Question

your patient is a 55 - year - old man with a history of chronic bronchitis. you have been called to his home today because of an increased dyspnea. the patient is on 2 liters per minute of oxygen by nasal cannula at home. your assessment reveals difficulty speaking due to shortness of breath, leaning forward to breathe, a productive cough, and a respiratory rate of 32 per minute.
what signs/symptoms lead you to this decision?
mental status
tidal volume
respiratory rate
skin color
airway sounds
accessory muscle use

Explanation:

• Respiratory Rate: A rate of 32 per minute is elevated (normal adult respiratory rate is 12 - 20 breaths per minute), indicating respiratory distress.
• Accessory muscle use: Leaning forward to breathe suggests the use of accessory muscles (e.g., sternocleidomastoid, scalene muscles) to aid in breathing, which occurs when the body is working harder to ventilate.

Answer:

• C. Respiratory Rate
• F. Accessory muscle use