1.A 62-year old male presents to the Emergency Department with the chief complaint to the nurse that “I have shortness of breath that started about an hour ago.” The patient informs the nurse that he has a history of asthma and that during today’s attack, his inhaler but it “didn’t seem to help.”
A. What information would be most helpful for the nurse to obtain regarding this patient’s health history and history of present illness?
“The nurse would utilize the mnemonic OLD CART to formulate the questions that need to be asked. The nurse would begin by asking the patient the onset of the shortness of breath, when did the patient first notice the shortness of breath, the second question that the nurse would ask is the location, this is where …show more content…
What are adventitious sounds? Would the nurse expect to find adventitious sounds in this patient? If so, which ones would most likely be present?
“Adventitious sounds are extra sounds that are superimposed on the usual breath sounds. Yes, the nurse would find adventitious sounds in this patient, the nurse would hear wheezing which suggest a narrowed airway.” (p.314)
E. What notes/tones would the nurse expect to find with percussion of the thorax in this patient?
The nurse would expect to hear the hyperresonance due to the excess air in the lungs during an asthma attack. 2. Mary is a 50-year-old woman who developed 3/10 substernal chest pain (on a 0-10 pain scale) and shortness of breath this morning and came to your clinic. She was alert and oriented, heart rate of 90, 110/70 mm Hg, oxygen desaturation at 88%, and afebrile. History included hypertension for 20 years, mild obesity, DM, and hyperlipidemia. She has a 30-pack year history of smoking. Significant findings on physical exam cm were jugular venous pressure (JVP) at 5 above the clavicle and a laterally displaced point of maximal impulse, S4 and S3, and a 3/6 systolic murmur of mitral regurgitation. There was hepatojugular reflux (HJR). She had 1+ pitting edema to mid shin …show more content…
You should also ask the patient to point to location of the pain and to describe the feelings associated with the pain, what kinds of activities bring on the pain, does it radiate into your neck and shoulder, back or down your arm, what are the associated symptoms, what makes it better. Regarding the history of present illness, the nurse would ask about prior’ cardiovascular problems, past surgeries, any allergies, family history and lifestyle and habits.”
A. What information would be most helpful for the nurse to obtain regarding this patient’s health history and history of present illness?
“The nurse would utilize the mnemonic OLD CART to formulate the questions that need to be asked. The nurse would begin by asking the patient the onset of the shortness of breath, when did the patient first notice the shortness of breath, the second question that the nurse would ask is the location, this is where …show more content…
What are adventitious sounds? Would the nurse expect to find adventitious sounds in this patient? If so, which ones would most likely be present?
“Adventitious sounds are extra sounds that are superimposed on the usual breath sounds. Yes, the nurse would find adventitious sounds in this patient, the nurse would hear wheezing which suggest a narrowed airway.” (p.314)
E. What notes/tones would the nurse expect to find with percussion of the thorax in this patient?
The nurse would expect to hear the hyperresonance due to the excess air in the lungs during an asthma attack. 2. Mary is a 50-year-old woman who developed 3/10 substernal chest pain (on a 0-10 pain scale) and shortness of breath this morning and came to your clinic. She was alert and oriented, heart rate of 90, 110/70 mm Hg, oxygen desaturation at 88%, and afebrile. History included hypertension for 20 years, mild obesity, DM, and hyperlipidemia. She has a 30-pack year history of smoking. Significant findings on physical exam cm were jugular venous pressure (JVP) at 5 above the clavicle and a laterally displaced point of maximal impulse, S4 and S3, and a 3/6 systolic murmur of mitral regurgitation. There was hepatojugular reflux (HJR). She had 1+ pitting edema to mid shin …show more content…
You should also ask the patient to point to location of the pain and to describe the feelings associated with the pain, what kinds of activities bring on the pain, does it radiate into your neck and shoulder, back or down your arm, what are the associated symptoms, what makes it better. Regarding the history of present illness, the nurse would ask about prior’ cardiovascular problems, past surgeries, any allergies, family history and lifestyle and habits.”