Subjective Data This is a 65 year old Caucasian female presenting with complaints of a persistent rarely productive cough lasting two weeks; causing shortness of breath, and orthopnea. She has been treated for this cough three month ago in the emergency room. At that time chest x-ray (CXR) revealed hyperinflated lungs suggestive of emphysema. She refused to be treated in the hospital at that time, ad was sent home with an inhaler and antibiotics. She also refused the pulmonary function test. She has a history of childhood asthma, and a hysterectomy in the 1970’s. She admits to smoking one pack of cigarettes for the past 40 years. She denies any other medical issues. Currently she takes only Tylenol 650mg, 2 orally for pain, as she needs it.
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Initially, client should be educated on each of the diseases processes and how each disease can perpetuate the other, and what the options are for managing them. The client needs to be educated on receiving the Pneumonia vaccine and the Influenza vaccine annually to prevent recurrent pneumonia, or flu viruses that can be easily acquired with her respiratory condition. She also needs to be educated on pulmonary hygiene and avoiding individuals that currently have a respiratory infection. Exercising is important for lung health, and should be encouraged. The APN and the client can create an exercise plan that is progressive and doable for a client her age with her condition. The APN can also suggest or encourage the client to seek her daughters company with exercises that could include Sunday or Saturday walks. The client can be prescribed short acting inhalers to assist in decreasing dyspnea while exercising. Encouraging the client to stop smoking and recommending local recourses; such as quit smoking now, that offers assistance, and providing nicotine gum or patches to assist with this goal. This assistance may be encouraging from an economic perspective; since the client does not have disposable income for this type of an
Initially, client should be educated on each of the diseases processes and how each disease can perpetuate the other, and what the options are for managing them. The client needs to be educated on receiving the Pneumonia vaccine and the Influenza vaccine annually to prevent recurrent pneumonia, or flu viruses that can be easily acquired with her respiratory condition. She also needs to be educated on pulmonary hygiene and avoiding individuals that currently have a respiratory infection. Exercising is important for lung health, and should be encouraged. The APN and the client can create an exercise plan that is progressive and doable for a client her age with her condition. The APN can also suggest or encourage the client to seek her daughters company with exercises that could include Sunday or Saturday walks. The client can be prescribed short acting inhalers to assist in decreasing dyspnea while exercising. Encouraging the client to stop smoking and recommending local recourses; such as quit smoking now, that offers assistance, and providing nicotine gum or patches to assist with this goal. This assistance may be encouraging from an economic perspective; since the client does not have disposable income for this type of an