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Assessing respiratory system
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Respiratory patient
56-year-old woman in a chair her level of consciousness is responsive. The patient says she cannot breathe, airway open, noisy breathing heard breathing 30 breaths/min. Symmetrical rise and fall of the chest Circulation Carotid and radial pulses Skin color, temperature, and condition Pale, cool, and clammy. Lungs: Inspiratory and expiratory wheezes in the uppers; diminished in the bases, allergic to penicillin, medication that the patient been taking is Proventil inhaler, patient medical history is high blood pressure and asthma, last oral take was breakfast, and was sitting in a chair.
Diabetic patient
Arrived on scene with patient who responds to verbal commands, patient has a medic-alert bracelet identifying him as a diabetic. Patient is irritable and confused. Patient is protecting his own airway. Sign and symptoms sweaty, pale, confused, not breathing normally, not allergic to anything, medication the patient has been taking is Glucotrol, patient is a diabetic, last oral intake was lunch at 12:15, event leading to injury was nothing just finish working and was heading home.
Abdominal patient
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You arrive on scene at a brown house with lights on and door open. To a patient that skin is pink warm (normal). Blood pressure 112/76 and pulse 61. Pupils are Equal and reactive, patent airway, says hurts to breath in once in a while. He says the pain has been radiating from his back, then side, then inner thigh/abdomen area for 2 weeks or so. No vomiting or nausea, no allergies, takes vitamins every day, fish oil. No meds, no pertinent past history, ate a tuna sandwich earlier that day with some red bull. The pain has just been generally getting worse for the past 2 weeks. He thought he pulled a muscle during
R.S. has chronic bronchitis. According to the UC San Francisco Medical Center “Chronic bronchitis is a common type of chronic obstructive pulmonary disease (COPD) in which the air passages in the lungs — the bronchi — are repeatedly inflamed, leading to scarring of the bronchi walls. As a result, excessive amounts of sticky mucus are produced and fill the bronchial tubes, which become thickened, impeding normal airflow through the lungs.” (Chronic Bronchitis 2015) There are many things that can be observed as clinical findings. R.S. will have a chronic cough that has lasted from 3 months to two years or more, and a lot of sputum. The sputum is due to
Respiratory assessment is a significant aspect of nursing practice. According to the National Institute for Health and Care Excellence, respiratory rate is the best indicator of an ill patient and it is the first observation that will demonstrate a problem or deterioration in condition (Philip, Richardson, & Cohen, 2013). When a respiratory assessment performed effectively on a patient, it can result in upholding patient’s comfort and independence in progress of symptom management. Studies have acknowledged that in spite of the importance of the respiratory rate (RR) it is documented rarely than the other vital signs in the hospital settings (Parkes, 2011). This essay will highlight the importance of respiratory assessment and discuss why nurses
Mrs. Jones, An elderly woman, presented severely short of breath. She required two rest periods in order to ambulate across the room, but refused the use of a wheel chair. She was alert and oriented, but was unable to speak in full sentences. Her skin was pale and dry. Her vital signs were as follows: Temperature 97.3°F, pulse 83, respirations 27, blood pressure 142/86, O2 saturation was 84% on room air. Auscultation of the lungs revealed crackles in the lower lobes and expiratory wheezing. Use of accessory muscles was present. She was put on 2 liters of oxygen via nasal canal. With the oxygen, her O2 saturation increased to 90%. With exertion her O2 saturation dropped to the 80's. Mrs. Jones began coughing and she produced large amounts of milky sputum.
She had a two week history of feeling generally unwell, complaining of tiredness and lethargy. She had no other significant symptoms. Her past history includes well controlled asthma and anxiety. She was a smoker of 20 cigarettes per day. She was taking amitriptyline, Symbicort (budesonide and formoterol inhaler). She had no significant family history of medical illness and had no clinical findings on examination. Blood tests showed corrected calcium of 4.22mmol/L (NR 2.20 -2.60) with suppressed paired PTH of 1.45pmol/L (NR1.60- 6.9). Her renal function was initially impaired, but normalized with rehydration. Her liver function tests, full blood count, vitamin D, myeloma screen and serum ACE levels were all within normal limits. Ultra sound scan (USS) of kidneys, USS of parathyroid and computerized tomography (CT) of thorax, abdomen and pelvis were all reported as normal with no cause found for her
The purpose of this essay is to explore nursing care priorities for a patient with a common health condition. A common health condition is a disease or condition which occurs most often within a population. The author has chosen scenario 3 for this essay and will describe the nursing assessment and care planning provided to a patient with Chronic Obstructive Pulmonary Disease (COPD). The WHO definition of COPD is a lung disease which has a chronic obstruction of the airways that impedes normal breathing and is not fully reversible (). According to), there are estimated to be over 3 million people in the UK with COPD. It is common in later life and there are approximately 25,000 deaths each year, with 15% of COPD being work related (The identity of the patient will remain anonymous in adherence with the Nursing and Midwifery Council, Code of Conduct on patient confidentiality (). However, the patient will be referred to as Mr B in this essay. The author has chosen the priority of eating and drinking for Mr B. Patients with COPD are at increased risk of malnutrition and nurses must make certain they screen patients and offer advice or refer as necessary (). If this priority is managed well it will have a positive effect on the other priorities (, 2012). In accordance with NICE Guideline 101 (), the treatment and care provided should consider each persons’ individual requirements and preference. Care and treatment should take into account people’s individual needs and choices. To allow people to reach informed decisions there must be good communication, supported by evidence-based practice (). This essay will provide an evidence based discussion on how care will be implemented in relation to Mr B and his eating and drin...
Room 28, a 73-year-old married male and retired railroad engineer, presented to his local hospital with a chief complaint of dyspnea resulting in the inability to perform physical activity without difficulty in breathing or SOB. After observing Room 28’s SpO2 level of 83%, which demonstrated his hypoxemic state, he was sent to his local hospital for further testing in order to reveal any lung disease or abnormalities. Room 28 was diagnosed with severe emphysema demonstrated by a chest x-ray examination and an ABG analysis after resting 20 minutes on room air. Room 28 was prescribed continuous O2 therapy, by route of nasal cannula, at a 2L flow rate. Severe emphysema will be discussed along with pathogenesis, risk factors, diagnostic tools and
On admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings. J.P. was positive for dyspnea and a productive cough. She also was positive for dysuria and hematuria, but negative for flank pain. After close examination of her integumentary and musculoskeletal system, the examiner discovered a shiny firm shin on the right lower extremity with +2 edema complemented by severe pain. A set of baseline vitals were also performed revealing a blood pressure of 124/80, pulse of 87 beats per minute, oxygen saturation of 99%, temperature of 97.3 degrees Fahrenheit, and respiration of 12 breaths per minute. The blood and metabolic panel exposed several abnormal labs. A red blood cell count of 3.99, white blood cell count of 22.5, hemoglobin of 10.9, hematocrit of 33.7%, sodium level of 13, potassium level of 3.1, carbon dioxide level of 10, creatinine level of 3.24, glucose level of 200, and a BUN level of 33 were the abnormal labs.
Bacterial pneumonia also known as Streptococcus pneumoniae is pneumonia caused by a Gram-positive bacterium that often lives in the throat of people who do not have pneumonia bacteria.When the inflammation caused by pneumonia occurs in the alveoli (microscopic air sacs in the lungs), they fill with fluid. The lungs lose elasticity and cannot take oxygen into the blood, or remove carbon dioxide from the blood, as efficiently as usual. When the alveoli has trouble work efficiently, one’s lungs has to work even harder to make up for the lack of work that the alveoli is not putting out to put so your body can receive the oxygen it had trouble getting. This causes the feeling of being short of breath, which is one of the most common symptoms of
Caring for people is my passion. My senior year of high school is when I witnessed my grandmother live on a ventilator for about a week. It awakened a new level of passion in me to care for people with cardiopulmonary problems. The Respiratory Therapy Care profession has intrigued me with how they improve the quality of life in their patients. I will enjoy working closely with patients in addition to working high tech equipment. By entering into this program and graduating out of this program I know that this will satisfy my personal goals for the next five years in many ways. The continues challenges of trying to figure out what’s wrong the heart that day or what’s wrong with the lung the next day will always keep me on my toes. It will always
A 22-year-old male presents to the ER for evaluation of recurrent nosebleeds. He reports a 6-day history of nosebleeds that occur at daily and last up to 30 minutes. Nosebleeds have been worsening. He has noticed large bruises on his abdomen and thighs recently. He has been unable to work up these past 2 days due to a fever of 102°F. He also complained of fatigue and SOB. He denies throat pain, cough, nausea, and emesis. He reports headaches and mild gum bleeding when brushing his teeth. Physical examination reveals vital signs include a temperature of 101°F, heart rate of 113, RR of 21, and BP of 131/74. The patient is pale but in no acute distress. Head, eye, ear, nose, and throat examination reveals that his oropharynx is slightly dry with
To introduce the respiratory system, use the SOS strategy found in the DE Techbook teacher section Silence is Golden. Show the video segment Cow’s Lungs in Explore More Resources with no audio and ask the students to describe what is happening and why. As they discuss aloud what they are seeing, educators will get an idea of what they understand, need to still master and want to know more about. Ask the students to record their observations in their notebooks. Then to finish up, have them explain to a partner what the video has demonstrated. As the students observe the cow’s lungs experiment, they will be isolating a single system and constructing a simplified model of it; imagining an artificial boundary between the respiratory system and
75 year old man with a history of diabetes, coronary artery disease, and COPD requiring nasal oxygen is brought to the clinic by his daughter. She reports that the patient has poor memory and has been getting worse over the past 2 years. She states that after he makes a statement or asks a question, he will repeat the statement or question again 15 or 20 minutes later. He can no longer manage his personal finances. The patient reports that his mood is good, and that he gets up occasionally to urinate throughout the night, but is able to get back to sleep quickly once he is done..
Smoke inhalation injury, a unique form of acute lung injury, greatly increases the occurrence of post-burn morbidity and mortality. In addition to early intubation for upper-airway protection, subsequent critical care of patients who have this injury should be directed at maintaining distal airway patency. High-frequency ventilation, inhaled heparin, and aggressive pulmonary toilet are among the therapies available (Cancio , 2009).
This was his second episode since 10 days ago where he develop the same pain at his right flank. He suddenly experienced severe pain 8 hours before admission when the pain shifts to his right lower quadrant of his abdomen. The onset is at 6.30 am before worsening at 10 p.m to 2 p.m. He described the pain as continuous sharp pain and gradually increased in severity. There is no radiation of the pain. The pain was exaggerated on movement and touch. There were no relieving factor and he scale the severity as 7/10. He experienced fever for 1 day prior to admission. It was a mild grade continuous fever. He does not experienced chills and rigor. The patient does not experience any nausea or vomiting, no dysphagia, no pain during micturition and no alteration in bowel habit. He experienced loss of appetite but not notice any weight loss.
The patient has high temperature-sign of fever, a very fast pulse rate (tachycardia), and chest wheezing when listened to using a stethoscope (Harries, Maher, & Graham, 2004, p.