Nur-641e week 3 assignment acid-base case study paper
This case study is based on a patient, Mr. Jones, who has been admitted to your unit and assigned to you as the RN in charge of his care. Mr. Jones is an 84-year-old male with end stage chronic obstructive pulmonary disease (COPD). He was diagnosed 10 years ago and he has continued to decline since that time despite aggressive treatments including oxygen therapy, pharmacological management and various lifestyle modifications. His current complaint upon admission was shortness of breath refractory to treatment at home.
Mr. Jones appears depressed and states repeatedly during assessment “just let me die” Referring physicians report a history of COPD exacerbations but have not indicated any underlying cause such as recent infections or exposure to environmental agents (smoking). In addition, it was noted that he seems isolated from family and suffering from loneliness; this may be contributing to his overall deterioration despite medical interventions for COPD control over the past 10 years since diagnosis.
On physical exam, Mr. Jones appears cachectic with diminished muscle mass over his extremities along with accompanied weakness secondary to immobility due presumably due limited activity levels following baseline COPD diagnosis 10 years prior.. His vital signs are within normal limits except for respiratory rate which is elevated @ 30/min., oxygen saturation at 89% while room air breathing(R/A) ,and an extended expiratory phase seen during chest auscultation characterized by prolonged ‘wheezing’ bilaterally with decreased intensity throughout all lung fields without any significant crackles or rhonchi heard in the lungs bases noted during inspiration or expiration phases respiration cyclebreath sounds The primary physician initiates IV antibiotics treatment regimes immediately followed by additional supportive care measures such as supplemental oxygen via cannula placed upn nose post evaluation .The patient continues verbalizing lack of will & desire continue living It is important note also there no evidence alcoholism nor substance use disorder behavior leading further descent into depression demoralization.