Patient Information

Exacerbation of COPD

Patient Information
Patient: Susan
Ethnocultural background: African descent
Age: 51

Related Clinical Chapters
Chapter 4: The Interview

Chapter 9: Assessment Techniques and the Clinical Setting

Chapter 19: Lungs and Thorax
Chapter 20: Heart and Neck Vessels

Chapter 21: Peripheral Vascular

Susan is a 51-year-old female. She is in the medical surgical department with exacerbation of chronic obstructive pulmonary disease (COPD). She has a 66-pack-year history of smoking and occasional drug and alcohol use. She is divorced and lives alone in an older apartment. Initial assessment on the day shift:

Subjective:
Denies pain, states cough is tiring at times, productive with yellow sputum, remaining dyspneic at rest and upon exertion.
Misses her three cats and asks if the nursing assistant can take her outdoors for a cigarette.

Objective:
T 37.4° C; P 78 regular rate and rhythm, R 26 regular and shallow, BP 136/94 LA, pulse oximeter 95% on 4 litres of oxygen by nasal cannula
Pain 0/10
Inspection: Sitting on side of bed with elbows on overbed table, cyanosis absent, use of accessory muscles with breathing
S₁ and S₂ regular rate and rhythm, no extra sounds.

Palpation
Radial pulse 2+ and symmetric. Doralis pedis pulse 1+ left, and 2+ right
Skin cool with flaking on the lower legs and feet. No edema noted.

Answer the following questions- Week 2- Lungs and Thorax

Q1.Briefly describe COPD and what is might look like on clinical presentation,

Q2. What is the best description for the way Susan is sitting? How may this be related to the way she prefers to sleep?

Q3.What lung sounds might you expect to hear in this patient? Explain what side of your stethoscope you would use and why.

Q4.Describe the best way to assess Susan’s for cyanosis.