Patient Introduction Vincent Brody is a 67-year-old male admitted directly from
ID: 248072 • Letter: P
Question
Patient Introduction
Vincent Brody is a 67-year-old male admitted directly from the provider’s office several hours ago for exacerbation of his chronic obstructive pulmonary disease (COPD). He is maintaining O2 saturations at 94% on 2 L/min of oxygen per nasal cannula. IV of potassium chloride in 5% dextrose and normal saline is infusing at 100 mL/hr in his right hand. He has responded well to medications and treatments and appears to be resting. He continues to have a productive cough. Patient has a 50-year history of smoking 2 packs a day. During the last year he has had two exacerbations. Physical findings include a barrel chest and clubbed fingers.
Medical Case 3: Vincent Brody
Guided Reflection Questions
1. How did the scenario make you feel?
2. When a patient develops a rapid onset of shortness of breath, what are the nurse’s immediate priorities?
3. What assessment findings would indicate that the patient’s condition is worsening?
4. Review Vincent Brody’s laboratory results. Which results are abnormal? Discuss how these results relate to his clinical presentation and chronic disease process.
5. What are safety considerations when caring for a patient with a chest tube?
6. What key elements would you include in the handoff report for this patient? Consider the SBAR (situation, background, assessment, recommendation) format.
7. What patient teaching priorities would be important in the patient experiencing an acute exacerbation of COPD?
8. For a patient with COPD who is stable, what resources would you recommend?
9. What would you do differently if you were to repeat this scenario? How would your patient care change?
Explanation / Answer
1). The scenario indicates (barrel chest and clubbed fingers) that the patient had an exacerbation of COPD (chronic obstructive pulmonary disease).
2). If the patient develops shortness of breath, the nurse must position the patient in the upright posture to ease breathing, and instruct the patient to pursed-lip breathing. The nurse should measure the SpO2 levels and also the vital signs.
3). If the SpO2 levels are below 90%, this indicates that the condition is worsening.