Joe Ritter, a 74-year-old retired bricklayer, has a 40-pack-year tobacco history and a history of COPD. Today, he presents to the emergency department in respiratory distress with retracting respirations of 26 breaths/min, BP is 154/76 mm Hg, pulse is 120 beats/min, and temperature is 37°C. His skin color is pale gray, his chest is barrel-shaped, and he uses accessory muscles to breathe; he appears anxious and is sitting in a tripod position. His nail beds are bluish in color; his oxygen saturation by pulse oximetry is 72%. Chest auscultation reveals wheezes and decreased-to-absent breath sounds in bilateral bases. Hyperresonance is noted upon chest wall percussion. Chest x-ray showed atelectasis bilaterally in the bases. Mr. Ritter coughs with minimal amounts of clear sputum. A 12-lead ECG recorded his heart rate as 140 beats/min, rapid, and irregular with an interpretation by the physician as atrial fibrillation. Upon further exam, the left lower extremity is edematous warm and tender to touch. Determine:1. What subjective and objective data can the nurse gather from the information available about Mr. Ritter in the given scenario? 2. What questions would you ask Mr. Ritter during the interview portion of the health assessment related to his symptoms, SOB, chest pain, cardiac rate and rhythm? 3. What findings from the given scenario represent abnormal objective data?
Answers: 3
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Joe Ritter, a 74-year-old retired bricklayer, has a 40-pack-year tobacco history and a history of CO...
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