Paul Year Male Explained for Students (Easy Guide)

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Original Question

Paul is a 68-year-old male admitted with an exacerbation of chronic obstructive pulmonary disease (emphysema and chronic bronchitis), and a chest infection, he is mildly cyanotic, SOB, and anxious. On entering Paul’s room later in the day, a nurse finds him 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. Past History – Ex-smoker: smoked a packet of cigarettes for 30 years Medications – Salbutamol, Seretide, Bromhexine and Augmentin Duo Forte. Assessment – Alert and orientated Nil complaints of pain Cyanosis around lips and fingernails Barrel chest and use of accessory muscles SOB Moist productive cough Vitals – BP 120/85 HR 115 RR 24 O2 Sats. 89% room air – 2L O2 applied O2 saturation increased to 95% Temp 38.5 Plan – Collect blood cultures, regular paracetamol to maintain patient comfort, chest X-ray and obtain sputum sample Salbutamol and Atrovent nebulisers and Prednisolone 50mg for 5 days. Q1) Expand the acronym “COPD” and provide an explanation of the term Explain the disease processes of emphysema and chronic bronchitis. Q2) What are five signs and symptoms of respiratory distress a nurse may observe in a client with COPD? Q3) Using your Harvard’s Nursing Guide to Drugs, look up: Prednisolone, Salbutamol, Bromhexine, Augmentin Duo Forte Briefly describe the main action of each drug Briefly describe how each medication will benefit this patient’s recovery NB: Ensure your answers are specific to Paul’s documented conditions – do not list medication benefits that do not relate to this patient Q4. Using the link below, explain why patients with COPD are more susceptible to acute and chronic chest infections (Describe at least 4 reasons) https://erj.ersjournals.com/content/35/6/1209 Q5) Using the link below, discuss why administration of high levels of oxygen therapy is contraindicated in some patients with COPD. https://medicinespecifics.com/copd-and-hypoxic-drive-mechanism/ https://www.criticalcarepractitioner.co.uk/hypoxic-drive/ Q6) List two (2) nursing interventions that this patient would benefit from and provide a rationale for each.

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