Question

Critical Thinking Activity

Mrs. Phillips, age 65, has smoked three packs of cigarettes a day for 40 years. She complains of difficulty fixing her own meals, bathing and dressing herself, and an inability to climb a short flight of stairs due to shortness of breath. She lives in a second floor apartment building that does not have an elevator. Her constant cough is congested sounding, respiratory rate of 26 beats/minute, a shallow breathing pattern, an oral temperature of 37.7˚C (99.8˚F), blood pressure of 140/92 mm Hg, height 160 cm (5 ft 3 in), weight 57 kg (127 lb)

Instructions: From the case study above identify a cue cluster and possible diagnostic conclusion(s) (health promotion[wellness], risk, or actual nursing diagnosis). Describe your critical thinking process. Identify the collaborative problems for which the client is at risk

Answer 1

From available data Mrs Philip's problems are

chronic smoker with COAD and probable Corpulmonale.Present isuue seems to be COAD exacerbation secondary to chest infection and worsening of associated Congestive cardiac failure of corpulmonale.

How to approach this case?

Check oxygen saturation and identify she needs supplemental oxygen.

Any other comord illness like IHD or Diabetes mellitus

Identify how bad is the chest infection by having an chest xray

ECG and Echo cardiography to assess cardiac status

Immediate risk is respiratory failure and patient should be in high dependancy unit.

Once stabilised from current acute state plan counselling for smoking cessation and advise breathing exercise and lifestyle modification and advise to follow doctor instruction regarding medications