Ms. S is a 76-year-old female client who is admitted to the hospital with a diag

Question

Ms. S is a 76-year-old female client who is admitted to the hospital with a diagnosis of pneumonia. Upon examination, you notice a barrel chest and diminished breath sounds in the bases. Her arterial CO2 is 55 mm Hg, and further questioning reveals that she has a history of chronic obstructive pulmonary disease (COPD). She has smoked two packs of cigarettes per day for the past 50 years. (Learning Objectives: 2, 3, 15, and 17)

1. How does her history of smoking increase her risk for pneumonia? 2. What findings make you suspect COPD? Why? 3. Ms. S has thick tenacious secretions that are blocking the airways. How will this impact her ventilation and perfusion? Why is this important? 4. Further lab testing reveals a low hematocrit and hemoglobin. How will this impact her respiratory status? 5. Write a paragraph about the determinants of airway resistance and the relationship between lung volume and airway resistance.

Explanation / Answer

1. Smoking increases her risk for pneumonia because smoking increases the risk of infection in any patient and having COPD on top of this also increases risk for infection such as pneumonia.

2.We suspect COPD because the patient is barrel chested which is contestant with COPD.
-Diminished breath sounds are also consistent, but many chronic lung diseases can present with.

3. Ventilation and perfusion refers to the air and blood that reaches the alveoli.
-The thick tenacious secretions will make it much more difficult for the air and blood to reach the alveoli, thus making it harder for Ms. S to breathe normally.

4. Low hematocrit levels and low hemoglobin levels can mean that a patient needs a blood transfusion, this is most common in a person whose body cannot produce sufficient red blood cells in a short amount of time.

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