ROFILE OF PATIENT Mr. Asare is a 75-year-old male admitted with an exacerbation of chronic obstructive pulmonary disease (emphysema) at Korle-Bu Teaching Hospital. He has been keeping the head of the bed up for most of the day and night to facilitate his breathing which has resulted in lower back pain. Acetaminophen (Tylenol) was not effective in reducing his pain, so the health care provider has prescribed oxycodone/acetaminophen (Percocet) one to two tablets PO every four to six hours as needed for pain. Mr. Asare is on 2 liters of oxygen by nasal cannula. He can receive respiratory treatments of albuterol (Proventil, Ventolin) every six hours as needed. Mr. Asare needs someone to walk beside him when he ambulates because he has an unsteady gait and often needs to stop to catch his breath. CASE STUDY The nurse enters the room and finds Mr. Asare hunched over his bedside table watching television. He says this position helps his breathing. His lung sounds are clear but diminished bilaterally. Capillary refill is four seconds and slight clubbing of his fingers is noted. His oxygen saturation is being assessed every two hours to monitor for hypoxia. Each assessment reveals oxygen saturation at rest of 90% to 94% on 2 liters of oxygen by nasal cannula. After breakfast, Mr. Asare complains of lower back pain that caused him increased discomfort while ambulating to the bathroom. He describes the pain as a dull ache and rates the pain a “6” on a 0–10 pain scale. He requests two Percocet tablets. The nurse assesses Mr. Asare’s vital signs (blood pressure: 150/78mmHg, pulse: 90bpm, respiratory rate: 26cpm) and gives the Percocet as prescribed. Forty-five minutes later, Mr. Asare states the Percocet has helped relieve his back pain to a “2” on a 0–10 pain scale and he would like to take a walk in the hall. The nurse checks his oxygen saturation before they leave his room, and it is 92%. Using a portable oxygen tank, the nurse walks with Mr. Asare from his room to the nurse’s station (approximately 60 feet). Mr. Asare stops to rest at the nurse’s station because he is short of breath. His oxygen saturation at the nurse’s station is 86%. After a few deep breaths and rest, his oxygen saturation rises to 91%. Mr. Asare walks back to his room where he sits in his recliner to wait for lunch. His oxygen saturation is initially 87% when he returns and then 91% after a few minutes of rest. Expiratory wheezes are heard bilaterally when the nurse assesses his lung sounds. While Mr. Asare waits for lunch to arrive, the nurse calls respiratory therapy to give Mr. Asare his albuterol treatment. The respiratory treatment and rest relieves his acute shortness of breath. His oxygen saturation is now 93%, and his lung sounds are clear but diminished bilaterally. 5. List four (4) nonpharmacologic interventions that the nurse could implement to help decrease Mr. Asare’s difficulty breathing.

ROFILE OF PATIENT Mr. Asare is a 75-year-old male admitted with an exacerbation of chronic obstructive pulmonary disease (emphysema) at Korle-Bu Teaching Hospital. He has been keeping the head of the bed up for most of the day and night to facilitate his breathing which has resulted in lower back pain. Acetaminophen (Tylenol) was not effective in reducing his pain, so the health care provider has prescribed oxycodone/acetaminophen (Percocet) one to two tablets PO every four to six hours as needed for pain. Mr. Asare is on 2 liters of oxygen by nasal cannula. He can receive respiratory treatments of albuterol (Proventil, Ventolin) every six hours as needed. Mr. Asare needs someone to walk beside him when he ambulates because he has an unsteady gait and often needs to stop to catch his breath. CASE STUDY The nurse enters the room and finds Mr. Asare hunched over his bedside table watching television. He says this position helps his breathing. His lung sounds are clear but diminished bilaterally. Capillary refill is four seconds and slight clubbing of his fingers is noted. His oxygen saturation is being assessed every two hours to monitor for hypoxia. Each assessment reveals oxygen saturation at rest of 90% to 94% on 2 liters of oxygen by nasal cannula. After breakfast, Mr. Asare complains of lower back pain that caused him increased discomfort while ambulating to the bathroom. He describes the pain as a dull ache and rates the pain a “6” on a 0–10 pain scale. He requests two Percocet tablets. The nurse assesses Mr. Asare’s vital signs (blood pressure: 150/78mmHg, pulse: 90bpm, respiratory rate: 26cpm) and gives the Percocet as prescribed. Forty-five minutes later, Mr. Asare states the Percocet has helped relieve his back pain to a “2” on a 0–10 pain scale and he would like to take a walk in the hall. The nurse checks his oxygen saturation before they leave his room, and it is 92%. Using a portable oxygen tank, the nurse walks with Mr. Asare from his room to the nurse’s station (approximately 60 feet). Mr. Asare stops to rest at the nurse’s station because he is short of breath. His oxygen saturation at the nurse’s station is 86%. After a few deep breaths and rest, his oxygen saturation rises to 91%. Mr. Asare walks back to his room where he sits in his recliner to wait for lunch. His oxygen saturation is initially 87% when he returns and then 91% after a few minutes of rest. Expiratory wheezes are heard bilaterally when the nurse assesses his lung sounds. While Mr. Asare waits for lunch to arrive, the nurse calls respiratory therapy to give Mr. Asare his albuterol treatment. The respiratory treatment and rest relieves his acute shortness of breath. His oxygen saturation is now 93%, and his lung sounds are clear but diminished bilaterally. 5. List four (4) nonpharmacologic interventions that the nurse could implement to help decrease Mr. Asare’s difficulty breathing.

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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Question

PROFILE OF PATIENT

Mr. Asare is a 75-year-old male admitted with an exacerbation of chronic obstructive pulmonary disease (emphysema) at Korle-Bu Teaching Hospital. He has been keeping the head of the bed up for most of the day and night to facilitate his breathing which has resulted in lower back pain. Acetaminophen (Tylenol) was not effective in reducing his pain, so the health care provider has prescribed oxycodone/acetaminophen (Percocet) one to two tablets PO every four to six hours as needed for pain. Mr. Asare is on 2 liters of oxygen by nasal cannula. He can receive respiratory treatments of albuterol (Proventil, Ventolin) every six hours as needed. Mr. Asare needs someone to walk beside him when he ambulates because he has an unsteady gait and often needs to stop to catch his breath.

CASE STUDY

The nurse enters the room and finds Mr. Asare hunched over his bedside table watching television. He says this position helps his breathing. His lung sounds are clear but diminished bilaterally. Capillary refill is four seconds and slight clubbing of his fingers is noted. His oxygen saturation is being assessed every two hours to monitor for hypoxia. Each assessment reveals oxygen saturation at rest of 90% to 94% on 2 liters of oxygen by nasal cannula. After breakfast, Mr. Asare complains of lower back pain that caused him increased discomfort while ambulating to the bathroom. He describes the pain as a dull ache and rates the pain a “6” on a 0–10 pain scale. He requests two Percocet tablets. The nurse assesses Mr. Asare’s vital signs (blood pressure: 150/78mmHg, pulse: 90bpm, respiratory rate: 26cpm) and gives the Percocet as prescribed. Forty-five minutes later, Mr. Asare states the Percocet has helped relieve his back pain to a “2” on a 0–10 pain scale and he would like to take a walk in the hall. The nurse checks his oxygen saturation before they leave his room, and it is 92%. Using a portable oxygen tank, the nurse walks with Mr. Asare from his room to the nurse’s station (approximately 60 feet). Mr. Asare stops to rest at the nurse’s station because he is short of breath. His oxygen saturation at the nurse’s station is 86%. After a few deep breaths and rest, his oxygen saturation rises to 91%. Mr. Asare walks back to his room where he sits in his recliner to wait for lunch. His oxygen saturation is initially 87% when he returns and then 91% after a few minutes of rest. Expiratory wheezes are heard bilaterally when the nurse assesses his lung sounds. While Mr. Asare waits for lunch to arrive, the nurse calls respiratory therapy to give Mr. Asare his albuterol treatment. The respiratory treatment and rest relieves his acute shortness of breath. His oxygen saturation is now 93%, and his lung sounds are clear but diminished bilaterally.

5. List four (4) nonpharmacologic interventions that the nurse could implement to help decrease Mr. Asare’s difficulty breathing.

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