Pulmonary Rehab Case Study
The 57-year-old male was admitted to Arbor Ridge Rehabilitation and Healthcare Center from Clara Mass Medical Center. The patient was admitted with Acute Respiratory Failure, Hypoxia & Sepsis Pneumonia.
Nursing Interventions
- Medication Management- Apixaban, Metoprolol, Tessalon Perles, Humalog
- Monitor Labs, Diagnostics and Vitals- CBC, CRP, ESR, D-Dimer, BBG’s, CXR
- Maintain Fluid Balance- Maintain Hydration
- Maintain Proper Nutrition- Constant Carbohydrate Diet
Respiratory Interventions
- Maintain Adequate Oxygen/ Wean as Tolerated – Admitted on oxygen at 6 lpm
- Deep Breathing and Cough
- Bronchodilatation Therapy- Budesonide, DuoNeb via Volara
- Incentive Spirometry Oscillation and Lung Expansion Therapy via Volara System from Hillrom
- Pacing and Endurance Training
Therapy
The patient followed weekly by our In-House Pulmonologist, Dr. Magdy Wahba. Through his leadership and the guidance of Arbor Ridge’s onsite Respiratory Therapist, the patient’s condition improved allowing for increased strength and endurance.
Accomplishments
Over time, the patient progressed with an improved ability to ambulate. Oxygen dependency decreased from 6 lpm to 2 lpm via Nasal Cannula. The patient continues to work to fully wean from oxygen therapy. He has chosen Arbor Ridge for long term care.
Pulmonary Rehab Case Study
56 years old female, Patient of admitted to Arbor Ridge Healthcare and Rehabilitation Center from Engelwood Hospital Following VATS and Wedge Resection Surgery. Patient has recent history of Acute Respiratory Failure and COPD and Anxiety.
Nursing Interventions
Medication Management: Bronchodilitation Medications, Anti-Anxiety Medications
Wound Healing: Right Chest wall dressing
Monitor for Signs and Symptoms of Infection: Vitals Q shift
Pacing and Endurance with all activities
Respiratory Interventions
Maintain Adequate Oxygenation-Assess continued need upon Discharge, Bronchodilation, DB&C Exercises and continued Smoking Cessation Education
Initial Oxygen Settings 5 Liters Oxygen and had been requiring high flow in hospital prior to coming. Throughout stay, patient oxygen weaned to 3 lpm continuous via nasal cannula and set up with Lincare DME for continued use at home. She is using Breo for maintenance and a nebulizer with Duoneb QID. Incentive Spirometry for Deep Breathing exercises used independently for atelectasis and pneumonia prevention.
Therapy
Upon admission, Patient required moderate assistance with all self-care tasks and was able to ambulate 30 feet with a roller walker, mod assist. She was receiving occupational and physical therapy for 5 times a week for 2 weeks. Upon discharge, she was independent with all self-care tasks, able to ambulate 175 feet with a rolling walker and ascend/descend 1-2 flights of stairs with Bilateral Hand-Rails.
Patient returned home alone, with assistance from a very supportive sister, after 14 days LOS in STR. She will follow up with PCP, Dr. Mary Bergen, With Valley Community Health in the community.
