Homework SourseIn paragraph formation may I have help with this scenario Th
In paragraph formation, may I have help with this scenario. Thank you.
Ms. S is a 76-year-old female client who is admitted to the hospital with a diagnosis of pneumonia. Upon examination, you notice a barrel chest and diminished breath sounds in the bases. Her arterial CO2 is 55 mm Hg, and further questioning reveals that she has a history of chronic obstructive pulmonary disease (COPD). She has smoked two packs of cigarettes per day for the past 50 years.
1. How does her history of smoking increase her risk for pneumonia?
2. What findings make you suspect COPD? Why?
3. Ms. S has thick tenacious secretions that are blocking the airways. How will this impact her ventilation and perfusion? Why is this important?
4. Further lab testing reveals a low hematocrit and hemoglobin. How will this impact her respiratory status?
Solution
1. Smoking increases the risk of acquiring pneumonia by damaging the hairs in lungs that prevent germs and bacteria from entering the lungs. Major causative organisms of pneumonia associated with smoking are Streptococcus pneumoniae and Legionella pneumophila.
2. The natural elasticity of bronchial tubes and air sacs is lost in COPD due to which arterial CO2 is more in such patients since they cannot exhale the entire amount of CO2. Smoking further increases the risk by damaging lungs. Ms.S shows both these findings - long term smoking and 55 mmHg arterial CO2 which are suggestive of COPD.
3. It will cause more complications in pneumonia and the treatment will be difficult. Also, the patient will take time to recover since the lungs are already filled with fluid further worsening pneumonia by making the ventilation and perfusion difficult.
4.Low hemoglobin will further reduce the amount of oxygen in the body. The patient has a history of COPD affecting the CO2 amount in the body. Due to this, there will be increased CO2 which affects the respiratory status of the patient negatively. The body cells along with brain will not get enough oxygen leading to increased delirium
