Case Study #2: Oxygenation Impaired by Secondary Infection

Luanne Yazzie is 56 years old and has been a lifelong passive smoker. Her parents smoked in the house she grew up in, her first husband smoked before he died of complications from diabetes, and she worked as a dealer at a Nevada casino where smoking was legal. Although she had never smoked, Luanne learned a year ago that she was showing early symptoms of emphysema.

Question #1 (2 points)

What symptoms does Luanne have that indicate early signs of emphysema? (check all that apply) .

  1. Increased shortness of breath when climbing stairs .
  2. Production of dark yellow-green sputum.
  3. Wheezing on exhalation
  4. Increased mucus production in the morning.
  5. Barrel chest.

Question #2 (2 points)

Luanne’s doctor ordered a Chest X-ray (CXR) and a Pulmonary Function Test (PFT), confirming that she was at an intermediate (stage 2) level the second she was sick The forced expiratory volume (FEV1) was 65% of normal. There is hyperinflation on CXR. Luanne has a lot of questions for the nurse about what this means. How should caregivers respond? (Check all that apply.)

  1. Chest X-ray showing damage to the air sacs in the lungs.

  2. Your lungs are no longer working at full capacity, which is why you are short of breath.

  3. Your condition has improved since symptoms started a year ago.

  4. Your information needs explanation

)Question #3 (8 points / 1 point each)

Luanne comes to the clinic with shortness of breath and worsening symptoms. Healthcare providers are considering several lung laboratory and diagnostic tests. Match the diagnostic tests on the left with the corresponding customer scales on the right.

  1. Arterial blood gas (ABG) ____F_
  2. Oxygen saturation ___D__
  3. Pulmonary function test (PFT) ). ) ___B__
  4. Serum hemoglobin level (Hgb ) ___G__
  5. Chest X-ray (CXR) ___H___
  6. Computed Tomography (CT) __E___
  7. Sputum Culture & Sensitivity (C&S) _A_
  8. Bronchoscopy __C____
  1. Make sure your sample is sputum from the lungs, not saliva.
  2. You breathe hard into the machine to determine the amount of air in your lungs.
  3. While you sleep, a tube will be inserted into your lungs to look at structures and take tissue samples if necessary.
  4. Place a clip on your finger to determine the oxygen level in your blood.
  5. You will lie quietly on your back and be placed in the large machine for the scan.
  6. The blood sample will be drawn from your wrist and may be painful.
  7. A blood test that supports the blood’s ability to carry oxygen.
  8. A test that can determine the shape of enlarged lungs.
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