Think as a Nurse Oxygenation

THINK LIKE A NURSEOxygenation
N222 Spring 2023
EXERCISE – 50 points
Requirements: Full credit for this exercise will be based on the following:
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Adhere to the information in the scenario.
Concisely answer the questions.
Provide at least one paragraph for each question.
Remember a paragraph has at least 3 statements.
Responses must be well researched & provide nursing rationale.
There must be references for each answer.
References must be in APA format.
The senior students are participating in an outreach program to enhance the pulmonary health of the
community. They are involved in two aspects of the program, prevention/teaching, and symptom
surveillance and diagnostic testing for infectious pulmonary diseases with referral as indicated.
In preparation for their work the instructor asks them to study the following entities in pulmonary
disease: upper respiratory infection, influenza, pneumonia, and tuberculosis. The common pathological
processes in these diseases include inflammation, infection, production of secretions, and compromised
oxygenation.
Every person visiting the program has the following assessments done:
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Health history: assessment of risk factors inclusive of any smoking history
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Vital signs and pulse oximetry
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Pulmonary assessment: breathing pattern/effort, lung sounds, and presence/absence of cough
1
The nurse at the outreach program says to the students, “We get a lot of older adults
coming for appointments; they have developmental changes that put them at risk for
many pulmonary problems.” Discuss what the nurse meant by this statement? (4
points)
Answer
The first visitor the students see is Mr. Eli King, a 67-year-old male requesting help with smoking
cessation. He tells the students, “I know I need to quit especially since I have gotten this cough in the
last week that brings up so much phlegm. Some days I feel so rotten-almost like I am taking a chest
cold. I have been smoking two packs a day for the last 50 years.”
2
Formulate three questions to elicit further information regarding this patient’s complaint. (3
Points)
Answer
3
The student is having difficulty obtaining a pulse oximetry reading using the patient’s left
index finger. Discuss strategies to use to ensure accurate readings. (2 Points)
Answer
4
The protocol for the program is to obtain a sputum specimen for any patient complaint of
productive cough. How will you instruct the patient to obtain this specimen? Be detailed. (5
points)
Answer
5
Discuss the teaching that is needed for this patient to enhance the mobilization of his
secretions that he can do at home. (3 Points)
Answer
6
What aspects of smoking cessation can be addressed at this visit and which ones need to be
referred? (3 points)
Answer
The next patient is a mother with three children. She is concerned regarding prevention of common
respiratory problems during the upcoming winter months; she is particularly concerned about the flu.
The youngest child, a 3-year old, is in day care, the middle child in the 4th grade, and the eldest will be
starting college in the call.
7
What simple modality can you teach the parent and children to help prevent the spread of
infection? How would you approach the teaching for each of the children based on age? Take
into consideration the place and time constraints of the program. (5 points)
Answer
8
What key points should the students address with this parent in regard to preventative
strategies for influenza? (2 points)
Answer
This day the program also is doing follow-up readings for purified protein derivative (PPD) tests
administered 3 days ago.
9
This test screens for what respiratory infection? How do you give this test? (4 points)
Answer
10
Develop three questions to ask patients to determine possible exposure risk to this disease. (3
points)
Answer
11
The nurse laughingly says to the students, “The best nurse for this job is a blind nurse.” Why
is this comment applicable to the reading of the PPDs? How are they read? (2 points)
Answer
Despite intervention, a week later the students learn that Mr. King was admitted to the hospital with a
diagnosis of community-acquired bacterial pneumonia. He requires oxygen therapy and chest
physiotherapy. One of the outreach program nurses does a follow-up visit to Mr. King and two of the
students accompany him on this visit. Mr. King tells the nurse, “It seems all that junk was just
pneumonia after all. The worst of it is in my right lung. They are giving me medicine in my IV and this
oxygen helps though I hate having this tubing all over my head and in my nose.”
12
Mr. King is receiving oxygen therapy at 2L/min via nasal cannula prn to keep O2 saturation
greater than 94%. The primary nurse has identified a nursing diagnosis of Risk for Impaired
skin integrity. Why is this applicable to this patient’s situation? Relate the defining
characteristics of the diagnosis to your answer. (4 points)
Answer
13
Answer
The patient asks, “Can I take this oxygen tubing off to go to the bathroom?” What is the
appropriate response to this question? What variables will drive your response? (2 points)
14
The respiratory therapy technician comes in to do chest physiotherapy with Mr. King. To
best clear the secretions from the middle and lower lobes of his right lung, what positions
should be used to facilitate success of secretion mobilization and removal? (2 points)
Answer
Mr. King asks the nurse for “help staying away from cigarettes when I get home.” Using an
SBAR format, how should the nurse address this issue with the primary care provider? (4
points)
Answer S (Situation)15
B (Background)A (Assessment)R (Recommendations)-
References APA (2 points):