Case study: Pulmonary Disorder Scenario: Jonas Borta Borta, a 61 year old male, is admitted to your floor with

a diagnosis of pleural effusion. He complains of SOB, pain in his chest, and weakness. His v/s are 140/80, 118, 38 (labored and shallow), 37.8C. His CXR shows a large pleural and pulmonary infiltrates in the RLL consistent with pneumonitis. QUESTIONS: Given his diagnosis, are Jonas admission VS expected? Explain. How does his increased metabolic rate relate to his nutritional needs? Clarify. What is pleural effusion? List three common causes of pleural effusion. What is the difference between exudate and transudate? The MD performs a thoracentesis and drains 1500 ml of fluid. A specimen for C&S is sent to the laboratory, and the patient is started on cerufoxime 1G q 8hrs. 6. What is a thoracentesis? 7. What maneuvers would promote the clearance of pulmonary secretions? 8. You enter the room to reposition Jonas. If he is on his back, what side would you turn him to? Why?
1. 2. 3. 4. 5.

Case study: pulmonary disorder Scenario: Marcova Tan, is a very healthy, active 71 y/o, f, who came in the ED one day with a chief complaints of chills and cough. After taking a quick history, the MD gives a diagnosis of r/o pneumonia. The headnurse asks you to complete your routine admission assessment and to call her MD with your findings. Marcova is not taking any medication and denies food and drug allergies. QUESTIONS: 1. Identify the five most things to include in your assessment. State your rationale. Your other assessment findings are as ffs. VS 150/80, 105, 32, 37C. You auscultate crackles in the LLL anteriorly and posteriorly. Her nailbeds are dusky on fingers and toes. She has productive cough rusty sputum and complains of pain her left chest when she coughs. Marcova seems to be well- nourished and adequately hydrated. She comments that shes been healthy as horse except that she got hives when she took one of them antibiotics pills a few years ago. 2. Which of these assessment findings concern you? State your rationale? 3. What is a culture and sensitivity test, and why is it important? 4. Why would blood cultures be drawn if the patient spikes fever? 5. Why are blood cultures drawn from two different sites? 6. Discuss 5 strategies for preventing community acquired pneumonia should be discharge. 7. What are the different types of PN? ( as to etiology, location/ distribution, vector/ route) 8. What would make the sputum turn rust-colored?
KrischandaowanRN