P.W. is a 77-year-old woman with a history of smoking two to three packs of cigarettes per day for..

P.W. is a 77-year-old woman with a history of smoking two to
three packs of cigarettes per day for the past 60 years. P.W. has been
diagnosed with COPD for the past 4 years. She has required supplemental oxygen
at 2 L/min for the last 18 months. Three days ago, P.W. was admitted with chief
complaints of increasing dyspnea on exertion and a productive cough yielding
thick, green-yellow sputum. She states that she does “not know why she is
coughing up this awful stuff.” Physical examination of P.W. this morning
revealed vital signs of T = 101.5°F, P = 124 beats/min, R = 38 breaths/min, BP
= 16
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P.W. is a 77-year-old woman with a history of smoking two to
three packs of cigarettes per day for the past 60 years. P.W. has been
diagnosed with COPD for the past 4 years. She has required supplemental oxygen
at 2 L/min for the last 18 months. Three days ago, P.W. was admitted with chief
complaints of increasing dyspnea on exertion and a productive cough yielding
thick, green-yellow sputum. She states that she does “not know why she is
coughing up this awful stuff.” Physical examination of P.W. this morning
revealed vital signs of T = 101.5°F, P = 124 beats/min, R = 38 breaths/min, BP
= 168/74 mm Hg, and sonorous and sibilant wheezes on expiration and in the
posterior lung fields, with superimposed coarse crackles heard in the right
posterior lower lung field. She is unable to ambulate to the bathroom or
complete other ADL because of the dyspnea. Chest x-ray showed a large area of
consolidation in the right lower lobe. Sputum culture is still pending.

The following questions will guide your development of a
nursing care plan for the case study.

1. List the clinical manifestations that indicate P.W. is
experiencing an infection concomitant with her COPD.

2. Explain why COPD predisposes a client to respiratory
infection.

3. Explain why the physician will increase P.W.’s oxygen
flow to 3 to 4 L/min.

4. List the subjective and objective data the nurse should
obtain during the nursing assessment.

5. Identify three nursing diagnoses and client goals that
would be pertinent to P.W.’s care.

6. List the above diagnoses in order of priority, with
number one being the highest.

7. Describe client outcomes indicating that P.W.’s treatment
and nursing care regimen have been successful.

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