Presents to the Emergency Department (ED). Nursing Case Study: Oxygenation - Video & Lesson Transcript | Study.com. Organic mercury, of which methylmercury is an example, has garnered significant attention recently following several large outbreaks as a result of environmental contamination in Japan in 1956 (17) and grain contamination in Iraq in 1972 (18). This would help confirm the diagnosis of COPD and tell you how severe the condition is. He first noticed a tight and squeezing feeling in his chest the night before.
He had denied fevers, chills, myalgias or vomiting. I would also look over the peak flow meters cleaning instruction and help show Jeremy what to do to keep his meter clean and in good condition. Harada M. Congenital Minamata disease: intrauterine methylmercury poisoning. Methylxanthines (Theophylline). Kizoir, 2018) (Adams, 2017, p. 667). Agarwal R, Reddy C, Aggarwal AN, et al. The MetroHealth System, Case Western Reserve University. Two probable causes of his asthma are not using his medication before exercise or activity, and not using his preventative medication on a regular basis. To err on the side of caution, it is prudent to recommend forms of nonpharmacologic relief of congestion in this case, including nasal decongestant strips, saline or a teapot, or topical camphor- or menthol-containing preparations that may help clear inflamed nasal passages. Case report: severe mercuric sulphate poisoning treated with 2, 3-dimercaptopropane-1-sulphonate and haemodiafiltration. Respiratory case studies for nursing students. Ann Clin Biochem 2004;41:233-236. Try refreshing the page, or contact customer support.
Blood tests are also taken and an x-ray will occur shortly. The use of accessory muscles, using the tripod position to facilitate easier. Use of accessory muscles while breathing. Science 1973;181:230-241. What information can you provide regarding self-management of HW's COPD?
I would want to make sure that Jeremy understands what asthma is, and what is happening in his body when he has an attack. FEES testing with Thin Liquids and Regular Diet Advancement; Peg Tube removed. His ABG results also indicate that COPD is present because the interpretation shows compensated respiratory acidosis with mild hypoxemia. In this case, learners have an opportunity to: - Review etiological factors (i. e., risk factors, prevalence, comorbidities) associated with respiratory disease. Inhaled corticosteroids (Budesonide). With asthma, the bronchi and bronchioles constrict as a result of an irritant and spasm, constricting airflow and creating wheezes. I believe that Jeremy is at the point of confusion right now. Pursed lip breathing. I would instruct Jeremy to use his preventative medication 5-60 minutes before exercise or activity. NextGen NCLEX Test Bank - University of Maryland School of Nursing Maryland Nursing Workforce Center. But we know that the PaCO2 is still increased, which means that we need to increase the IPAP setting even more. Pacing with Activities. 1999 Oct-Dec;3(4):338-42. This type of communication would allow Jeremy to express how he is feeling, and my silence would give him time to answer.
Pertinent items from the patient's history include prior diagnosis of asthma, onset, and triggers for the exacerbation, current asthma medications, and prior ED visits or hospitalizations for asthma (including intensive care unit admissions and/or intubations). The SpO2 was at 84% and has now decreased to 80% and his retractions are worsening. Explain your answer. The increased ventilation rate in the distressed child accelerates volume loss, decreasing perfusion to multiple organ systems. When we create case scenarios for PCS Spark, we think holistically of the patient we are creating and build the scenarios out as complete people in a sense that they have a complete backstory, past medical history, likes, dislikes, etc. High School Courses. Was taught by the respiratory specialist physiotherapist from the pulmonary rehab team how to manage breathlessness, breath hold, prevent cough with 'stop cough' exercises and prevent wheeze. Be sure to include "related to" statements. I had no confidence and felt weak. "I felt supported, and that everyone looking after me were 'talking to each other'". Mercury levels can be reduced with chelating agents such as succimer, dimercaprol (also known as British anti-Lewisite (BAL)) and D-penicillamine, but their effect on long-term outcomes is unclear (22-25). Acute Respiratory Distress Syndrome—A Case Study : Critical Care Nursing Quarterly. Eur Arch Psychiatry Clin Neurosci 2008;258:317-318.
Mrs X was now aware when to increase medication and when to call for help. Get access to 25+ premium quizzes, mini-courses, and downloadable cheat sheets for FREE. Taylor, 2015, p. 86). Organic mercury is also present in a teratogenic agent leading to development of a syndrome similar to cerebral palsy termed "congenital Minamata disease" (20). Respiratory case studies for nursing students and teachers. Try PCS's Free Virtual Patients. What is the classification of this drug, its therapeutic effect, and when should it be taken? Gries DM, Moffitt DR, Pulos E, Carter ER. These pathophysiologic changes cause distal alveoli to trap air and become hyperinflated. Is there a role for noninvasive ventilation in acute respiratory distress syndrome?
The epidemiology of emergency medical services use by children: an analysis of the National Hospital Ambulatory Medical Care Survey. Life-span development. I would stick to the basics and not get very in depth, so she doesn't feel overwhelmed or get confused. Try Risk Free for 3 Days. Serum alanine aminotransferase (ALT) values should be monitored while patient is using Singulair. First and foremost, encourage AT to stay home and avoid contact with others as much as possible, unless she needs medical care. The patient used mercury to clean coins. This episode began two hours ago and has been accompanied by a runny nose without any other symptoms. Resources created by teachers for teachers. I would be open to modifying my approaches to meet their cultural needs and the language barrier of his parent's. He had unintentionally lost approximately 30 pounds over the last 6 months and had nightly sweats. Pilbeam's Mechanical Ventilation: Physiological and Clinical Applications. Allergic Reaction (RESPIRATORY).
Her oxygen saturation is 82% on O2 at 2LNC. How might the nurse assess these systems and what findings would the nurse expect to find? The Acute Respiratory Distress Syndrome Network. Wilkins' Clinical Assessment in Respiratory Care. Next, I would instruct Jeremy to take a second-deep breath, place the meter mouth piece in his mouth and blow out as hard and fast as he can through his mouth. He has been admitted to the emergency room with chest tightness, shortness of breath, and wheezing.
Bonus Assessment: If you were able to correlate the patient's elevated bilirubin and ALT levels to his history of liver failure, great job — you get bonus points. Secretion Management. The lab values that point to COPD are his increased RBC, Hct, and Hb levels. Nicotine replacement therapy may be indicated as well. What adjustments would you make to the BiPAP settings?
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