Subjective
• A Female patient in her teens was admitted for bronchiectasis exacerbation. History of present illness of the patient is difficult Patient Medical History (PMHx) includes Common Variable Immunodeficiency (CVID), bronchiectasis, cutaneous T-cell lymphoma, asthma, and interstitial lung disease. Patient presents with 1-week history of subjective fever and worsening cough. Patient was previously admitted due to congestion and cough with fever, discovered to have bronchiectasis exacerbation requiring IV meropenem. Patient’s past medical history is combined T and B cell Immunodeficiency, chronic interstitial lung disease with bronchiectasis, bronchiectasis with exacerbation, and recurrent sinusitis. Past surgical history consists of …show more content…
Patient was sitting on the bed. Nasal cannula wasconnected but in use because doctor is weaning patient off oxygen in the …show more content…
Pulse oximetry was taped on patient’s toe. False desaturation was noticed from irregular waveforms and was corrected when patient uncrossed legs.
• Chest assessment – Wheezes were heard on expiration in the right upper lobe, right middle lobe, and right lower lobe. Bronchiectasis leads to occasional wheezes and diminished breath sounds. Breath sounds were diminished in the left upper lobe, left middle lobe and left lower lobe.Diminished breath sounds could be from collapsed airways due to bronchiectasis.
• Medications – Intrapulmonary Percussive Ventilation (IPV) every 6 hours while delivering albuterol 2.5mg/3mL and sodium chloride 7%/4ml. IPV loosens and helps push up airway secretions from the lungs and makes it easier for the patient to cough out the secretion. IPV pressure was set to 9 cm H2O. Symbicortwas administered via MDI inhaler with 2 puffs twice a day as a maintenance treatment of asthma, and Tobramycinwas administered via small volume nebulizer twice a day, which is indicated to treat bacterial infectionssuch as having a positive gram stain. All of these medications were given during the first round. For the second round we only administered IPV while delivering albuterol 2.5mg/3mL and sodium chloride
• A Female patient in her teens was admitted for bronchiectasis exacerbation. History of present illness of the patient is difficult Patient Medical History (PMHx) includes Common Variable Immunodeficiency (CVID), bronchiectasis, cutaneous T-cell lymphoma, asthma, and interstitial lung disease. Patient presents with 1-week history of subjective fever and worsening cough. Patient was previously admitted due to congestion and cough with fever, discovered to have bronchiectasis exacerbation requiring IV meropenem. Patient’s past medical history is combined T and B cell Immunodeficiency, chronic interstitial lung disease with bronchiectasis, bronchiectasis with exacerbation, and recurrent sinusitis. Past surgical history consists of …show more content…
Patient was sitting on the bed. Nasal cannula wasconnected but in use because doctor is weaning patient off oxygen in the …show more content…
Pulse oximetry was taped on patient’s toe. False desaturation was noticed from irregular waveforms and was corrected when patient uncrossed legs.
• Chest assessment – Wheezes were heard on expiration in the right upper lobe, right middle lobe, and right lower lobe. Bronchiectasis leads to occasional wheezes and diminished breath sounds. Breath sounds were diminished in the left upper lobe, left middle lobe and left lower lobe.Diminished breath sounds could be from collapsed airways due to bronchiectasis.
• Medications – Intrapulmonary Percussive Ventilation (IPV) every 6 hours while delivering albuterol 2.5mg/3mL and sodium chloride 7%/4ml. IPV loosens and helps push up airway secretions from the lungs and makes it easier for the patient to cough out the secretion. IPV pressure was set to 9 cm H2O. Symbicortwas administered via MDI inhaler with 2 puffs twice a day as a maintenance treatment of asthma, and Tobramycinwas administered via small volume nebulizer twice a day, which is indicated to treat bacterial infectionssuch as having a positive gram stain. All of these medications were given during the first round. For the second round we only administered IPV while delivering albuterol 2.5mg/3mL and sodium chloride