Male, 59 years old, is John. He

Male, 59 years old, is John. He is admitted via the Emergency Room due to an emphysema exacerbation. Patient is alert but a little drowsy. Physical characteristics include a pulse of 88, consistent blood pressure of 110/70, and a body temperature of 38.2°C. Throughout, breath sounds are barely audible. Reduced chest expansion, particularly in the bases. The patient occasionally coughs weakly and ineffectively. Patient has warm, dry skin and is in a semi-Fowlers position. Lab results: 1L/min nasal cannula, PH = 7.47, PaC02 = 33, Pa02 = 55, HC03 = 24, Sa02 = 90%. WBC = 9,800, Hgb = 13.8 Nasal cannula O2 to be increased to 3L/min. Apply IPPB with 2.5mg of albuterol in 2cc of 20% mucomyst every fourth hour. Would you implement this order as it is written? What would you recommend in its place? Would you add or delete anything from this order?

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