NURSING 7105 Acute Care Nursing I



Bill McDonald is 65 years of age and is a male patient who is diagnosed with Chronic Obstructive Pulmonary Disease (COPD). He has smoked one pack per day of cigarettes for 35 years. He has a long history of recurrent bronchial infections. He has a chronic productive cough with copious amounts of purulent sputum. On admission, the patient complains that he is short of breath even at rest and wheezing, productive coughing and lethargy more than usual.

After a few days of treatment in the hospital, Bill is going to be discharged with home oxygen at 2 litres per minute per nasal cannula. The patient’s O2 saturation on room air was less than 88% and his PaO2 was less than 55, which was obtained from an arterial blood gas (ABG) at room air.

 The nurse needs to make arrangements with the community nurse to obtain an agency to supply the oxygen equipment needed and to provide follow-up home care on a regular basis. The supplier makes arrangements to deliver an oxygen concentrator and portable tanks or concentrated oxygen and oxygen regulators and needed supplies, including 20 meters of tubing and nasal cannulas.

Analyse the case and respond to all below questions in the essay

  • Discuss the pathophysiology of COPD as it relates to the acute and chronic symptoms the patient is experiencing.
  • Analyse the management plans (medical and nursing) for a patient with an acute exacerbation of COPD.
  • Explore home care considerations that need to be assessed before Bill is discharged.
  • Identify support resources available in the community and develop an education plan for Bill, particularly his learning needs associated with his disease process and discharge plans.
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