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Patient Profile

Patient Profile

Mr. Artuso is a 63-year-old electrician who came to the emergency department complaining of shortness of breath, morning cough, and swelling in his lower extremities.

Subjective Data

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Has smoked one pack of cigarettes daily for over 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%

Question 1

What in Mr. Artuso’s history is commonly associated with pulmonary problems?

Question 2

Interpret Mr. Artuso’s arterial blood gases.

Question 3

What is a likely medical diagnosis for Mr. Artuso?

Question 4

What assessment data and diagnostic study results led you to this diagnosis?

Question 5

What complication associated with this diagnosis does Mr. Artuso also have? What clinical manifestation led you to that and what is the cause of it?

Question 6

What are the priority nursing diagnoses for Mr. Artuso at this time?

Question 7

What interventions are indicated for Mr. Artuso and what outcome is expected for each intervention?

Question 8

As part of patient teaching, is it “too late” to encourage Mr. Artuso to stop smoking? Why?

Question 9

What other teaching needs would you review with Mr. Artuso while he is hospitalized?

 

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