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Question: Patient Introduction Vincent Brody is a 67-year-old male admitted directly from the provider’s of...

Patient Introduction

Vincent Brody is a 67-year-old male admitted directly from the provider’s office several hours ago for exacerbation of his chronic obstructive pulmonary disease (COPD). He is maintaining O2 saturations at 94% on 2 L/min of oxygen per nasal cannula. IV of potassium chloride in 5% dextrose and normal saline is infusing at 100 mL/hr in his right hand. He has responded well to medications and treatments and appears to be resting. He continues to have a productive cough. Patient has a 50-year history of smoking 2 packs a day. During the last year he has had two exacerbations. Physical findings include a barrel chest and clubbed fingers.

Medical Case 3: Vincent Brody

Guided Reflection Questions

4.   Review Vincent Brody’s laboratory results. Which results are abnormal? Discuss how these results relate to his clinical presentation and chronic disease process.

5.   What are safety considerations when caring for a patient with a chest tube?

6.   What key elements would you include in the handoff report for this patient? Consider the SBAR (situation, background, assessment, recommendation) format.

7.   What patient teaching priorities would be important in the patient experiencing an acute exacerbation of COPD?

8.   For a patient with COPD who is stable, what resources would you recommend?

9.   What would you do differently if you were to repeat this scenario? How would your patient care change?

Answer 1

4) According to his chest x-ray which clearly states and a peculiar thing which occurs in these types of patients ( barrel chest and clubbed nail)

5) Safety measures to be taken with chest tube

• Secure it tightly
• Check for occupation and kinks
• Maintain water level at 2cm always
• Check for air leakage by noticing the bubbles
• Never lift above chest level
• Keep the tubing and drainage bag below chest level
• Monitor vital signs with O2
• Propped up position

6)Key elements in the handover should specify

• Amount of Oxygen administered
• Vital signs with Spo2
• Kcl drip
• IV fluid rate

6) patient teaching should include

• To cease smoking
• Respiratory rehabilitation
• Vaccination
• Improve air quality indoor and outdoor
• Portable O2 as per need
• Increase bronchodilator
• Administer steroids
• Proper follow up
• Use digital application to contact health care provider