Cohen is a 75 year old male is admitted to the general medical floor today with an exacerbation of chronic obstructive pulmonary disease…

Question Mr. Cohen is a 75 year old male is admitted to the general medicalfloor today with an exacerbation of chronic obstructive pulmonary disease (emphysema). He does NOT use oxygen at home. He has been keeping the head of the bed up for most of the day and night to facilitate his breathing which has resulted in lower back pain. Tylenol has not been effective in reducing his pain, so his physician has prescribed oxycodone/acetaminophen (Percocet) 1-2 tabs orally every 4-6 hours as needed for pain. Mr. Cohen is on 2 liters of oxygen by nasal cannula. He can receive respiratory nebulization treatments of albuterol every 4-6 hours prn. He needs someone to walk with beside him when he ambulates because he has an unsteady gait and often needs to stop to catch his breath.   Looking through his chart you note the following in his medical history: Emphysema (COPD)   Hypertension Diabetes type II           Hyperlipidemia Anxiety                         Cigarette smoking 1 ppd x55 years   You as the student nurse enter his room and you find him hunched over his bedside table watching TV. He says this position helps his breathing. His lung sounds are clear but notably diminished bilaterally when you auscultate his chest posteriorally. Capillary refill is 4 seconds and slight clubbing of his fingers is noted. His oxygen saturation is assessed continually to monitor for hypoxia. He is consistently between 90-92% at rest on 2 liters by nasal cannula.  After breakfast Mr. Cohen complains of lower back pain that caused him to increased discomfort while ambulating to the bathroom. He describes the pain as a “dull ache” and rates it as a “7” on a 0-10 pain scale. He requests Percocet 2 tablets. You obtain his VS: T-99.2 P-90 R-26 BP- 154/82 O2 sats 92% on 2l per n/c. The Percocet is given and within an hour he states that he feels much better and the pain is now a “2” and would like to walk in the hall. -What  diseases in his medical history have been directly influenced by his 55 pack years of smoking? -Describe the action, side effects, nursing implications and patient teaching for Percocet: -Based on the time-action-profile of Percocet, what timeframe would be the BEST to reassess the response of Mr. Cohen?  You check his O2 sats one more time and they are 91%. You obtain a portable oxygen cylinder, and take a short walk of 50 feet to the nurses station. He states he needs to rest at the nurses station because he is feeling SOB. You check his O2 sats and they are now 86% with a heart rate that correlates with the oximeter at 98/minute.   -What is your primary concern right now (think A-B-C’s) ?-Is there any more nursing assessment data or information you need? -What nursing diagnosis is most relevant and what will be your nursing interventions based on this concern?  Health Science Science Nursing MED-SURG CLINICAL 211 Share QuestionEmailCopy link Comments (0)