Pathogram: Chronic Respiratory Failure

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Chronic Respiratory Failure

Shelby Lynch

Date of Care: 03/19/2013

Chamberlain College of Nursing

NR 340: Critical Care

|Assessment |Medical/Nursing Diagnoses |Treatment | |Brief review of the patient |Medical Diagnoses: |Therapeutic Modalities | |Age: 86 years old |Admitting Diagnosis: |-Continuous vital sign machine: to constantly monitor vital (HR, BP, respiration, temperature and O2| |History of present illness: This 86 year-old |Chronic Respiratory Failure (worsening of condition)- |saturation) and to see changes in patient’s health status. | |Asian male admitted to the ER on 03/18/2013. He |Respiratory failure is a condition that results when too |-Tracheostomy: to prevent closure of airway because of patient’s chronic respiratory failure and | |was brought to the ER from home by his family |little oxygen passes from the lungs into the blood or when |paralysis of throat muscles secondary to past CVA. | |who care for him. The patient’s family found him|the lungs are unable to properly remove CO2 from the |-Trach collar with 40% O2:To maintain adequate oxygenation. | |in respiratory distress and called emergency |blood. |-PICC line in right arm: for IV medication and central venous pressure monitoring (CVP) to measure | |services. Fire and rescue responded and found |--Acute respiratory failure develops quickly and often |fluid volume status. | |the patient experiencing respiratory distress |requires emergency treatment. |-Hemodynamic pressure monitoring system: to monitor CVP for determining fluid volume status, | |with an O2 saturation of 80% and palpitations. | |pulmonary status, and right-sided cardiac function. | |Fire rescue suctioned patient, which improved |--Chronic respiratory failure develops slowly and is |-Foley Catheter: to accurately monitor urinary output and prevent further skin breakdown due to | |his 02 saturation, and brought him to the ER. |usually recognized by a combination of chronic hypoxemia, |incontinence. | |Upon arrival, the patient’s temperature was |hypercapnea and compensatory elevated HCO3 levels. In pure |- Fluid replacement with Normal Saline 100 mL/hr: to maintain adequate hydration and to prevent | |101.8. Patient was admitted to the ICU for |chronic respiratory failure, the pH value on arterial blood|hypovolemia and electrolyte imbalances. | |further evaluation for sepsis. |gases will be normal (7.35-7.45). |-Sequential Stockings: to prevent DVTs in the patient’s legs related to immobility. | |This patient has had multiple prior | |-PEG tube: for enteral feedings due to patient being unable to swallow fas a result of previous CVA| |hospitalizations with similar complications. He |The patient presented to the ER with shortness of breath, |-Peripheral IV in left AC: to have IV access for volume replacement and in case of an...
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