What clinical findings are likely in R.S. as a consequence of his COPD? How would these differ from those of emphysematous COPD? Patients that do have chronic bronchitis ( B COPD) typically exhibit shortness of breath on exertion, excessive amounts of sputum, chronic cough, and evidence of excess bodily fluids (edema, hypervolemia). Chronic cough tends to be most severe in the mornings, is productive, and occurs for more than 3 months and occurring each year for at least 2 consecutive years. In addition, patients tend to complain about chills, malaise, muscle aches, fatigue, loss of libido, and insomnia. Smoking is also a typical clinical manifestation and is the leading cause of B COPD (accounting for 90% of cases). Late signs include right-sided heart …show more content…
is stated to have a history of prolonged smoking, a leading cause of B COPD. R.S. has a PaO2 of 50 mm Hg and PaCO2 of 60 mm Hg, showing elevated PaCO2, and decreased levels of PaO2 that are consistent with that of B COPD. Patient is taking inhaled β2 agonists and theophylline which are treatments of COPD. Since R.S.’s PaO2 is less than 50 mm Hg, it is recommended that R.S. be treated with low-dose oxygen therapy. Since PaO2 is decreased in R.S., excess strain on the heart would occur in order to move oxygen throughout the body which could go along with coronary artery disease and peripheral arterial vascular disease as these are diseases of the arteries and arteries pump oxygenated blood away from the heart. Smoking is also a possible involvement of coronary artery disease and peripheral arterial vascular disease. Coronary artery disease and peripheral arterial vascular disease are usually caused by atherosclerosis of coronary arteries unrelated to COPD. Additionally, patients with B COPD often exhibit bacterial colonization that causes pneumonia. Since R.S. has an area of consolidation in his right lower lobe that is thought to be consistent with pneumonia, patient is as risk of
History of Present Illness: Ms. Babula is a very pleasant 76-year-old woman who was previously seen in this office by Elvira Aguila, MD for moderate COPD by pulmonary function testing in 2010. She is currently on monotherapy with Atrovent p.r.n. and she has not used her bronchodilators for quite some time. She does have some stable dyspnea on exertion, which does not limit any of her activities. She does take care of an 18-month-old child as well. She denies any cough, though she does feel that she has some chest congestion in the morning. She denies any chest pain or wheezing.
Mr. HS is a 78-year-old retired male, who presented to the emergency room at Northeast Methodist Hospital initially on February 11, 2011, with complaints of shortness of breath and coughing. He was diagnosed as having a COPD Exacerbation and was placed on antibiotic therapy and was released home. He was also advised at that time to complete the entire course of antibiotics and return to his primary treating physician if his condition did not improve.
D.Z.is a 65-year-old man admitted to medical ward with an exacerbation of chronic obstructive pulmonary disease (COPD; emphysema). Past medical history (PMH) indicates hypertension (HTN), well managed with enalapril (Vasotec) past six years, diagnosis (Dx) of pneumonia yearly for the past three years. D.Z. appears cachectic with difficulty breathing at rest. Patient reports productive cough with thick yellow-green sputum. He seems anxious and irritable during subjective data collection. He states, he has been a 2-pack-a-day smoker for 38 years. He complains of (c/o) insomnia and
The lung function tests showed a moderate degree of airflow obstruction with normal gas transfer factor which would be consistent with moderate degree COPD.
Dyspnea, the most common symptom of COPD, comes on gradually and is first noticed during physical exertion or during acute exacerbations
COPD is one of the greatest causes of disability and mortality in the twenty first century with future predictions painting an even graver story. Occupation, genome, and primarily smoking are the main causes of COPD. COPD is the third leading cause of death in America, claiming the lives of 134,676 Americans in 2010. Symptoms are typical of a constant smokers cough which progresses into the debilitating palliative stage of the disease; the development of co-morbidities exacerbates these symptoms. COPD has a complex pathophysiology involving hyperinflation, excessive mucus production and airway remodeling; diagnosis is through lung function tests. COPD is poorly managed with few effective treatments and a poor
The main symptoms of COPD are long lasting cough, mucus that come up when you cough, and when you exercise (or even just walk up the stairs) shortness of breath can get worse. When COPD gets worse, it gets harder to eat or exercise, and breathing takes much more energy. People often lose weight and get weaker. Symptoms might even flare up and get much worse. This is called COPD exacerbation. An exacerbation can range from mild to life threatening. The longer you have this disease, the more severe the flare up can get.
The R.S is likely to show signs of wheezing in his breathing and a productive cough/sputum. These coughs could last for months. Shortness of breath and chest discomfort are also common in patients with chronic bronchitis. The R.S. could be suffering from hypoxemia (low oxygen in the blood) and polycythemia (over production of hemoglobin in the blood due to the RBC's trying to compensate for the lungs not working to their full potential). Cardiac failure could be present, which is important in this case due to the fact that our R.S. has a history of coronary artery disease. Emphysematous COPD clinical findings include shortness of breath and intermittent dyspnea (difficulty in breathing). Dyspnea in this case is progressive and the R.S. could
D.Z., a 65-year-old man, is admitted to a medical floor for exacerbation of his chronic obstructive pulmonary disease (COPD; emphysema). He has a past medical history of hypertension, which has been well controlled by Enalapril (Vasotec) for the past 6 years. He has had pneumonia yearly for the past 3 years, and has been a 2-pack-a-day smoker for 38 years. He appears as a cachectic man who is experiencing difficulty breathing at rest. He reports cough productive of thick yellow-green sputum. D.Z. seems irritable and anxious; he complains of sleeping poorly and states that lately feels tired most of the time. His vital signs (VS) are 162/84, 124, 36, 102 F, SaO2 88%. His admitting diagnosis is an acute
METHODS: The study included 400 COPD patients. COPD diagnosis was defined by GOLD criteria (FEV1/FVC < .70 post-bronchodilator). Information was collected on the following comorbidities: heart diseases, hypertension, diabetes mellitus, dyslipemia, anemia,osteopenia&osteoporosis, muscle weakness,pneumonia, lung cancer, gastroesophageal reflux and psychological conditions .
A person with COPD has damaged alveoli and bronchi. This means they have weakened and ruptured air sacs that are unable to efficiently perform the exchange of gases (oxygen and carbon dioxide). As the disease progresses, damage increases to the air sacs to the point of a person feeling breathless even when
The major goals of treatment are to ease the symptoms, to slowdown disease progression, and to improve the quality life of the patients. Patients with mild to moderate COPD can be adequately managed in the primary care setting by the family physician, whereas patients with more severe COPD and multiple comorbidities need a multidisciplinary approach to treatment. Family physicians should perform spirometry on all patients over 40 years old for early diagnosis, especially if one falls into to the risk group and have history of smoking, chronic cough, shortness of breath, and even frequency of cold (Eeden & Burns, 2008). Smoking cessation remains the single most important factor in slowing the decline in lung function in patients with COPD. Pulmonary rehabilitation (PR) is recommended for the patients with moderate and severe COPD.
Chronic Obstructive Pulmonary Disease, also known as COPD, is the third leading cause of death in the United States. COPD includes extensive lungs diseases such as emphysema, non-reversible asthma, specific forms of bronchiectasis, and chronic bronchitis. This disease restricts the flow of air in and out of the lungs. Ways in which these limitations may occur include the loss of elasticity in the air sacs and throughout the airways, the destruction of the walls between air sacs, the inflammation or thickening of airway walls, or the overproduction of mucus in airways which can lead to blockage. Throughout this paper I am going to explain the main causes, symptoms, diagnosis, and ways to reduce COPD.
There are no cure for this disease. However, there are different treatment to prevent further deterioration of the lungs function in order to improve the quality of life of the patient by increasing capacity of their physical activity. One of the main severe complication a patient with COPD can develop is exacerbation. Increased breathlessness, increased sputum volume and purulent sputum are the signs and symptoms of exacerbation. Early detection of the signs of exacerbation can help keep the condition of the patient from worsening. The treatments of COPD mainly aims at controlling the symptoms of exacerbation such as taking inhalers. Patients who are over the age of 35 and ex-smokers with chronic cough and bronchitis are recommended to have spirometer (NICE, 2004). This is because it is possible to delay or prevent patients from developing severe case of COPD is identified before they lose their lungs functions. Oxygen therapy is another treatment for COPD as the patients with this condition has high
Ineffective breathing pattern related to decreased oxygen saturation, poor tissue perfusion, obesity, decreased air entry to bases of both lungs, gout and arthritic pain, decreased cardiac output, disease process of COPD, and stress as evidenced by shortness of breath, BMI > 30 abnormal breathing patterns (rapid, shallow breathing), abnormal skin colour (slightly purplish), excessive diaphoresis, nasal flaring and use of accessory muscles, statement of joint pain, oxygen saturations of 85-95% 2L NP, immobility 95% of the day, and adventitious sounds throughout lungs (crackles) secondary to CHF, hypertension, pain caused by gout and arthritis, and obesity