Assessment of Respiratory Status

Assessment of Respiratory Status

Assessment of Respiratory Status (graded)

Nelson Carson is a 62-year-old man who presents to his private practitioner’s office with a hacking, raspy cough.

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Subjective Data

  • PMH: HTN, CAD
  • Cough is productive, bringing up green, thick phlegm
  • Runny nose, sore throat
  • No history of smoking or seasonal allergies
  • Complains of fatigue

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Objective Data

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  • Vital signs: T 37 P 72 R 14 BP 134/64
  • Lungs: + Rhonchi bilateral upper lobes, wheezes
  • O2 Sat = 98%

Assessment of Respiratory Status

Medications: Metoprolol 25 mg per day, ASA 325 mg/daily

  1. What other questions should the nurse ask about the cough?
  2. What nursing diagnoses can be derived from the data?
  3. What should be included in the plan of care?
  4. What risk factors are associated with this age group?
  5. Based on the readings, what is the most likely cause of cough for this patient?

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