Chapter 6, Problem 94R

"A patient with a history of COPD presents with increased shortness of breath and a productive cough. What are the immediate nursing actions and considerations for ongoing care?"

Mrs. G HISTORY Mrs. G, a 62-year-old white woman, was seen in the emergency department for complaints of increasing shortness of breath. She stated that she had the flu approximately 1½ weeks earlier and that her breathing has been more difficult since that time. Her ankles have been swollen for the first time, and sleeping during this time has required "two pillows to support her." She stated that occasionally she awakens in the middle of the night noticeably short of breath. These episodes of nocturnal dyspnea are relieved by sitting up for several minutes. She has been producing ¼ cup of yellow sputum since the onset of the flu. Her exercise tolerance was 1 block but is now 20 feet. Mrs. G stated that 7 years ago her family physician told her she had pulmonary emphysema. Mrs. G started smoking at age 12 and smoked approximately 2 packs of cigarettes a day until she quit 2 years ago. Mrs. G took the following home medications: small-volume nebulizer (SVN) with metaproterenol four…

Very briefly describe the genetic abnormality responsible for cystic fibrosis and state the disorder's effect on lung function.

S.M. is a 25-year-old man in the clinic today for worsening shortness of breath. He smoked one pack of cigarettes per day from ages 18-20, but states he has not smoked in 5 years. Physical examination reveals a thin man in moderate respiratory distress. There is marked increase in the anteroposterior diameter, distant lung sounds, and occasional expiratory wheeze. Blood gases on room air are as follows: pH 7.42, PaCO2 40, PaO2 71, HCO3- 26. Select a potential diagnosis for S.S. and describe the pathophysiology of that diagnosis. How does the pathophysiology explain S.S.’s physical exam and lab findings?