[Solved]: Mr. Abraham is a 58-year-old man with a history of COPD

Mr. Abraham is a 58-year-old man with a history of COPD who presents to a walk-in center complaining of a productive cough off and on for 2 years with shortness of breath the last 4 days. He reports he has had several chest colds in the past year and had covid during the summer and reports his breathing just hasnt been the same. He says, “this shortness of just wont go away. His significant other has been sick with a fever for the last 2 days but does not remember her temperatures. 1. What is COPD and explain pathophysiology. 2. What nursing assessments should be performed and what other information should you ask the client? In your assessment, you auscultate crackles throughout the lower lobes, occasional expiratory wheezes throughout lung fields. Vital signs:BP 152/86HR 110RR 34T 1020F SpO2 85% RA 3. Interpret findings and what do you think the next steps should be? The APRN places the client on 2 lpm oxygen via nasal cannula and calls 911 to transport client to ED. While waiting for ambulance another SpO2 was repeated results 87% on 2 lpm. Oxygen is increased to 4 lpm. The ambulance arrives, the nurse reports that the client was SOB and hypoxic, with current sat of 90% on 4 lpm, client is resting, alert and oriented. 4. What is going on with client?5. What would you have done differently? Why? Mr. Abraham arrives in ED and the nurse notices that he is somnolent and difficult to arouse. VS:BP 140/72HR 98RR 26SpO2 96%/4 lpm NC 6. What is the possible cause of somnolence and difficulty to arouse? 7. What orders do you expect from the ED provider? Prescription:Keep Sats 88-92%CXRLabs: ABG, CBC, BMPAlbuterol nebulizer 2.5 mgBudesonide-formoterol 160/4.5mcg two puffs 8. What is the first thing you will do? Labs and ABG drawn. An IV catheter is placed. The ABG results:pH 7.32pCO2 54HCO3 28pO2 56SaO2 92% 9. Interpret the ABG results 10. Which medications should be given first and why? Mr. Abrahams condition improves after respiratory medications, SpO2 90% on RA. RR 26, SOB has decreased, T 100.8. The ED provider prescribes a broad-spectrum antibiotic for questionable pneumonia which may have caused exacerbation of clients COPD. Two inhalers are also prescribed, one a bronchodilator and the other a corticosteroid. The ED provider feels that the client can be discharged to home with follow-up to his PCP. 11. What are priority discharge teaching topics for this client?