, nondiabetic, & smoker was rush to the nearest
hospital and admitted due to worsening of cough associated with tightness all over the chest, with profuse
expectoration of mucoid sputum, and difficulty of breathing more markedly during moderate to severe
exertion.
Initially, cough was present during cold season only and persisted for 2 to 3 months. For the last 3 months,
the same signs & symptom were present throughout the day and night, more markedly in the morning
and also on exposure to cold and dust. The patient also complains of occasional tightness all over the
chest, which worsen upon coughing. He also complains of difficulty in breathing, more markedly during
moderate to severe exertion but relieved by taking rest.
There is no history of chest pain, hemoptysis, and paroxysmal nocturnal dyspnea. He does not have any
history of fever, swelling of the ankle or weight loss. His bowel and bladder habits are normal.
Two years ago, he was admitted in the hospital due to severe attack of cough and breathlessness. He
smokes 30 sticks a day for last 35 years. All the family members are in good health. No such illness in
family.
CBC Results
WBC 8000/ul
RBC 4.8 million/ul
Hgb 15 g/dl
Hct 56%
WBC Differential
Neutrophils 60%
Lymphocytes 35%
Monocytes 5%
Eosinophils 4%
Basophils 1%
Platelet Count 200,000/mm3
VC- 52 mL/kg
FEV- 73%
RV- 128%
TLC- 118%
Pao2- 50 mmHg
PaCO2- 50 mmHg
pH- 7.30
O2 Sat- 89%
HCO3- 29 mmol/L
Impression: Enlarged heart with a flattened diaphragm. Consolidation in the lung fields is observable.
Questions:
1. Based on the given scenario, identify the priority signs and symptoms.
2. Interpret the laboratory and diagnostics results with clinical significance.
3. Using a concept map, explain the pathophysiology of the specific condition integrating
the diagnostic/laboratory results and possible medical managements.
4. Develop a course in the Ward.
5. Based on the priority problems of the client’s condition, Formulate 5 priority nursing
care plan.
6. Make an FDAR charting.