A 67-year-old male is admitted to the medical-surgical unit…
A 67-year-old male is admitted to the medical-surgical unit for acute bronchitis and chronic obstructive pulmonary disease (COPD) exacerbation. Reported symptoms on admission included increased cough with sputum production. The physical examination revealed a barrel chest, diminished lung sounds bilaterally on auscultation, abdominal distention, and 2+ pitting edema in bilateral lower extremities. On the day following admission, the licensed vocational nurse (LVN) assigned to the client notes a productive cough with yellow/green sputum, crackles in the left lower lobe of the lungs while other lobes are diminished, and subjective reports of chills. Vital signs include temperature 101.2° F (38.3° C), pulse 106 beats per minute, respirations 22 breaths per minute, blood pressure 104/68 mmHg, SpO2 94% at 1.5 Liters via nasal cannula (NC). Based on these findings, the LVN assists in creating a plan of care.Based on the clinical presentation, select if the prescription listed is either Indicated (appropriate or necessary), Contraindicated (could be harmful) or Non-Essential (makes no difference or is not necessary) for the client’s care at this time.