F. T Case Study Essay

History of Present Illness: Mr. Olson is a very pleasant 57-year-old gentleman with multiple medical problems to include severe COPD, who is here today for an initial consultation for his shortness of breath. He is followed by a pulmonologist Dr. William Goodman, at the Veteran Affairs Administration. His last evaluation there was in February 2015. Mr. Olson states he has had ongoing dyspnea on exertion over the last two years. He complains of minimal cough. He does note some sinus problems for which he is on Flovent. In the past, he has had pulmonary function testing that did demonstrate reversible airflow obstruction, therefore he likely has some component of asthma overlay. He states that occasionally has chest tightness and chest heaviness. He has gained about 25 pounds over the last year. He is currently using Spiriva, albuterol as needed as well as Symbicort. He is also using supplemental oxygen at 2.5L per minute at night as well as on an as needed basis during the day. Mr. Olson admits to continued tobacco use with about a half pack to a pack a day. He states that when he is feeling depressed, he will smoke more.

According to the provider, the claimant's cough has been improved. His review of systems was positive for fatigue, malaise, sleep difficulty, shortness of breath, wheezes, and a cough. His blood pressure was 115/71 mmHg and his BMI was 30.35 kg/m2. The physical examination revealed wheezes. Clonazepam was prescribed for agitation. Atorvastatin, Nystatin, Citalopram, and a probiotic were prescribed. Continued use of Aspirin and a regular inhaler were suggested. Further, a follow-up visit with Endocrinology, Cardiology, and Pulmonology. As it relates to a spot in his lung, a repeat CT scan was recommended. The bronchial washes were negative for

Lungs: Mild end-expiratory wheezing. Pursed-lip breathing noted and has a prolonged expiratory phase. Chest x-ray shows pulmonary hyperinflation, flattening of the diaphragm; Pulmonary function test (after bronchodilation with 2 puffs albuterol—FEV1/FVC ratio 0.60 FEV1 60% of predicted value)

Countless of different patients come to seek healthcare and advice for a variety of reasons including certain signs and symptoms they feel that their health is threatened by. It is a crucial skill that health practitioners have a working knowledge of different pathologies patients can present with to direct the patient appropriately towards the correct diagnosis and thus, prescribe the most effective treatment in return. Mr Smith is a 63-year-old male suffering from hypertension and diabetes for the last 20 years. He irregularly monitors blood pressure and blood glucose levels as well as inconsistently uses Minidiab and Tritace for treatment. He presents with shortness of breath worsening over the past five weeks as well as other multiple symptomologies. Throughout this case study, we will examine the pathophysiology of Mr Smith’s health concerns, clarify and interpret the physical examination outcomes and laboratory tests. Through the exams, we will then propose a number of possible and justified diagnoses and after that lead to further diagnostic tests suggested as a result of these interpretations.

Mrs. K., A 68 year-old white woman, has been admitted to the critical care unit with shortness of breath at rest. Vital signs are BP, 218/100 mm Hg; HR, 110 beats/min; and RR, 3 breath/min. She has run out of her antihypertensive medication for the fourth time this year and only came to the hospital because of her breathing difficulties.

The physical signs and symptoms of COPD and CHF may coexist, and it will be hard for the physician to determine which causing the shortness of breath to patient X. The history of progressive shortness of breath can help with the diagnosis and since patient X has history of previous hospitalization of COPD, it is given that its mainly the cause. Chest x-ray shows hyperinflation of the lungs which is indicative of COPD. Blood tests like complete blood count and biochemistry results does not show much relevance to disease however arterial blood gases demonstrates hypoxia. Patient X displays poor improvement after 5 days and electrocardiogram presents high negative predictive value for the diagnosis of systolic ventricular

In most cases of having shortness of breath, it is due to the heart or lungs that can be caused by various conditions such as, asthma, cardiomyopathy, chronic bronchitis, chronic obstructive pulmonary disease (COPD), congestive heart failure, diastolic dysfunction, emphysema, neuromuscular conditions, pneumonia, pulmonary edema, pulmonary fibrosis, pulmonary hypertension, and ventricular dysfunction

A 25-year-old female with a history of seasonal allergies presents with intermittent shortness of breath when exercising for the past 6 months. She also notices occasional waking up at night due to shortness of breath, about 2 times per month. You administer a peak flow and she reaches 75% of her peak flow. What is the best treatment for her condition?

The patient is a 69-year-old woman who has COPD, and asthmatic bronchitis; who presents for evaluation of increasing shortness of breath, cough, and increased sinus congestion and pressure. She has been on steroids because of exacerbation of asthma now for some time, is actually on 40 mg daily. In spite of this she notes ongoing wheezing, and shortness of breath when doing her exercise tolerance. She has had no high fevers, no localized chest pain. She is using her inhalers as prescribed. Others at time in [Place] have also had an upper respiratory illness. She wanted to make sure she would not need antibiotics. She has had some facial pain, that seems to better today. She had some yellow discharge that now seems to be clear. The patient did

This 59-year-old female presents to the clinic with a history of progressive shortness of breath, with a white colored productive cough He indicated that these symptoms started three days ago and that his inhaler is not helping anymore. He was treated for asthma attack about 14days ago. Patient has a history of asthma, hypertension, anxiety, insomnia and hyperlipidemia. The patient is a chronic smoker. He smokes about one and a half pack of cigarette a day. He has been a smoker for over 40years.

In the emergency department, the patient had labored breathing and a SpO2 of 72% on room air. This patient was then placed on BiPAP. His weight is 117kg and temperature of 99.1. Blood pressure was 61/41 on arrival to the emergency department and the patient was tachycardic with a heart rate of 145bpm. An EKG showed the patient was in atrial fibrillation with rapid ventricular response. IV fluids were given in the right antecubital and norepinephrine was administered. While the patient was on BiPAP with 100% FiO2, he had a SpO2 reading of 80%. The doctor decided to intubate the patient with an oral endotracheal tube size nine. Prior to the procedure the patient was sedated with fentanyl. The patient was put on PRVC with 100% FiO2. A chest x-ray showed that the endotracheal tube was in the correct placement and had a prominent ill-defined rounded opacity overlying the left mid lung with additional patchy airspace disease involving the remainder of the left lung. On auscultation, there were scattered crackles and rhonchi on the left side and the right side was diminished. A complete blood count was ordered on this patient and the results showed increased white blood cells at 26.2 and an increased glucose 194, BUN 82, and

History of Present Illness Mrs. A. is complaining of a dry cough for 2 weeks with exertional shortness of breath including, a low grade fever and a sore throat present in the morning. She reports she has orthopnea with the need to sit up right to breathe easier. Mrs. A. explains she had a similar episode 3 months ago in which she was treated with inhalers and antibiotics but refused hospitalization.

There are various risk factors of ARF. Smoking or chewing tobacco products, injury to the spinal cord, brain, chest, history of respiratory disease, COPD, cancer of the lungs are at higher risk for getting this disease. People with ARF are often confused, inability to breathe well, bluish color of their skin, lips, and fingertips. The ARF is diagnosed by doing physical exams, inquiring about the personal and family health history, checking O2 level, chest x-ray, and by doing the arterial blood gas test. In order to give better treatment, it is very important to address the underlying conditions of an individual. People need medications, surgeries (tracheostomy, endotracheal intubation, etc.), O2 treatment therapy, pulmonary rehab – education,

In Mr Smith's case pulmonary hypertension may be regarded as an underlying condition, as Dynspnea is the main symptom of the disease and it usually worsens. This worsening of Mr Smiths shortness of breath as well as his inconsistent management of hypertension reinforces that fact that he has pulmonary hypertension (Chung). Hypertension is a chronic condition in which the blood pressure of the arteries are higher Smith has had hypertension and diabetes for over 20 years, both these diseases make him quite prone to Atherosclerosis as they increase the force being place upon the arterial walls.

The scenario 1 indicated that patients may show similar symptoms that could be the result of different causes. The cause of dyspnea and shortness of breath could be a result of heart failure or even pneumonia. The practitioner should analyze each set of evidence carefully and compare the information to different possible diagnosis. The information in the case study pointed out the importance of not reaching an early conclusion without a thorough evaluation. The patient’s subjective information could significantly help the NP in identifying the cause of the problem. The subjective information provided specific indications for the NP on what physical evaluations are necessary for the patient (Seidel et al., 2011). The use of such resources contributed