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Title: “Managing Asthma in the Post-Operative Patient: A Case Study in Canadian Nursing”
Relate research from Canadian Nursing. CASE SCENARIO
48 year old male
The patient in Room 205 admitted with a fractured Right tibia and is 1 day post op. He has a cast on. He has been quiet most of the evening. He is just coughing and is experiencing some SOB. He says he has a history of Asthma and that he gets his way every now ands then . I did not detect any wheezing. Vital signs T 98.8 F, P90, R28, BP 140/88, pulse oxygen 92%, pain level 3 out of 10 in the pain scale , circulation, movement and sensation are WNL in the Right leg.
Patient Care Kardex
Up in chair
Diet: Regular
PT to teach crutch walking
IV: Saline lock #20g RFA
Circ. movement, sensation and temp. (CMST)
right leg q4h
Elevate leg on one pillow
PRN Medication:
PCA – morphine sulfate 1 mg on demand;
8 min lock out; 4 hour dose limit = 30 mg
Medical History
Smokes 1⁄2 -1 pack of cigarettes/day
Respiratory infection 1 month ago
Uses cromolyn inhaler prn
Lab work done on the day of admission:
CBC – WNL
ESR
Follow up Nursing Action plan:
0200 nursing assessment: The patient is beginning to cough more frequently and complains of chest tightness. Respiratory assessment indicates inspiratory and expiratory wheezes in bilateral lungs. You call the physician and obtain the following telephone orders:
IV D5/0.9 NS at 125 mL/hr
Oxygen at 2 L/min/NP
Albuterol inhaler 2 puffs q4h
Metaproterenol nebulizer treatment 0.3 mL (5%) in 2.5 mL NS q4h prn
ABG, sputum for eosinophils
Methylprednisolone sodium 125 mg IVP q6h
Check oxygen saturation with pulse oximeter q2h
Call physician with ABG results
Questions:
Based on the Physician’s telephone orders which nursing interventions require immediate follow up?
What nursing actions can you delegate/assibcign to the personal support worker?
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