Follow Up Asthma Case Study

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

R.J. is a 15-year-old boy with a history of asthma diagnosed at age 8. His asthma episodes are triggered by exposure to cats and various plant pollens. He has been using his albuterol inhaler 10 to 12 times per day over the last 3 days and is continuing to wheeze. He normally needs his inhaler only occasionally (2 or 3 times per week). He takes no other medications and has no other known medical conditions. Physical examination reveals moderate respiratory distress with a respiratory rate of 32, oximetry 90%, peak expiratory flow rate (PEFR) 60% of predicted, and expiratory wheezing.

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.

Lungs: Diminished breath sounds in all lung fields. Resonant to percussion. No wheezes, rales, or rhonchi. Symmetric chest expansion. Breathing nonlabored.

This patient needs some education on the use of her asthma medication, both for long- acting which is Fluticasone (Flovent) and short - acting which is albuterol. Since SE has an exacerbation at this time, albuterol should be given to control her present symptoms and flovent should also be used for her daily maintenance. It is safer for a pregnant woman who has asthma to be treated with asthma medications than for her to have asthma symptoms and attack. This is because poor control of asthma poses a greater risk to the fetus than asthma medicine

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

Her past medical history was suggestive of asthma, morbid obesity, obesity hypoventilation syndrome, left ventricular hypertrophy most likely to be hypertensive heart disease and diabetes mellitus type II. Upon physical examination he was in moderate distress and ill looking appearance. He exhibited hypoxic respiration, tachypneic, shallow breaths sounds with bilateral diminished wheezes presented expiratory

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.

Respiratory system: Denies problems. “A cold in the winter once a year” No exposure to pollutants, No history of tobacco use, no history of alcohol, denies difficulty in breathing and cough. Lung sounds was heard in all areas, a respiration of 16, even and unlabored with no adventurous sound on

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Discuss the prevalence of asthma in certain patient populations that you might see in primary care. Asthma is chronic airway inflammation disorder that is characterized by persistent episodes of wheezing, breathlessness, chest tightness, and non-productive cough, mainly at night and in the early morning. The inflammation of the airway results from physical, chemical, and pharmacologic stimulus, which causes bronchial hyper-responsiveness, constriction of the airways, edema of airway wall, and chronic airway remodeling (Cash, 2014). Asthma occurs at all ages, with about 50% of all cases developing during childhood and another 30% before age 40. In the United States, it is estimated that 25 million people have asthma and the prevalence continues to increase (McCance, & Huether, 2014). Previously, asthma was considered

Medications used are corticosteroids, bronchodilators, and leukotrienes. Corticosteroids are used to suppress the inflammatory process in the airways of asthmatics. This medication stops the regulation of pathways that are involved in the cytokines and inflammatory mediators. Corticosteroids work its way into the respiratory epithelial cell in the airway through the glucocorticoid receptor. The steroid receptor within the nucleus promotes the transcription of genes that decrease inflammation and stops the gene that encodes protein that increases inflammation. Examples of corticosteroids are qvar, pulmicort, symbicort, and advair. The benefits to using corticosteroids are to decrease asthma symptoms, decrease airway hyperresponsiveness, and fewer exacerbations (Sobande & Kercsmar, 2008). Bronchodilators are used to relax contractions of smooth muscle of the bronchioles and improve ventilation. These drugs work on the B-2 receptors in the cells of the airway and cause the smooth muscles to relax, making it easier to breath. There are short-acting bronchodilators such as albuterol and xopenex. Long-acting bronchodilators include advair and symbicort (Ohar & Donohue, 2010). Bronchodilators are used in conjunction with steroids to decrease inflammation and to relax smooth muscle; thus making it breathes better. Leukotrienes are a new class of medication that is used to treat asthma over the last two decades. Leukotrienes

On clinical observation, Cora's pulse rate was 105 beats per minute (bpm), respiratory rate 29 bpm appears to be with the normal range, indicating that Cora's asthma exacerbation is under control. According to Li et al (2009) in asthma exacerbation, a pulse rate >30 bpm and a respiration rate >120bpm is considered to be an indication of a moderate exacerbation. Cora is conscious, alert, not agitated and able to respond verbally, though she is breathless. Li et al (2009) emphasizes that the signs and symptoms of slow breathing, disorientation, exhaustion, unconsciousness, total lack of communication and cyanosis of the fingernails in an individual with asthma exacerbation are signs that the asthma attack is becoming life threatening and needs urgent

Patient is a 10 year-old male admitted into the hospital for Chronic Asthma. Patient is experiencing shortness of breath, fatigue, nausea, and tightness in chest area. Patient has a history of Chronic Asthma since birth. .

Patients’ education should also include trigger avoidance, an understanding of the disease process and its management; properly use of asthma devices, keeping asthma under control, and more importantly adherence to the asthma medication. Patients education should also cover the understanding of the disease process such as asthma is a treatable and manageable, but not curable. Therefore, medication should not be discontinued even when the symptoms are under control. Lastly, patients’ education should also include compliance to the follow-up appointments even when the symptoms are under control or not. If patients’ symptoms are not under control, then the further referral may have needed to an allergist and a pulmonologist for further testing in order to achieve the overall