Chapter 24: Care of the Adult with a Respiratory Condition

A 77-year-old woman is admitted to hospital following a fall in the bathroom at home several days ago. She sustained rib fractures on the right side which are becoming increasingly painful. She has a past medical history of COPD (15 years). She normally maintains a moderate level of activity at home and has been managed with PRN salbutamol and carbocysteine.

When she is admitted her observations are as follows: respiratory rate 22 bpm, BP 171/83, HR 95 bpm, temperature 37.5°C, SpO2 86% on 4 L O2. The patient produces some yellow sputum.

Questions

  • What are you going to observe for during your respiratory assessment?
  • What would your nursing management of this patient include?

Answer

  • Given her history of COPD what are your specific concerns regarding this additional assessment data?
  • What is the potential impact on her ventilatory load, capacity and drive?
  • Review the BTS guidelines.
  • How would you manage oxygen therapy for this woman?
  • What additional assessment and specialist input might you require to optimise management for this woman given her history of COPD?

Refer to the resources available on the companion website and the national guidelines that have been mentioned within this chapter.