Assessment & Diagnostics
Forced Expiratory Volume (FEV1)
How much air someone can force out of their lungs in 1 second. 45% is indicative of worsening COPD in Sam.
For Sam why would an WBC count be important addition to his plan of care?
Due to his risk of infection & clinical signs such as a temperature of 38.5 and green sputum
Administration of High levels of 02 can result in a decreased __________ in patients with COPD
Hypoxic Drive
Mainstay Treatment for AECOPD + Respiratory Failure
Oxygen Administration
Daily Double!!
Why would Sam need Cardiac Monitoring?
Acidosis can result in Potassium Shifts placing the patient at risk for Cardiac Dysrhythmias.
Hemoglobin is our oxygen carrier to our tissues, therefore decreased perfusion can result due to the lack of transport mechanisms.
V/Q Mismatch
The inequality of Ventilation to Perfusion Ratios due to damaged alveoli, alveolar hypoventilation and intrapulmonary shunting.
A high-flo device that delivers specific amounts of oxygen independent of the patients respiratory pattern
Venturi Mask
3 Appropriate Nursing Assessments for Sam
RESP, CVS, CNS, VS
pH 7.25, pC02 73 mmHg, Pa02 56 mmHg, HCO3 28
Uncompensated Respiratory Acidosis
Sam is in Type 1 or Type 2 Respiratory Failure
Sam is exhibiting signs of both due to possible complications including pneumonia & congestive heart failure.
Name an IV medication that we would anticipate being ordered for Sam
Diuretic, Steroid, &/or Antibiotics
Daily Double!!
Endotracheal Tube Placement Assessment
Auscultate over the epigastrium, Bilateral Chest Expansion, Bilateral Lung Sounds, Check CO2 detection device
An increase in RBC due to hypoxia which increases SVR
Polycythemia
A positive pressure ventilation complication resulting in physical damage and ruptured alveoli.
Barotrauma
What type of Oxygen Device did Anna the RT apply to Sam?
NIPPV more specifically Biphasic Positive Airway Pressure Mask (Bipap)