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57 yo M (Secondary Dx/ Hx (COPD, HTN, Nsg interventions (Monitor H+H for…
57 yo M
Secondary Dx/ Hx
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Nsg interventions
Monitor H+H for further signs of potential anemia, supplement with B12
Medical tx
famotidine, albuterol-ipratropium, methylpredisolone,
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Respiratory failure
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Pathophys
Progressed disease or injury causing inadequate gas exchange within the lungs, causing respiratory alkalosis
S/S
coughing, SOB, blue tint to lips, fatigue, anxiety, confusion, wheezing
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Nsg Interventions
Monitor oxygen and oxygen perfusion through body with capillary refill assessment, and assist pt with breathing techniques as applies when pt taken out of sedation
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Anoxic brain injury
Dx tests
CT scan - mild parenchymal wolume loss and mild chronic white matter change. Bilat ethmoid sinus sinusitis. Mild to mod bilat L greater than R sphenoid. - Indicating brain swelling evidenced by assymetrical sphenoid.
S/S
Confusion, loss of consciousness, vomiting, headache, change in behavior or sensation
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Medical tx
Supplemental O2, enoxaparin to reverse damage within the ischemic penumbra
Pathophys
Hypoperfusion following the respiratory and cardiac failure causing inadequate blood supply to the brain, potentially putting patient at risk for cerebral infarction - irreversible ischemia occurs when ischemic penumbra surrounding the brain's central core becomes necrotic. Global damage of brain, not focal.
Nsg interventions
Monitor for s/s bleeding, neurological exam to monitor present brain function
Respiratory infection
Medical tx
azithromycin
Monitor for diarrhea, angioedema, CDAD
Nsg interventions
fluid replacement, antibiotic tx, s/s further infection
S/S
coughing, headache, fever, fatigue
Dx tests
Positive sputum culture, positive blood test for MRSA
Risk factors
COPD, ventilation, smoking
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