CASE STUDY -
MedSurge - COPD w/
Pneumonia - Darrell
Johnson PROCTORED
EXAM (ACTUAL2024-
2025) WITH
RATIONALES AND
DETAILED VERIFIED
ANSWERS RATED A+
62M comes to ED w/a 4 day history of
increased sputum production, change in
character of sputum, increased SOB, and
fever 101F. History of smoking
2packs/day prior, beginning at age 14. He
reports he had asthma as a child and he's
been treated with Albuterol inhalers as
an adult. Has been hospitalized 2x
w/pneumonia; the most recent was 2
years ago.
Physical exam:
VS: 101F, P 115, R 30, BP 120/80
Respirations shallow and labored, w/use
of accessory muscles
Increased AP diameter of chest
Skin dry and warm touch, inelastic skin
turgor, fingernail clubbing.
Which assessment is most important for
nurse to complete next? - ANSWERAuscultate breath sounds
RATIONALE:
This is the highest priority because Mr.
Johnson is clearly exhibiting respiratory
distress
Which assessment finding supports pt's
diagnosis of pneumonia - ANSWER-Pulse
of 110-- tachycardia is most consistent
w/infectious process, in addition pt's
fever and rapid RR are also VS findings
that indicate a problem--> infection
RATIONALE:
Tachycardia is consistent with an
infectious process. In addition, Mr.
Johnson's fever and rapid respiratory
rate are also vital sign findings that
indicate a problem, such as an infection.
Crackles
ABG:
pH 7.28
pCO2 55
HCO3 25
pO2 89
These ABG results indicate that pt is
experiencing which acid-base imbalance -
ANSWER-Respiratory acidosis--
RATIONALE:
The low pH indicates that acidosis is
present. The elevated pCO2 indicates
that the problem is respiratory in nature.
Clients w/any condition that depresses
respirations are prone to the
development of respiratory acidosis.
Even though pt has a rapid RR, his
underlying COPD causes retention of CO2
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