COPD exacerbation
Impression: COPD exacerbation
Condition: Fair – Poor
Diet: NPO till stale
Activity: As tolerated
Please:
1. CBC, BUN, Cr, Na, K, BS, UA
2. ABG ( assess acidosis and hypoxia )
3. CXR(PA)
4. ECG
5. Echo ( evaluation of pulmonary HTN )
6. Pulse oximetry ( keep Sat-O2 near 90% )
7. O2 nasally 3 lit/min
8. Hydrocortisone 100 mg IV stat, then Q8h
9. Aminophylline 250 mg in 250 ml DW5% over 30 min slowly
10. Theophylline Tab SR 200 mg PO Bid
11. NAC EffTab PO Tid
12. Imipenem 500 mg IV Q6h
13. Nebulizer Ventolin Tid
14. Salbutamol Spray 2 puff q20 min till stable then PRN
15. Atrovent Spray 2 puff q30min till stable, then Tid
16. IV Fluid – if necessary
