CASE STUDY - Resp..docx - 1 Name Celene Hirrschoff Monica...

This preview shows page 1 - 2 out of 6 pages.

1 Name: Celene Hirrschoff, Monica Goudy, Annie Lindberg, Brianne Gonzales Respiratory Case Study Directions: Please complete prior to class on Friday, March 1. The completed case study will be turned in to Karla Hanson prior to the start of class. This will take the place of a quiz and will be awarded up to 5 points based on the degree and quality of completion. Please support your answers from the text with page numbers. You may work together or in groups. If you work as a group, please write all group members names and turn in one case study as all will receive the same number of points. Brenda Smith is a 53 year old teacher who developed influenza A in February. Prior to this illness, she has never been sick and does not have a history of any chronic disease. Despite treatment with bronchodilators and prednisone for a reactive airway, she continued to experience acute SOB, fevers, chills, and a productive cough. A chest x-ray was repeated and a diagnosis of pneumonia was made with consolidations noted in both the R and L lung fields. Ms Smith was admitted to the medical floor with a diagnosis of community acquired pneumonia and bilateral pleural effusions. Pertinent initial orders/assessments included: O2 at 2L per Nasal Cannula Blood and sputum cultures IV D5.45NS with 20mEq KCL at 125cc’s/hr Antibiotics: Gentamycin 60 mg IV every 8 hours Cefoxitin 2 Gm IV every 6 hours ABG’s: pH 7.34, pCO 2 44, HCO 3 24 , PaO 2 80 Vitals: 124/84, T 101.6, P 104 R 20 SpO 2 94% Labs on admit: Na 140, K + 3.7, BUN 22, Cr 1.2, albumin 3.9, H/H 14.2/39, WBC 14.2 Bilateral thoracentesis to be done in radiology following admission to the floor Once you have admitted Ms. Smith, you call radiology to do the thoracentesis. Ms. Smith is concerned about the procedure and that she will have to lay flat which could increase her shortness of breath. 1. What would you tell her? a. “I understand your concern Ms. Smith. During the thoracentesis procedure, however, you will be able to sit down and won’t have to lie flat. You will sit up, over the edge of the bed with your feet hanging to the floor, but supported so they aren’t dangling. You will sit upright, with your elbows resting on the overbed table. You will not have to lie flat so your shortness of breath should not increase. Do you have any other concerns related to this procedure?” Lewis, et. al, page 516. 2. What kind of teaching is needed prior to a thoracentesis? a. Teaching of what a thoracentesis is so the patient understands what is going to happen to them is necessary. It is important to put the procedure into simple terms that the patient understands. It is also important to explain the benefits of the procedure as to why it is necessary. For example: “The doctor has ordered for you to have a thoracentesis. A thoracentesis is a procedure that is going to help take fluids off of your lungs. This should help with your shortness of breath in that it will be easier to breathe with less fluid around your lungs. The doctor’s will also be able to use the fluid that is removed for diagnostic testing which is not indicated at this time. The doctor will have you sit
Image of page 1

Subscribe to view the full document.

Image of page 2
  • Spring '12

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern