Case study 2 Jenny is 76 years old. She lives at home alone with her 3 cats. Jenny has two children however they both live interstate. Her NOK is her next door neighbour Gladys.

CASE STUDY 2

Jenny is 76 years old. She lives at home alone with her 3 cats. Jenny has two children however they both live interstate. Her NOK is her next door neighbour Gladys. Jenny smoked for 40 years and now has a diagnosis of COPD. Jenny no longer smokes or drinks. Jenny has had 2 falls in the last 3 weeks. Jenny's father died from lung cancer when he was 57 years old and her mother died from coronary artery disease 15 years ago. Jenny was diagnosed with hypertension (approximately 20 years ago) and COPD (8 years ago).

Her current medications are:

Atorvastatin 10 mg daily.

Salbutamol 200 mcg (2 puffs) every 4 hours when required.

Spiriva 1 capsule (10mcg) inhaled daily.

Pulmicort Turbuhaler (100mcg) 2 inhalations twice daily.

Jenny has recently been experiencing a persistent cough throughout the day. This cough is producing large amounts of tenacious green sputum. She has also been experiencing increased breathlessness, which she has been noticing when she tries to work in the garden. In the last 4hrs Jenny has noticed she is unable to walk and is now talking in broken sentences. Jenny phoned 000 and was taken to emergency. On examination the doctor finds the following:

Respiration 32

• SP02 88%

BP 200/80
Pulse 110
Temperature 38.1°C
Auscultation of the chest: widespread expiratory wheeze with reduced air entry on both sides.

Following a CXR Jenny has been diagnosed with exacerbation of COPD caused by left lower lobe pneumonia.

Question 1

Jenny is on 3 different medications for her COPD.

Explain the difference between all three of these medications and why it is important to have all three.
Is there another medication that Jenny would benefit from and why?

Ensure you link your information to the case study.

300 words

Question 2

Describe in detail three nursing interventions that you would prioritise for Jenny and why.
Analyse how you will evaluate the effectiveness of these interventions.

Ensure you link your information to the case study.

300 words

Question 3

Non-invasive treatment options for COPD include High Flow Oxygen and CPAP