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Central Australia. She has been referred and admitted to hospital for
exacerbation of her COPD. She is currently receiving increased regular
salbutamol, oral steroids in addition to her regular medications and
intensive respiratory physiotherapy rehabilitation before returning to her
community in the next week.
Hx COPD, cor pulmonale
It is 0800 and you attend to undertake her observations. She looks at
you vaguely and asks where she is. However, after a moment she
seems fine. She seems a bit agitated and says she doesn’t want
breakfast because she feels like she needs to vomit.
Palliative Factors: Nothing makes me feel better
Q: aching
R: Everywhere
S: “not too severe, I just don’t
feel right”.
T: “I woke up during the night
feeling hot all over”.
• HR: 112bpm
• RR: 26 bpm
• Temp: 38.1°C
• Sp02: 87% on RA
Assessment
findings
Pulse – Regular, rapid and
palpable
JVP - not visible
Peripheries are warm
Pale
CXR - Nil evidence of enlarged
cardiac shadow or lung changes pre-
operatively.
ECG – Sinus Tachycardia
Assessment
• Dyspnoeic
• Increased Work of
breathing
• Generalised Bilateral
crackles
• Decreased lung sounds L
side
• Chest Xray – Extensive L
sided chest consolidation all
fields.
• LOC: A&O x3
• PERRLA
• Motor and sensory function
intact
GCS: 15- but slow to respond
Evaluate outcomes?
Step by step
Solved in 2 steps
- Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week.u Hx COPD, cor pulmonaleu It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindingsu Pulse – Regular, rapid…ngarla Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse –…ngarla Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse –…
- Ngarla Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse –…ngarla Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse –…ngarla Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse –…
- ngarla Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse –…Ngarla Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse –…ngarla Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse –…
- Ngarla Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse –…ngarla Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse –…Kngwarreye is a 60 yr old Anmatyerre woman from Urpuntia inCentral Australia. She has been referred and admitted to hospital forexacerbation of her COPD. She is currently receiving increased regularsalbutamol, oral steroids in addition to her regular medications andintensive respiratory physiotherapy rehabilitation before returning to hercommunity in the next week. Hx COPD, cor pulmonale It is 0800 and you attend to undertake her observations. She looks atyou vaguely and asks where she is. However, after a moment sheseems fine. She seems a bit agitated and says she doesn’t wantbreakfast because she feels like she needs to vomit. P: Provoking Factors: coughing and taking a deep breathPalliative Factors: Nothing makes me feel betterQ: achingR: EverywhereS: “not too severe, I just don’tfeel right”.T: “I woke up during the nightfeeling hot all over”. BP: 104/68 mmHg• HR: 112bpm• RR: 26 bpm• Temp: 38.1°C• Sp02: 87% on RA CardiacAssessmentfindings Pulse – Regular,…