Writing Assignment: HESI RN Case Study: Breathing Patterns (Graded) Please complete the following case study. Present the rationale(s) for your response(s). * * Mr. Charles Lamont is a 45-year-old patient who is visiting his primary care physician for his an annual checkup. His wife is waiting for him in the lobby; she is hoping that he will tell the physician about his recent bout of coughing and shortness of breath. Mr. Lamont works for a construction company as a heavy machine operator.
He smokes 1? packs of cigarettes per day. His wife has been encouraging Mr. Lamont to stop, but he has not showed any interest in quitting.
Laura, the registered nurse, takes Mr. Lamont to an examination room. Laura asks him about his overall health, and he tells her about a nagging cough and how he sometimes feels short of breath. He then denies any other health problems. Laura takes Mr. Lamont’s vital signs and gets the following results: blood pressure 156/94 mm Hg, temperature 99.
8 °F orally, apical pulse 104 beats/min, respirations 25 breaths/min and regular, and pulse oximetry 95%. The primary care physician examines Mr. Lamont and tells him he should quit smoking. He gives him an antihypertensive medication to help lower his blood pressure.
Mr. Lamont asks Laura if she can teach his wife how to take his blood pressure. Laura agrees and brings Mrs. Lamont in to explain the process. Laura decides that she will use demonstration to teach Mrs. Lamont the procedure, but she also wants to explain some important concepts. What should she include? Select all that apply. All of the above A. Choose a cuff that is the right size. If a cuff that is not the right size is used the reading will be false, examples are if the cuff is too wide the reading will be false and low, if the cuff is too narrow or short the reading will be false and high(Potter,2013;p462).
B. Ensure that the patient is sitting or lying. The arm needs to be at heart level to insure accurate reading if the arm is below heart level the reading will be false and high, if the arm is above heart level the reading will be false and low, the preferred position is sitting unless orthostatic hypotension is indicated (Potter, 2013;p461-462). C. Support the extremity. If the Arm is not supported, the reading will be false and high (Potter, 2013;p462). D. Ensure proper cuff application.
If the cuff is wrapped too loose or unevenly the reading will be false and high (Potter, 2013;p462) Mr. Lamont tells Laura that he doesn’t understand how smoking could influence his blood pressure. How should Laura respond? Laura should respond to Mr. Lamont by saying, that smoking results in a narrowing of the blood vessels or vasoconstriction, Blood pressure rises when a person smokes and returns to normal about 15 minutes after smoking stops (Potter, 2013;p460). Reference: Potter, P. A. , Griffin Perry, A. , Stockert, P. A. , & Hall, A. M. (2013). Fundamentals of nursing.
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