Chapter 41, Problem 3CAQ

Summary Introduction

To discuss:

The two priority nursing diagnoses and list two or three appropriate interventions to be implemented based on the initial condition of Mr. E.

Case summary:

Mr. E is a 75-year-old who is admitted in the hospital for suspected pneumonia. 48-hours after admission, Mr. E was dyspneic with abnormal lung sounds in both upper and lower base of the lung and he coughs and spits thick yellow sputum. His vitals showed blood pressure of 88/42 mm Hg, pulse rate of 110 beats/min, respiration of 32 breaths/min, and SpO₂ of 82%. Mr. E had difficulty in speaking and unable to lie flat, a non-rebreather mask at oxygen of 60% was kept for him. His arterial blood gas level showed respiratory acidosis and PaO₂ was 65 mm Hg with pH of 7.30 and SpO₂ of 80%. Mr. E spent 5 days in the ICU and 2 weeks in a transitional care unit and discharged with home oxygen therapy. The discharge plan states that he should start an outpatient rehabilitation program after 1 month.