Response post MDC week 6

Respond to at least one other student's post. Please check the Course Calendar  for specific due dates.

Courtney Spina

15 hours ago, at 9:09 PM

 

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What potential problems can occur based on the above findings?

The potential problems that can occur for Sarah based on the above findings are her ABG results which suggest that she has uncompensated respiratory acidosis with mild hypoxemia. Sarah's uncompensated respiratory acidosis could be attributed to her past medical history of COPD and pneumonia. Based off of Sarah's chest x-ray the pneumonia has cause her to have reduced alveolar capillary diffusion which has led to poor gas exchange and CO2 retention. Sarah's COPD has also caused her to have airway obstruction with prevent's air movement and results in poor gas exchange and CO2 retention which leads to acidosis. Sarah's mild hypoxemia is concerning because it can effect the tissues in the heart and the brain due to a lack of oxygen. If Sarah's blood gas doesn't improve she can develop worsening respiratory acidosis and/or result in respiratory failure (Ignatavicius et al., 2021).

How would you provide multidimensional care for Sarah?

As the nurse caring for Sarah I would provide care to her by helping reduce her shortness of breath which would include repositioning every 2 hours to help improve gas exchange, starting Sarah on oxygen therapy, administering bronchodilators such as Albuterol, or a Duoneb as well as a corticosteroid, like solumedrol, to help ease her work of breathing and increase alveloi strength and patency. Antibiotics might also be considered for her respiratory infection. I would also want to work closely with the Respiratory Therapist to determine if there is any other treatments that would be beneficial to Sarah such as Acapella or Chest PT which would help with mobilization of secretions and lung expansion due to her pulmonary infiltrates. Other multidimensional care efforts would be continuous cardiac monitoring and oxygen saturation monitoring. It is important to make sure that Sarah oxygen saturations increase with the treatments, however she has a history of COPD thus her baseline oxygen saturations are 88-92%. Otherwise she may need further interventions such as CPAP, BiPAP or potentially need to be intubated and mechanical ventilation performed (Ignatavicius et al., 2021)

Describe the roles of other departments in Sarah’s treatment plan.

Some other roles or departments that should be included in Sarah's treatment plan is pulmonary rehab. This would be a good resource for her because she has a history of heart failure and COPD. Pulmonary is beneficial for Sarah becuase it would help her maximize lung function through exercises training and education. Sarah would learn breathing techniques, proper medication adherence, oxygen usage, and how to preserve her energy for ADL's with SOB.

References

Ignatavicius, D., Workman, L., Rebar, C. & Heimgartner, M. (2021). Medical-surgical nursing: Concepts for interprofessional collaborative care (10th ed.). Elsevier. 

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