NFDN 1002 Org plan Practice scenario #15 Oxygenation

Case Study #15: Mr. Green

Mr. Green is 45 years old. He has a history of asthma and no known allergies. He arrives in the
Emergency department with shortness of breath, audible wheezing and his lips are cyanotic and he
informs the nurse he does not have his medications with him. He is alert and oriented x 4 spheres.
Once on the stretcher, he positions himself in the tripod position. VS are as follows: Temp 36.2,
Pulse 110 bpm, regular and strong, Respirations 24, labored with accessory muscle use, BP 146/88
sitting, SPO2 90% on room air. A focused respiratory assessment revealed the following: Chest
shape and configuration is equal bilaterally anteriorly and posteriorly, on auscultation adventitious
sounds are heard – high pitched wheezing bilaterally to upper lobes. He denies pain presently.

Doctor’s orders:
 Salbutamol 2 puffs with aerochamber every four hours PRN (as needed)
 O2 via nasal cannula to keep SpO2 over 92%
 Vital signs every hour X 4 until stable

1. What is your PRIORITY nursing diagnosis?

2. Please provide a client outcome (must be measurable and must meet SMART criteria)
3. Now you need to plan your nursing interventions: you MUST include one nursing, one
medication and one teaching intervention.
4. How will you evaluate the effectiveness of the nursing interventions?
5. Research your medication:
a. Purpose in laymen’s terms
b. Safe dose? Y or N: please provide rationale
c. Nursing assessment (related to medication administration)

Jan 2021