What in D.B.’s history is commonly associated with pulmonary problems?

Ch. 28. Chronic Obstructive Pulmonary Disease with Exacerbation Patient Profile D.B. is a 63-year-old electrician who came to the emergency department with shortness of breath, morning cough, and swelling in his lower extremities. Subjective Data Has smoked one pack of cigarettes daily for more than 30 years Has difficulty breathing when he walks Has been sleeping in a recliner to make it easier to breathe His shoes are tight at the end of the day Objective Data Physical Examination Blood pressure 125/90, pulse 90, temperature 98.4°F, respirations 32 Increased anterior-posterior diameter Breath sounds diminished with prolonged expiration 2+ peripheral edema bilateral lower extremities Thin with muscle wasting Respirations labored Diagnostic Studies Arterial blood gases: pH 7.32, SaO2 86%, PaCO2 55 mm Hg, PaO2 70 mm Hg Chest x-ray shows hyperinflation of lungs FEV1 65% Discussion Questions 1. What in D.B.’s history is commonly associated with pulmonary problems? 2. Interpret D.B.’s arterial blood gases (ABGs). 3. What is a likely medical diagnosis for D.B.? 4. What assessment data and diagnostic study results led you to this diagnosis? 5. What complication associated with this diagnosis does D.B. also have? What clinical manifestation led you to that and what is the cause of it? 6. What interventions are indicated for D.B. and what outcome is expected for each intervention? 7. As part of patient teaching, is it “too late” to encourage D.B. to stop smoking? Why 8. What other teaching needs would you review with D.B. while he is hospitalized?

“Is this question part of your assignment? We Can Help!”