PowerPoint cause study
asel
AdultCaseStudy.pptx
CASE STUDY
1
69 year Female admit as inpatient. On Feb 13,17 at 09:33 AM with SBO with COPD (w/asthma and CO- morbidities such as GERD, HTn, HLD and Anxiety/depression.
She was started on Levaquin for UTI on POD2( Post-operative day 2).
She is diagnostic exploratory laparotomy and lysis of adhesions.
History of Present illness
I found it interesting case because I had never seen a patient who had SBO with COPD (w/asthma) and CO-morbidities before.
Reason for Choosing the Patient
COPD: Group of lung disease including emphysema and chronic bronchitis, that block airway and make it difficult to breathe. which is over time gets worse if its not treated.
COPD is the inflammatory response to cigarette smoke that case mucous hypersecretion (chronic bronchitis), tissue destruction (emphysema), and disruption of normal repair and defence mechanisms causing small airway inflammation.
SBO: A gastrointestinal condition in which blockage of normal passage of digested food through the small intestinal.
Asthma: a respiratory condition marked by spasms in the bronchi of the lungs, causing difficulty in breathing. It usually results from an allergic reaction or other forms of hypersensitivity.
She admitted as inpatient on Dec 14,15 with COPD with Asthmatic component and co-morbidtites including the flowing illness:
1- Diabetes Type 2
2- Tobacco Dependence Syndrome
3- Stricture of esophagus.
Medical History
stricture of esophagus: is narrowing of the esophagus that causes swallowing difficulties, can be related to acid reflex (GERD), and it cause asthma
Laparoscopic Cholecystetomy in 2001
Sinus Surgery in 1993.
Exploratory Laparotomy in 2013.
Surgical History
Age:69
Gender: Female
Weight: 123 Ib
Height: 61.0 inch
Breath Sound: Wheezing.
0xygen Therapy: 2L NC
Assessment
Assessment
Vital Signs
Temp: 97.9
RR: 22
HR: 95
O2 Sat: 93
BP: 116/88
Labs Rustle ABGs
WBC: 9.0 doesn't have.
Hgb: 10.3
RBC: 3.39
Na: 139
K: 3.7
Gluc: 123
Ca: 8.5
BUN:7
CXR
Bowel obstruction is found among people with Copd, especially for people who are female, 60+ old, take medication Spiriva and have High blood pressure. We study 148 people who have Bowel obstruction and Copd from FDA.
Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants—such as air pollution, chemical fumes, or dust—also may contribute to COPD.
Supporting research
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| Generic Name | Dose | Route of admins | Indication |
| Albuterol/ipratropium | 3ml q6h | Nebulizer | COPD |
| insulin | 71-159 qid | subcut | Diabetic |
| Albuterol | 2.5mg bid | inhalation | COPD/Asthma |
| Xanax | 0.5mg qhs prn | PO-Tablet | Anxiety/panic disorder |
| levofloxacin | 750mg q24h | PO-Tablet | Infection |
| Furosemide | 10mg q8h | PO-Tablet | Diuretic |
Medication
Aspirin (GI upset)
Penicillin (swells and rash)
Erythromycin (Lip swells)
Levaquin (coma)
Doxycline (rash-throat closes up)
Adverse and Allergic Drug Reaction
PEP therapy x72hours prn.
Oxygen therapy
Bronch hygiene protocol
Incentive spirometer q2h.
Respiratory Care Treatments
Plan
4L high flow NC
Midline incision intact.
Pain controlled.
Goals
Will pass Flatus.
Will deep breath and cough independently.
Will remain injury free
Will maintain no infection
Questions!
Secretion on chest x ray appear as ?
Which primary factor which leads to the development of COPD in US?
http://www.eh ealthme.com/cs/copd/bowel%20obstruction/
https://www.nhlbi.nih.gov/health/health-topics/topics/copd
References
Thanks!
