John Doe is a 78-year-old man who lived in supported accommo

John Doe is a 78-year-old man who lived in supported accommodation… John Doe is a 78-year-old man who lived in supported accommodation until his physical condition deteriorated and he was admitted to your ward for assessment and potential aged care placement. Past History – Heart Failure (left-sided) Medications – Aspirin, Perindopril, Lasix. Assessment – Alert and orientatedNil complaints of painSlightly cool to touch and paleIncreased lethargy. Peripheral refill is less than 3 seconds for capillary beds on fingertips but 5 seconds to toes Oedema present to lower limbsDorsalis pedis and posterior tibial pulses are absentChest appearance normal Shortness of breath on exertion Persistent productive cough Vital signs: BP 110/61HR 90RR 22O2 Saturation 95%Temp 36.6.Q1. Describe why the patient is experiencing SOBOE (include in your answer why SOB doesn’t occur when he is resting)? (Think about which tissue group is used more with movement, what the tissue requires for this movement, and how meeting that requirement is impaired) Q2.  Explain why an absent dorsalis pedis and tibial pulse is significant, and what it may be an indication of? – poor circulation …. Q3.   This patient was prescribed an increase in Furosemide (Lasix) to 80 mg Daily. Using your Harvard’s Nursing Guide to Drugs, look up this medication and… A. Discuss why this medication will benefit the patient B. Identify potential interactions (side effects) that may occur between the diuretic drug Furosemide and the ACE inhibitor (Perindopril) John is also taking  Q4. A nursing intervention for this patient includes a daily weigh. A. What does this intervention aim to monitor and evaluate for this patient? B. What could be the likely factors that could cause an increase of 1kg?     Simulation Scenario 2 – Paul RodgersPaul is a 68-year-old male admitted with an exacerbation of chronic obstructive pulmonary disease (emphysema and chronic bronchitis), and a chest infection, he is mildly cyanotic, SOB, and anxious. On entering Paul’s room later in the day, a nurse finds him hunched over his bedside table watching television. He says this position helps his breathing. His lung sounds are clear but diminished bilaterally. Capillary refill is four seconds and slight clubbing of his fingers is noted. His oxygen saturation is being assessed every two hours to monitor for hypoxia.Past History – Ex-smoker: smoked a packet of cigarettes for 30 years Medications – Salbutamol, Seretide, Bromhexine and Augmentin Duo Forte. Assessment -Alert and orientatedNil complaints of painCyanosis around lips and fingernailsBarrel chest and use of accessory musclesSOBMoist productive cough Vitals – BP 120/85HR 115RR 24O2 Sats. 89% room air – 2L O2 applied O2 saturation increased to 95%Temp 38.5Plan -Collect blood cultures, regular paracetamol to maintain patient comfort, chest X-ray and obtain sputum sampleSalbutamol and Atrovent nebulisers and Prednisolone 50mg for 5 days.Q1. Using your Harvard’s Nursing Guide to Drugs, look up:           Prednisolone, Salbutamol, Bromhexine, Augmentin Duo ForteA. Briefly describe the main action of each drugB. Briefly describe how each medication will benefit this patient’s recovery NB: Ensure your answers are specific to Paul’s documented conditions – do not list medication benefits that do not relate to this patient Q2.  Using the link below, explain why patients with COPD are more susceptible to acute and chronic chest infections (Describe at least 4 reasons) Describe these 4 reasons from the article Chronic inflammation – Microbial colonisation – Pathogens – Decreased lung function – Q3. Using the link’s below, discuss why administration of high levels of oxygen therapy is contraindicated in some patients with COPD.  Health Science Science Nursing HEALTH HLT54115

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