Conduct research relevant to your case study using the Internet, Concorde Library, clinical site library, and any other appropriate sources. Review a variety of sources including professional journals, reputable websites, research papers, and books. Write a 6-page APA formatted paper in which you address the following: Cover the entire medical case of a patient from their entrance to the hospital to the present time. Include the assessments, treatment decisions, and outcomes of those treatments. Include the explanation, rationale and outcomes of patient assessment, disease\/trauma pathology, ventilator strategy and management, respiratory therapeutics, patient education, pulmonary rehabilitation and experimental therapies. Include the long-term prognosis of the patient. NOTE: These are not copies of the patient’s chart. This should be written in an explanatory essay style. Support your paper with a minimum of 7 peer-reviewed and\/or scholarly resources, excluding the course textbooks. here\u2019s the information I gathered about my patient Patient Ventilator Case Study Initials: J.T. Age\/Sex: 67-year-old male Height: 5\u201910\u201d Weight: 85 kg Admitting Diagnosis: Acute-on-chronic hypercapnic respiratory failure secondary to COPD exacerbation Medical History: \u2022 Chronic Obstructive Pulmonary Disease (COPD) \u2013 chronic bronchitis type \u2022 Hypertension \u2022 Former smoker (40 pack-years) \u2022 Home use of CPAP at night Chief Complaint: Increased dyspnea, productive cough, fatigue, and confusion. Family reports increased oxygen demand and lethargy for two days prior to admission. \u2e3b Clinical Presentation Upon Admission \u2022 Respiratory Rate: 32 bpm (labored, using accessory muscles) \u2022 Heart Rate: 110 bpm \u2022 Blood Pressure: 154\/91 mmHg \u2022 SpO2 on 6 L\/min nasal cannula: 85% \u2022 Auscultation: Bilateral wheezing and diminished breath sounds \u2022 Mental Status: Lethargic, confused \u2022 Chest X-ray: Hyperinflation, flattened diaphragms, no acute infiltrates \u2022 ABG on 6 L\/min O2: \u2022 pH: 7.24 \u2022 PaCO2: 78 mmHg \u2022 PaO2: 54 mmHg \u2022 HCO3\u2212: 34 mEq\/L \u2e3b Initial Ventilator Settings (VCV): \u2022 Mode: Volume-Controlled Ventilation \u2022 Rate: 16 bpm \u2022 Tidal Volume (VT): 500 mL (~6 mL\/kg IBW) \u2022 FiO2: 40% \u2022 PEEP: 5 cm H2O \u2022 I:E Ratio: 1:3 \u2022 Flow Rate: 60 L\/min (square waveform) \u2022 Sensitivity: -1.5 cm H2O Sedation Ordered: Propofol IV titration (goal RASS -2 to -3) \u2e3b Ventilator Monitoring and Assessment (24\u201348 hours): \u2022 Improved synchrony after bronchodilator therapy (Albuterol\/Ipratropium) \u2022 Peak Pressure: 24 cm H2O \u2022 Plateau Pressure: 18 cm H2O \u2022 AutoPEEP: Not detected \u2022 Ventilator Graphics: No evidence of significant air trapping, normal flow-time return to baseline \u2022 ABG after 24 hrs on vent (FiO2 40%): \u2022 pH: 7.35 \u2022 PaCO2: 59 mmHg \u2022 PaO2: 75 mmHg \u2022 HCO3\u2212: 31 mEq\/L \u2022 Mental Status: More alert, following commands \u2e3b Respiratory Therapy Plan of Care Short-Term Goals: 1. Improve ventilation and oxygenation within 48 hours 2. Achieve ABG with pH > 7.35 and PaCO2 < 60 mmHg 3. Decrease work of breathing and respiratory rate 4. Prevent ventilator-associated complications (VAP, barotrauma) Interventions: \u2022 Maintain current ventilator settings and monitor ABGs every 8\u201312 hours \u2022 Administer bronchodilators via in-line MDI or SVN every 4 hours and PRN \u2022 Perform ventilator checks and suctioning every 2\u20134 hours \u2022 Monitor ventilator graphics for signs of autoPEEP or patient-ventilator asynchrony \u2022 Elevate HOB to \u2265 30\u00b0 to prevent aspiration \u2022 Daily sedation vacation and spontaneous breathing trial (SBT) when clinically appropriate \u2022 Oral care protocol every 4 hours with chlorhexidine \u2022 Chest physiotherapy and flutter valve therapy as tolerated \u2022 Encourage early mobilization once stable Long-Term Goals: 1. Wean from ventilator within 5\u20137 days 2. Return to baseline oxygen needs (home CPAP or nasal cannula) 3. Educate patient on COPD management, inhaler use, and smoking cessation (if applicable) \u2e3b Weaning Criteria (once stable): \u2022 Respiratory rate < 30 bpm \u2022 Spontaneous tidal volume > 5 mL\/kg \u2022 Rapid Shallow Breathing Index (RSBI) < 105 \u2022 FiO2 \u2264 40% and PEEP \u2264 5 cm H2O \u2022 Mental status: awake and alert \u2022 Stable ABG (pH > 7.35, PaCO2 trending down, PaO2 > 60) \u2e3b Outcome (Projected): With continued therapy, bronchodilation, and pulmonary hygiene, the patient is expected to be weaned to CPAP or nasal cannula within 5\u20137 days and discharged home or to pulmonary rehab<\/p>\n","protected":false},"excerpt":{"rendered":"
Conduct research relevant to your case study using the Internet, Concorde Library, clinical site library, and any other appropriate sources. Review a variety of sources including professional journals, reputable websites, research papers, and books. Write a 6-page APA formatted paper in which you address the following: Cover the entire medical case of a patient from […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"closed","template":"","meta":[],"disciplines":[288],"paper_types":[],"tagged":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/questions\/44663"}],"collection":[{"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/questions"}],"about":[{"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/types\/questions"}],"author":[{"embeddable":true,"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/comments?post=44663"}],"version-history":[{"count":0,"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/questions\/44663\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/media?parent=44663"}],"wp:term":[{"taxonomy":"disciplines","embeddable":true,"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/disciplines?post=44663"},{"taxonomy":"paper_types","embeddable":true,"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/paper_types?post=44663"},{"taxonomy":"tagged","embeddable":true,"href":"https:\/\/www.writemyessays.app\/blog\/wp-json\/wp\/v2\/tagged?post=44663"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}