Applied Nursing Science

Order Description Write a brief summary of the patients current health problems, relevant history and specific early management provided to address the primary problem prior to arrivin" rel="nofollow">ing to your ward. Case study 64yrs female presents with shortness of breath and worsenin" rel="nofollow">ing cough last 3/7. Background 1) severe brittle COPD - 4 admissions this year, current smoker (not a candidate for home oxygen), speculated lung mass RLZ 2) Hypercholesterolaemia 3) Prev TIA 4) AF - not anti coagulated 5) Osteoporosis Medications Rosuvastation 20mg night, Metoprolol 12.5mg twice daily, Aspirin" rel="nofollow">in 100mg daily, Seretide 250/25 x2puffs twice daily, atrovent 500mcg x4 daily, temazepam 10mg night and paracetamol 1g 4 times/day as required Lives with husband, away a lot. current smoker, in" rel="nofollow">independent with activities daily livin" rel="nofollow">ing, mobiles in" rel="nofollow">independently. 3/7 worsenin" rel="nofollow">ing shortness of breath, left sided chest pain" rel="nofollow">in and more frequent cough shortness of breath progressive and similar to other episodes of admission left sided chest pain" rel="nofollow">in, sharp sin" rel="nofollow">ince 1500hrs today, worse on in" rel="nofollow">inspiration and coughin" rel="nofollow">ing, worse on pushin" rel="nofollow">ing cough more frequent, usually productive but unable to produce sputum no fevers/sweats/shakes always feelin" rel="nofollow">ing cold mobilisies to the mailbox, usual daily activity eatin" rel="nofollow">ing and drin" rel="nofollow">inkin" rel="nofollow">ing as normal On examin" rel="nofollow">ination T 36.6, HR 87, RR 22, BP 96/64 (normal), oxygen sats 89% on 2ltrs/min" rel="nofollow">in Speakin" rel="nofollow">ing in" rel="nofollow">in short sentences Decreased air entry bibasally, no creps, no wheeze Investigations WCC 14.5, CRP 98 - raised in" rel="nofollow">inflammatory markers Chest X-ray clear - no consolidation ECG -poor R weave profession, Q waves in" rel="nofollow">in III and aVF, flattened T waves in" rel="nofollow">in V6, I, aVL Implication non-in" rel="nofollow">infective exacerbation of COPD, type 1 respiratory failure Postural hypotension Admitt under oncall physician Steriods - Prednisone 50mg for 3 days Oral antibiotics - doxycyclin" rel="nofollow">ine Usual meds, DVT prophylaxis, s Bronchodilators - salbutamol nebulisors Slow IVFLuids - hypotension Chest physio for sputum clearance