CLINICAL NURSING CARE SCENARIO:

Patient X 30 years old, male, single and with fair complexion is admitted in the emergency
room of CBRC Medical Center. He is complaining of difficulty of breathing and tightness in the chest.
“Nurse parang hinahabol ko ang hininga ko. Nahihirapan akong huminga hindi na ako makatulog ng
maayos at kinakabahan ako baka malagutan ako ng hininga.” You assessed his vital signs which are the
following: PR: 68 bpm, RR: 26 cpm, Temp: 38.2 BP: 130/90 mmHg.
Upon further assessment patient X verbalized that he had been suffering from dry cough
for almost 3 weeks now, with intermittent low-grade fever at night, loss of appetite and difficulty
sleeping. The doctor ordered the following laboratory test: Complete Blood Count, Chest Xray and
sputum exam. After 2 hours the result of the laboratory test return:
1. CBC

Component Result Normal Value

WBC 13,000 4,000-11,000
RBC 5 4.2-6.1
Platelet 230,000 150,000-450,000
Hemoglobin 11 13-18
Hematocrit 37 35-45

2. Chest X-ray
Findings: Both lungs are clear and expanded with no infiltrates.
Impression: No active diseases.
3. Sputum
Result: Mycobacterium Tuberculosis detected.

Upon receiving the result, you immediately notify the physician of the findings and the
physician ordered the following:
A. Admit the patient in the Isolation room
B. Notify the infectious disease department
C. Start D5Lr 1 liter x 12 hrs
D. Start Rifampicin 200 mg/tablet to the patient three times a day for 6 months. The drug is available
at 500 mg/tablet
E. Start Isoniazid 300 mg to the patient three times a day for 6 months. The drug is available at 500
mg/tablet
F. Diet as tolerated
G. Give oxygen @ 4 LPM once patient complained of dyspnea.
H. Notify physician from time to time.

At the end of your shift, you checked the following

A. D5Lr at 550 ml level
B. Patient consumed 5 glasses of water approximatively 240 ml per glass.
C. Patient urinated 4 times and almost a glass of water per urination as verbalized by the patient.
D. No bowel movement noted.