How to Answer James Hodges Years Questions (Complete Guide)
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Original Question
Mr James Hodges is 83 years of age, admitted today from an aged care facility. You are working on the medical ward, and he is a patient who is delegated to you to care for. Mr Hodges has recently been discharged following an acute exacerbation of COPD and the residential care staff are concerned that he has been unable to eat because of dyspnoea and that he may not be responding to his medications. Mr Hodges is on continuous oxygen at 2 litres/minute via nasal prongs for at least 15 hours per day. Subjective data: Feeling anxious; tremor evident; dyspnoeic and fatigued. Objective data: Vital signs: Temperature: 38.6°C, pulse 104 beats per minute (BPM), blood pressure (BP) 140/90 mmHg, respirations 28 breaths per minute, SpO2 (oxygen saturation measured by pulse oximetry) 89% on 2 litres oxygen via the nasal prongs. Administer oxygen to maintain SpO2 at 88 to 92%. Q1. Outline the pathophysiology of COPD. Q2. Give a written explanation of the pathophysiological basis for the subjective and objective data Why is Mr Hodges feeling anxious? What is causing dyspnoea? Why is his temperature raised? Why is his heart rate raised? Why is his BP raised? Why are his respirations increased? Why is his oxygen saturation low? Q3. Give a detailed explanation of the pharmacokinetics and pharmacodynamics of each of the prescribed medications. Include explanations about drug class, drug action and common adverse effects to demonstrate that you understand how the drugs work and interact with the body. salbutamol sulfate (Ventolin) inhaler 100 microgram/metered dose. 2 puffs prn 4 hourly Drug class: PD: PK: Common adverse effects: ipratropium bromide (Atrovent) metered dose aerosol 21 microgram inhalation 2-4 puffs 3-4 times daily prednisolone (Panafcortalone) 30-50 mg orally once daily for 5 days. ( Q4. Mr Hodges is prescribed 2 litres of oxygen via nasal prongs continuously. What are the important nursing considerations when administering oxygen to patients with COPD? Q5. Mr Hodges is preparing for discharge and is prescribed a Salmeterol (Serevent) accuhaler 50 microgram/blister to take home. Apply your pharmacotherapeutic knowledge to the patient education you would provide to Mr Hodge’s prior to discharge Section 2 – Application of the ACSQHC Medication Safety Standards and Quality Use of Medicines principles to inform safe medication practice in this case? Section 3 – Application of nursing professional codes and standards to decision-making and safe medication practice in this case?
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