The 68-year-old male client is admitted to the hospital for treatment of pneumonia due to increasing respiratory difficulty and pulse oximeter readings of 88% while in the provider’s office. The client smokes ½ a pack of cigarettes daily and works for a grain elevator, loading and unloading grain as a usual part of their job. The client had been taking oral antibiotics for 5 days at home with no improvement. The client reports a lack of appetite and feeling “exhausted.” Now, the client is on 3 liters per minute of oxygen, a bronchodilator per nebulizer, and IV antibiotic medication. The client’s current vital signs include temperature 100.5°F, HR 96, RR 32, BP 150/80, and pulse oximetry 92%. Additional provider orders include an incentive spirometer, ambulate three times daily, and to collect laboratory specimens for a complete blood count (CBC) and comprehensive metabolic panel (CMP) (refer to Lesson 33 for lab values). The client’s lab values are reported, and all values are within normal limits except the potassium level of 3.2 mEq/L and hemoglobin level of 12 g/dL.
g. What nursing actions will the nurse take to address the top two priority problems identified? (Implementation/Take Action).
h. After one day of being hospitalized, the client needs more oxygen due to worsening of their condition. So the provider orders 5 L/min of oxygen, an additional antibiotic, and adds corticosteroids to their nebulizer treatments. Describe how you would modify the outcomes and nursing actions to meet the client’s needs. (Evaluation/Evaluate Outcomes)
i. How will the nurse determine if the desired patient outcome are met (Evaluation)
