Respiratory Case Study
Elijah Stevens is 74 year old male with a history of COPD. He is admitted to the hospital for an exacerbation of his COPD. He continues to smoke cigarettes (reports one pack a day). His current medications include theophylline, albuterol inhaler, beclomethasone dipropionate inhaler and a chewable aspirin 81 mg once a day.
His lung sounds are diminished bilaterally. Pulse oximetry reading is 90%. He is receiving oxygen at 2 liters per nasal cannula. He complains of shortness of breath with exertion.
Critical Thinking
1. Discuss COPD and explain which of his medications are prescribed for his COPD. Discuss how these medications treat the diseases process. Chronic obstructive pulmonary diseases include chronic …show more content…
Discuss the albuterol prescription-be sure to include: brand/generic names, safe dosage, pharmacodynamics, the purpose of the medication, side effects, important nursing considerations and teaching points. Albuterol is an adrenergic bronchodilator. Albuterol is the generic name while Accuneb, Proair HFA, Proventil HFA, Ventolin HFA and VoSpire ER are the brand names. The safe dosage is different depending on the route and the age. For a by mouth form, aged twelve or older, 2-4 mg 3-4 times a day (not over 32 mg/day) or 4-8 mg if using extended-release tables twice a day. For geriatric by mouth, 2mg 3-4 times a day, again not over 32 mg/day. A child’s by mouth is 0.1mg/kg 3 times a day (not over 2mg 3 times a day). The dose may be increased to 0.2mg/kg 3 times a day, not over 4 mg 3 times a day. The inhaled route for neonates is 1.25mg/dose every 8 hours or 1-2 puffs with metered dose inhaler every 6 hours. For children 0.15mg/kg/dose every 20 minutes for 3 doses then 0.15-0.3mg/kg every 1-4 hours as needed or 1.25 3-4 times daily for children 10-15 kg or 2.5 mg 3-4 times daily for children less than 15kg. Continuous nebulization is 0.5-3mg/kg/hr. For Adults and children over twelve, 2.5-5mg every 20 minutes for 3 doses and then 2.5-10 mg every 1-4 hours as needed. Continuous nebulization is 10-15mg/hr. A metered dose inhaler should be used with 2 inhalationos every 4-6 hours or 2 inhalations 15 minutes before exercise. NIH states children should receive 4-8 puffs every 20 …show more content…
Discuss the aspirin prescription-be sure to include: brand/generic names, safe dosage, pharmacodynamics, the purpose of the medication, side effects, important nursing considerations and teaching points. Aspirin is the generic name; ASA, Ascription, Aspercin, Aspergum, Aspirtab, Bayer Aspirin, Bufferin, Easprin, Ecotrin, Genacote, Halfprin, Healthprin, and St. Joseph Adult Chewable Aspirin are the brand names. The safe dosage is 80-325mg for myocardial infarction prevention for adults and 3-10mg/kg for children. For transient ischemic attacks dosage is 50-325mg/day. Inflammation has a dose of 2.4g to 3.6-5.4g/day for adults and 60-100mg/kg for children. For pain or fever, dosing is 325-1000mg every 4-6 hours, not to exceed 4000mg/day for adults and 10-15mg/kg every 4-6 hours for children. The drug works by producing analgesia and reducing inflammation and fever by inhibiting the production of prostaglandins. It also decreases platelet aggregation, which will decrease the incidence of transient ischemic attacks and myocardial infarctions. The purpose of the medication is to decrease inflammatory disorders including: Rheumatoid arthritis and osteoarthritis, for mild to moderate pain, fever and prophylaxis of transient ischemic attacks and myocardial infarction. Side effects include: tinnitus, gastrointestinal bleeding, dyspepsia, epigastric distress, nausea, abdominal pain, anorexia, hepatotoxicity, vomiting, anemia, hemolysis, increased bleeding time, anaphylaxis, and