144 CHAPTER2 GAS EXCHANGE Case Study 32 Name Class/Group Date P Scen O.H., a 73-year-old married, retired truck driver, visited his physician reporting, “Whenever | try to do any- thing, I get so out of breath I can’t go on. I think I'm just getting older, but my wife told me | had to see you aboutit.” He has a history of hyperlipidemia and hypertension, which are managed with lisinopril, furose- mide, atorvastatin, and metoprolol, and a 30-pack-year smoking history. He had greenish-yellow sputum, an oral temperature of 100.4°F (38°C), and an SpO, of 83%. He was admitted to the local hospital with a new diagnosis of chronic obstructive pulmonary disease (COPD) exacerbation. After a 5-day stay during which the diagnosis of COPD was confirmed, he was discharged on continuous oxygen (O,) therapy ata 2 L flow rate with new prescriptions for fluticasone/salmeterol (Advair Diskus) and albuterol (Ventolin). You are the case manager at the home agency assigned to O.H. 1. What is the reason for O.H.’s O, being at a 2 L flow rate? 2. What criteria need to be met for Medicare to pay for home O, therapy? 3. Which member of the interprofessional team would be involved in O.H.s care and how? 4. How would you prepare for the initial home visit? 5. What would you address with O.H. and his wife at the first visit?
