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Diagnosis Of Pleural Effusion Essay Discussion Paper

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A.B., a 68-year-old man, is admitted to your medical floor with a diagnosis of pleural effusion. He complains of shortness of breath; pain in his chest; weakness; and a dry, irritating cough. His vital signs (VS) are 142/82, 118, respirations 38 and labored and shallow, 102.1° F (38.9° C), and Spo2 85% on room air. Chest x-ray examination reveals a large pleural effusion and pulmonary infiltrates in the right lower lobe consistent with pneumonia. The physician performs a thoracentesis and drains 1500 mL of fluid. A specimen for culture and sensitivity (C&S) is sent to the laboratory, and A.B. is started on cefuroxime (Ceftin) 1 g intravenously (IV) every 8 hours. The pleural C&S results indicate a large amount of Klebsiella organism growth that is not sensitive to cefuroxime (Ceftin).The next day you are again assigned to care for A.B. At the beginning of the shift, you assess A.B. and find that his condition is stable. His lung sounds remain diminished in the right lower lobe and his Spo2 is 95% on oxygen at 2 L per nasal cannula. The chest drainage system is attached to suction at 20 mm Hg; there is still an air leak present. His morning chest x-ray examination showed some residual pleural effusion. Four hours into your shift, he pages you through the call system and tells you he feels “short of breath.” You immediately go to his room. A.B. is sitting in the chair.The remainder of A.B.'s admission is uneventful. After 6 days of aggressive antibiotic and pulmonary therapy, the chest tube is discontinued and A.B. is ready to be discharged. Diagnosis Of Pleural Effusion Essay Discussion Paper




1. 5 interventions

2. 5 rationales

3. objective and subjective data

4. evaluations

5. goals









Expert Answer

This solution was written by a subject matter expert. It's designed to help students like you learn core concepts.







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Step-by-step


1st step
All steps
Answer only


Step 1/2















EXPLANATION



Follow the Steps Given below in points:











 	Interventions:


 	Administer oxygen as ordered to maintain Spo2 above 90%.
 	Notify the physician of A.B.'s symptoms and vital sign changes.
 	Monitor and document A.B.'s respiratory status every 1-2 hours.
 	Assist with chest physiotherapy to promote airway clearance.
 	Encourage deep breathing and coughing exercises to improve ventilation.


 	Rationales:


 	Administering oxygen will increase oxygen saturation and prevent hypoxemia.
 	Notifying the physician will allow prompt interventions and prevent complications.
 	Monitoring respiratory status will detect changes early and guide appropriate interventions.
 	Chest physiotherapy will help mobilize secretions and improve gas exchange.
 	Deep breathing and coughing exercises will prevent atelectasis and improve lung function.


 	Objective and subjective data:


 	Objective data: Spo2 of 95% on oxygen at 2 L per nasal cannula, diminished lung sounds in the right lower lobe, chest drainage system attached to suction at 20 mm Hg, air leak present, residual pleural effusion on morning chest x-ray.
 	Subjective data: A.B.'s report of feeling short of breath.









Step 2/2















EXPLANATION



Follow the Steps Given below in points: Diagnosis Of Pleural Effusion Essay Discussion Paper











 	Evaluations:


 	Oxygen administration maintained Spo2 above 90%.
 	Physician notified promptly and interventions initiated.
 	Respiratory status monitored and documented every 1-2 hours.
 	Chest physiotherapy and deep breathing and coughing exercises implemented and tolerated.
 	A.B.'s symptoms relieved and respiratory status improved.


 	Goals:


 	Maintain Spo2 above 90%.
 	Prevent complications related to pleural effusion and pneumonia.
 	Improve A.B.'s respiratory status.
 	Relieve A.B.'s symptoms of shortness of breath, pain, weakness, and cough.
 	Facilitate A.B.'s recovery and discharge from the hospital.









Final answer








Hence, we solved question successfully and explained the answer in Points













Diagnosis Of Pleural Effusion Essay Discussion Paper

Expert Answer

Diagnosis Of Pleural Effusion Essay Discussion Paper

Question

(0)
A.B., a 68-year-old man, is admitted to your medical floor with a diagnosis of pleural effusion. He complains of shortness of breath; pain in his chest; weakness; and a dry, irritating cough. His vital signs (VS) are 142/82, 118, respirations 38 and labored and shallow, 102.1° F (38.9° C), and Spo2 85% on room air. Chest x-ray examination reveals a large pleural effusion and pulmonary infiltrates in the right lower lobe consistent with pneumonia. The physician performs a thoracentesis and drains 1500 mL of fluid. A specimen for culture and sensitivity (C&S) is sent to the laboratory, and A.B. is started on cefuroxime (Ceftin) 1 g intravenously (IV) every 8 hours. The pleural C&S results indicate a large amount of Klebsiella organism growth that is not sensitive to cefuroxime (Ceftin).The next day you are again assigned to care for A.B. At the beginning of the shift, you assess A.B. and find that his condition is stable. His lung sounds remain diminished in the right lower lobe and his Spo2 is 95% on oxygen at 2 L per nasal cannula. The chest drainage system is attached to suction at 20 mm Hg; there is still an air leak present. His morning chest x-ray examination showed some residual pleural effusion. Four hours into your shift, he pages you through the call system and tells you he feels “short of breath.” You immediately go to his room. A.B. is sitting in the chair.The remainder of A.B.'s admission is uneventful. After 6 days of aggressive antibiotic and pulmonary therapy, the chest tube is discontinued and A.B. is ready to be discharged. Diagnosis Of Pleural Effusion Essay Discussion Paper
1. 5 interventions 2. 5 rationales 3. objective and subjective data 4. evaluations 5. goals

Expert Answer

This solution was written by a subject matter expert. It's designed to help students like you learn core concepts.

Step-by-step

Step 1/2
EXPLANATION
Follow the Steps Given below in points:
  • Interventions:
  1. Administer oxygen as ordered to maintain Spo2 above 90%.
  2. Notify the physician of A.B.'s symptoms and vital sign changes.
  3. Monitor and document A.B.'s respiratory status every 1-2 hours.
  4. Assist with chest physiotherapy to promote airway clearance.
  5. Encourage deep breathing and coughing exercises to improve ventilation.
  • Rationales:
  1. Administering oxygen will increase oxygen saturation and prevent hypoxemia.
  2. Notifying the physician will allow prompt interventions and prevent complications.
  3. Monitoring respiratory status will detect changes early and guide appropriate interventions.
  4. Chest physiotherapy will help mobilize secretions and improve gas exchange.
  5. Deep breathing and coughing exercises will prevent atelectasis and improve lung function.
  • Objective and subjective data:
  1. Objective data: Spo2 of 95% on oxygen at 2 L per nasal cannula, diminished lung sounds in the right lower lobe, chest drainage system attached to suction at 20 mm Hg, air leak present, residual pleural effusion on morning chest x-ray.
  2. Subjective data: A.B.'s report of feeling short of breath.
Step 2/2
EXPLANATION
Follow the Steps Given below in points: Diagnosis Of Pleural Effusion Essay Discussion Paper
  • Evaluations:
  1. Oxygen administration maintained Spo2 above 90%.
  2. Physician notified promptly and interventions initiated.
  3. Respiratory status monitored and documented every 1-2 hours.
  4. Chest physiotherapy and deep breathing and coughing exercises implemented and tolerated.
  5. A.B.'s symptoms relieved and respiratory status improved.
  • Goals:
  1. Maintain Spo2 above 90%.
  2. Prevent complications related to pleural effusion and pneumonia.
  3. Improve A.B.'s respiratory status.
  4. Relieve A.B.'s symptoms of shortness of breath, pain, weakness, and cough.
  5. Facilitate A.B.'s recovery and discharge from the hospital.
Final answer
Hence, we solved question successfully and explained the answer in Points
Diagnosis Of Pleural Effusion Essay Discussion Paper

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