Case Study, Chapter 23, Management of Patients With Chest and Lower Respiratory Tract
Disorders
11/14/19
Assignment
Case Study, Chapter 23, Management of Patients with Chest and Lower Respiratory Tract
Disorders
1. Harry Smith, 70 years of age, is a male patient who is admitted to the medical-surgical unit
with acute community-acquired pneumonia. He was diagnosed with paraseptal emphysema 3
, Case Study, Chapter 23, Management of Patients With Chest and Lower Respiratory Tract
Disorders
years ago. The patient smoked cigarettes one pack per day for 55 years and quit 3 years ago. The
patient has a history of hypertension, and diabetes controlled with oral diabetic agents. The
patient presents with confusion as to time and place. The family stated that this is a new change
for the patient. The admission vital signs are as follows: blood pressure 90/50 mm Hg, heart rate
101 bpm, respiratory rate 28 breaths/min, and temperature 101.5°F. The pulse oximeter on room
air is 85%. The CBC is as follows: WBC 12,500, platelets 350,000, HCT 30%, and Hgb 10 g/dL.
ABGs on room air are pH 7.30, PaO 55, PaCO 50, HCO 25. Chest x-ray results reveal right
2 2 3
lower lobe consolidation, presence of apical bullae, flattened diaphragm, and a small pleural
effusion in the right lower lobe. Lung auscultation reveals severely diminished breath sounds in
the right lower lobe and absence of breath sounds at the base. The breath sounds in the rest of the
lungs are slightly decreased. The patient complains of fatigue and shortness of breath and cannot
finish a short sentence before the respiratory rate increases above the baseline and his nail beds
and lips turn a bluish tinge and the pulse oximetry decreases to 82%. The patient is diaphoretic
and is using accessory muscles. The patient coughs weakly, but he does not raise any sputum.
a. What nursing assessment findings support the diagnosis of pneumonia?
b. What diagnostic findings support the diagnosis of pneumonia?
c. What NANDA nursing diagnoses should the nurse formulate for the patient?
d. What goals should the nurse develop for the patient?
Disorders
11/14/19
Assignment
Case Study, Chapter 23, Management of Patients with Chest and Lower Respiratory Tract
Disorders
1. Harry Smith, 70 years of age, is a male patient who is admitted to the medical-surgical unit
with acute community-acquired pneumonia. He was diagnosed with paraseptal emphysema 3
, Case Study, Chapter 23, Management of Patients With Chest and Lower Respiratory Tract
Disorders
years ago. The patient smoked cigarettes one pack per day for 55 years and quit 3 years ago. The
patient has a history of hypertension, and diabetes controlled with oral diabetic agents. The
patient presents with confusion as to time and place. The family stated that this is a new change
for the patient. The admission vital signs are as follows: blood pressure 90/50 mm Hg, heart rate
101 bpm, respiratory rate 28 breaths/min, and temperature 101.5°F. The pulse oximeter on room
air is 85%. The CBC is as follows: WBC 12,500, platelets 350,000, HCT 30%, and Hgb 10 g/dL.
ABGs on room air are pH 7.30, PaO 55, PaCO 50, HCO 25. Chest x-ray results reveal right
2 2 3
lower lobe consolidation, presence of apical bullae, flattened diaphragm, and a small pleural
effusion in the right lower lobe. Lung auscultation reveals severely diminished breath sounds in
the right lower lobe and absence of breath sounds at the base. The breath sounds in the rest of the
lungs are slightly decreased. The patient complains of fatigue and shortness of breath and cannot
finish a short sentence before the respiratory rate increases above the baseline and his nail beds
and lips turn a bluish tinge and the pulse oximetry decreases to 82%. The patient is diaphoretic
and is using accessory muscles. The patient coughs weakly, but he does not raise any sputum.
a. What nursing assessment findings support the diagnosis of pneumonia?
b. What diagnostic findings support the diagnosis of pneumonia?
c. What NANDA nursing diagnoses should the nurse formulate for the patient?
d. What goals should the nurse develop for the patient?
