What classic manifestations indicate the patient had a COPD exacerbation?

M.B. is a 65-year-old male who is being admitted from the emergency department to the cardiopulmonary unit with an exacerbation of chronic obstructive pulmonary disease (COPD).

M.B. has been using ipratropium (Atrovent) and albuterol (Proventil) metered-dose inhaler for control of his symptoms. His admission vital signs are as follows: blood pressure 158/86 mm Hg, heart rate 118 beat/min, respiratory rate 36 breaths/min, temperature 101.4° F (38.4° C), and SaO₂ 85%. He is 5 ft 10 in tall, weighs 180 lb, and has a marked barrel chest.

Discussion Questions

1. What classic manifestations indicate the patient had a COPD exacerbation?

2. What are some likely causes of her COPD?

3. What symptoms indicate the overuse of inhalers, and which drug would cause the symptoms described?

4. What is the only way H.M. can halt the progression of her lung disease?

5. Why would H.M. “feel full fast” when eating? What could you do to minimize this issue?

6.   Priority Decision: What are nursing priorities for discharge planning and teaching?

8.  Priority Decision: Based on the assessment data presented, what are your priority nursing diagnoses? Are there any collaborative problems?