HESI CASE STUDY - COPD With Pneumonia (2023 Update) Darrell Johnson is a 62-year-old male who comes to the Emergency Department (ED) with a 4-day history of increased sputum production, a change in the character of sputum, increased shortness of breath, and a fever of 101° F. He has a smoking history of 2 packs a day for the past 20 years, and he smoked 1 pack a day prior to that, beginning at the age of 14. He reports that he had asthma as a child and that he has been treated with albuterol (Ventolin) inhalers from time to time as an adult. Mr. Johnson has been hospitalized twice with pneumonia; the most recent pneumonia-related hospitalization was 2 years ago.Which assessment is most important for the nurse to complete next? - Auscultate breath sounds Which assessment finding supports Mr. Johnson's diagnosis of pneumonia?
- Pulse rate of 110
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Based on these ABG results, which acid base imabalance is Mr. Johnson experiencing? - Respiratory acidosis Which nursing diagnosis has the highest priority when planning care for Mr.Johnson? - Ineffective airway clearance Which nursing action should be implemented before administering the prescribed Unasyn? - Obtain a sputum culture The levofloxacin 500 mg IVPB is supplied in 100mL of D5W to be delivered over 60min. There is no IV pump available so the nurse will infuse the antibiotic by gravity. The drop factor on the tubing is 20 gtts/mL. The nurse should set the IVPB to infuse at how many gtts per min? - 33 Which assessment is most important for the nurse to perform while Mr.Johnson is receiving Ventolin? - Monitor pulse and BP