Purpose
To work with a team of professionals, select appropriate nursing interventions within the LPN scope of practice, and recognize serious complications.
Competency
Explain care for the client with lower respiratory disorders.
Instructions
Read the case study below and answer the questions. Site any sources using APA format.
The Story
You are an LPN working in a community health clinic on a team of professionals that includes a medical assistant, RN, and nurse practitioner. The clinic is just opening for the day on a day that is particularly hot and humid. A woman runs into the clinic with an older gentleman yelling “he can’t breathe.” The client appears flushed (reddened skin), is unable to speak, and appears very short of breath. The client’s wife tells you that he has “emphysema” and refuses to put the air conditioning on in their home because he is afraid the electric bill will be too high. She also tells you that he ran out of his medications, including his inhalers and prednisone, almost 2 weeks ago. The client has a respiratory rate of 44 and an O2 Sat. of 84% on room air. His blood pressure is 168/100.
Question 1: List two nursing interventions that should be done immediately. (2-3 sentences)
Question 2: What environmental factor(s) do you think contributed to the client’s current situation? (2-3 sentences)
Question 3: What danger could the client face by abruptly stopping prednisone? (5-10 sentences)
Question 4: Explain why compliance is important in managing chronic diseases such as COPD? (5-10 sentences)
Question 5: After this client is stabilized and his breathing improves. What should be addressed with him on his next clinic visit? (5-10 sentences)
Title: Purpose in Nursing: Providing Care for Clients with Lower Respiratory Disorders
Introduction: Nursing is a profession driven by a profound sense of purpose and a commitment to improving the well-being of individuals in need. The case presented in this essay illustrates the importance of this purpose, especially when dealing with clients suffering from lower respiratory disorders. To effectively care for such clients, it is essential for nurses, including Licensed Practical Nurses (LPNs), to work collaboratively with a team of professionals, select appropriate nursing interventions within their scope of practice, and recognize potential complications. This essay will address the case study presented and answer questions related to the client’s immediate care, environmental factors contributing to his condition, the dangers of abruptly stopping prednisone, the importance of compliance in managing chronic diseases like COPD, and the aspects to address during the client’s future clinic visit.
Question 1: Immediate Nursing Interventions In the given scenario, two crucial nursing interventions that must be implemented immediately are: a) Administer oxygen therapy: The client’s oxygen saturation is at 84%, well below the normal range of 95-100%. Administering supplemental oxygen will help improve oxygenation and alleviate his severe shortness of breath. b) Assess vital signs and initiate blood pressure management: The client’s blood pressure is significantly elevated (168/100 mm Hg). High blood pressure can exacerbate respiratory distress, and therefore, monitoring and potentially administering antihypertensive medication should be considered.
Question 2: Environmental Factors Several environmental factors have contributed to the client’s current situation. First and foremost, the hot and humid weather conditions can worsen respiratory distress, particularly in individuals with pre-existing lower respiratory disorders. Additionally, the refusal to use air conditioning at home due to fear of a high electric bill likely exacerbated his condition, as maintaining a cooler environment can help reduce the work of breathing. Furthermore, the client running out of his prescribed medications, including inhalers and prednisone, for nearly two weeks significantly worsened his respiratory symptoms and led to the current crisis.
Question 3: Dangers of Abruptly Stopping Prednisone Abruptly stopping prednisone, especially in individuals with chronic obstructive pulmonary disease (COPD) like the client in this case, can lead to serious complications. Prednisone is a corticosteroid that helps reduce airway inflammation and improve lung function. When stopped suddenly, it can result in rebound inflammation, worsening of respiratory symptoms, and potential exacerbation of the underlying disease. The client could face increased difficulty in breathing, higher risk of respiratory infections, and even acute exacerbation of COPD, which may necessitate hospitalization.
Question 4: Importance of Compliance in Managing COPD Compliance with prescribed medications and treatment regimens is paramount in managing chronic diseases like COPD. Several reasons highlight the significance of compliance: a) Disease control: Regular medication adherence helps in controlling COPD symptoms, reducing the frequency and severity of exacerbations, and improving overall quality of life. b) Preventing complications: Non-compliance can lead to exacerbations, hospitalizations, and a decline in lung function, resulting in irreversible damage. c) Enhancing health outcomes: Adhering to prescribed therapies, such as inhalers and corticosteroids, can slow disease progression and minimize complications. d) Holistic care: Compliance enables healthcare providers to monitor progress, make necessary adjustments to the treatment plan, and provide timely interventions when required.
Question 5: Addressing Future Clinic Visit After the client’s immediate stabilization and improvement in breathing, his next clinic visit should focus on several key aspects: a) Medication management: Ensure the client understands the importance of consistent medication use and prescription refills. Discuss strategies to prevent running out of essential medications. b) Disease education: Provide education on COPD management, including lifestyle modifications, smoking cessation if applicable, and proper use of inhalers. c) Home environment assessment: Assess the client’s home environment to identify potential triggers or hazards affecting his respiratory health. Encourage the use of air conditioning as necessary. d) Regular follow-ups: Emphasize the need for regular follow-up appointments to monitor lung function, adjust treatment plans, and address any emerging issues promptly. e) Support systems: Assess the client’s support systems, including family and community resources, to ensure a holistic approach to care and assistance in managing his condition.
Conclusion: Nursing professionals, including LPNs, play a pivotal role in caring for clients with lower respiratory disorders, such as COPD. Their purpose-driven commitment to immediate interventions, understanding environmental factors, emphasizing compliance, and providing comprehensive care during clinic visits is essential for improving the lives of individuals struggling with chronic respiratory conditions. Through their dedication and collaboration with healthcare teams, nurses can make a significant difference in enhancing the health and well-being of clients like the one in the presented case.