Respiratory Case Study
1. Doctor’s orders for Corny would include activity levels, pharmacologic interventions, lab work, diet modification, strict intake and output measurements and respiratory therapy.
The activity level of Corny should be very minimal at first and then gradually increase to a level that is acceptable for Corny. Chronic fatigue often accompanies COPD, especially in the acute phase. Corny will need assistance with activities of daily living such as eating, bathing, grooming and ambulation. Corny should be allowed time to finish activities and be encouraged to not rush himself. This would cause Corny to experience increased dyspnea, fatigue and hypoxia. Corny should have most of the things he needs within reach such as water pitcher, Kleenex, etc. The call light should always be within reach for Corny. (Ignatavicious & Workman, 2006)
Corny will also need pharmacologic interventions such as bronchodilators, corticosteroids, antibiotics and anti anxiety medications. Bronchodilators are medications that help dilate the bronchial tubes or airways of the lungs. They work by relaxing the smooth muscles that line the airways making the airways open wider and allow more air to enter and exit the lungs. Bronchodilators are usually short acting and are given in the event of a flare up of athsma that will accompany COPD. Bronchodilators such as B2-adrenergic agonists and anticholinergic agents are often the main treatment for COPD. These medications are given by inhalation which produces bronchodilation. Some of these medications would include albuterol (Proventil), salmeterol (Serevent) and ipratropium (Atrovent). (Porth, 2007).
Corticosteroids reduce inflammation of the airways as well as reducing cough. These medications may be ordered for oral or inhalation route. Corticosteroids given by inhalation have “minimal systemic absorption and disruption of the hypothalamic-pituitary-adrenal function”. (Porth,...