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Running Head: CASE STUDY 1
Case Study, Chapter 23: Management of Patients with
Chest and Lower Respiratory Tract Disorders
Chidiebere Okoh

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CASE STUDY 2
Case Study: Chapter 23: Management of Patients with Chest and Lower Respiratory Tract
Disorders
The assignment pertains to case studies about the management of patients with chest and
lower respiratory tract disorders.
The answers to the two case studies are as follows.
Case Study 1
Harry Smith, 70 years of age, is a male patient who is admitted to the medical-surgical
unit with acute community-acquired pneumonia. He was diagnosed with paraseptal emphysema
3 years ago. The patient smoked cigarettes one pack per day for 55 years and quit 3 years ago.
The patient has a history of hypertension, and diabetes controlled with oral diabetic agents. The
patient presents with confusion as to time and place. The family stated that this is a new change
for the patient. The admission vital signs are as follows: blood pressure 90/50 mm Hg, heart rate
101 bpm, respiratory rate 28 breaths/min, and temperature 101.5°F. The pulse oximeter on room
air is 85%. The CBC is as follows: WBC 12,500, platelets 350,000, HCT 30%, and Hgb 10 g/dL.
ABGs on room air are pH 7.30, PaO2 55, PaCO2 50, HCO3 25. Chest x-ray results reveal right
lower lobe consolidation, presence of apical bullae, flattened diaphragm, and a small pleural
effusion in the right lower lobe. Lung auscultation reveals severely diminished breath sounds in
the right lower lobe and absence of breath sounds at the base. The breath sounds in the rest of the
lungs are slightly decreased. The patient complains of fatigue and shortness of breath and cannot
finish a short sentence before the respiratory rate increases above the baseline and his nail beds
and lips turn a bluish tinge and the pulse oximetry decreases to 82%. The patient is diaphoretic

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Running Head: CASE STUDY 1 Case Study, Chapter 23: Management of Patients with Chest and Lower Respiratory Tract Disorders Chidiebere Okoh CASE STUDY 2 Case Study: Chapter 23: Management of Patients with Chest and Lower Respiratory Tract Disorders The assignment pertains to case studies about the management of patients with chest and lower respiratory tract disorders. The answers to the two case studies are as follows. Case Study 1 Harry Smith, 70 years of age, is a male patient who is admitted to the medical-surgical unit with acute community-acquired pneumonia. He was diagnosed with paraseptal emphysema 3 years ago. The patient smoked cigarettes one pack per day for 55 years and quit 3 years ago. The patient has a history of hypertension, and diabetes controlled with oral diabetic agents. The patient presents with confusion as to time and place. The family stated that this is a new change for the patient. The admission vital signs are as follows: blood pressure 90/50 mm Hg, heart rate 101 bpm, respiratory rate 28 breaths/min, and temperature 101.5°F. The pulse oximeter on room air is 85%. The CBC is as follows: WBC 12,500, platelets 350,000, HCT 30%, and Hgb 10 g/dL. ABGs on room air are pH 7.30, PaO2 55, PaCO2 50, HCO3 25. Chest x-ray results reveal right lower lobe consolidation, presence of apical bullae, flattened diaphragm, and a small pleural effusion in the right lower lobe. Lung auscultation reveals severely diminished breath sounds in the right lower lobe an ...
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