Pathological Processes Help Distinguish Medical Conditions

Mr. John Doe is a 65 year old male admitted with complaints of dyspnea for the past week which has gotten worse when lying down and with exertion. He complains of a cough, especially at night and has also noticed swelling in his legs bilaterally. The patient has a history of hypertension. On examination, wheezes are noted in the lungs bilaterally as well as 2+ pitting edema in the lower extremities bilaterally. The patient is sitting up and in no acute respiratory distress.

Mr. Thomas’ additional symptoms included nausea and dysnea. Nausea is when a person’s stomach wants to empty itself, so a person gets the urge and sensation to vomit. Now, when it comes to dysnea it is when a person has difficulty breathing. Dysnea is the unpleasant or uncomfortable breathing sensation a patients gets.

The nurse found Mrs Smith to be tachypnoeic, her respirations were recorded as 24 breaths per minute it was observed as being fast and it appeared that her accessory muscles were being used. Mrs Smith’s pallor also appeared flushed and her saturations were documented as 93%. The nurse used the stethoscope to check for wheeze the patient’s lungs were clear and chest rise was symmetrical. Mrs Smith was commenced on 100% oxygen through a non-rebreathe mask, oxygen as an intervention is necessary as Creed & Spiers (2010) highlight ‘metabolic demand for oxygen throughout the body is hugely increased by sepsis and is essential to ensure the supply of oxygen is maximized’ .The nurse monitored the patient closely because in her confused state the patient may try to remove the oxygen mask.

Shallow breathing and pain altered this patient’s comfort. Therefore, one of the nursing diagnoses can be stated as “Breathing Pattern, Ineffective r/t pain and anxiety, as evidenced by respiratory depth changes" (Ackley & Ladwig p. 175). We briefly discussed the specifics of incentive spirometry use before initiating the intervention. After return demonstration, the patient was ready to use his incentive spirometer.

He also had a history of shortness of breath for several months (2014). He was evaluated by the cardiologist; the test results indicated that the heart was not causing the shortness of breath. Later he was referred to a lung specialist for further evaluation.

The patient may experience dyspnea, caused by pulmonary congestion. They may report orthopnea as blood is redistributed from the legs to the central circulation when the patient lies down a night, paroxysmal nocturnal dyspnea due to reabsorption of interstitial fluid when lying down, and reduced sympathetic stimulation while sleeping. Pulmonary congestion may also cause a non-productive cough. Later clinical manifestations of left sided heart failure include crackles due to pulmonary congestion and hemoptysis resulting from bleeding veins in the bronchial system caused by venous distention. On physical exam the patient may have cool, pale skin resulting from peripheral vasoconstriction, and may be restless and confused due to reduced cardiac

Generally, this is a well-developed man sitting comfortably in no acute distress. Skin is warm and dry. HEENT: Head is normocephalic, atraumatic. Pupils equal, reactive to light and accommodation. Sclerae are anicteric. Oral mucosa is moist without lesions. No JVD. No thyromegaly. Lymphatics: No cervical, supraclavicular, axillary, or inguinal adenopathy appreciated. Respiratory: Lungs are clear to auscultation bilaterally. Heart: Regular rate and rhythm. Abdomen: Soft, nontender. Positive bowel sounds. Liver and spleen not palpable. Strength is 5/5 throughout. Neurological exam is

The primary nursing diagnosis for this patient is impaired gas exchange, related to abnormal ventilation and perfusion ratio, as evidenced by restlessness, irritability, anxiety, decreased level of consciousness, abnormal arterial blood gases, and abnormal skin color (Gulanick & Myers, 2014, p. 82). A.C. has an endotracheal tube (ETT), and there is a note for the next day to have surgery to put in a tracheostomy. She is currently a smoker, her C02 is 74.6mEq/L which is high, her pH is low at 7.19, and the bicarbonate is 28.6mEq/L which is high. Her oxygen saturation is maintaining at 90%. Her PA02 is 56mm Hg and FI02 is 0.60. The patient is very anxious and restless in the bed, despite sedation and pain medication, and her skin is pale in color and she is diaphoretic.

Ineffective breathing pattern related to bronchoconstriction as evidenced by decreased SpO2 of 91% and increased respirations of 28 breaths per minute (Pillitteri, 2014, p. 1224).

Patients presenting Symptoms: Gradual onset of dyspnea on exertion, fatigue, frequent dyspepsia with nausea and occasional epigastric pain, trouble breathing while lying on his back and, which is relieved by sitting up (orthopnea), an hypertension.

Pt approached staff 2200 stating, she was having a hard time breathing. Pt also stated her tongue was swollen from an allergic reaction. Mild tongue swelling noted. After assessing the patient, she had bilateral audible wheezes and o2 stat at 96%. No s/s of respiratory distress noted. Pt received a nebulizer treatment at 2205 and was fine after tx, stating "my breathing improved." Prn Bendaryl was also given after a swallow evaluation. No further medical complaints. Slept well through the

Following the principles of patient physical examination by Lawson and Peate (2009), her breathing would be described as tachypnoeic with a respiratory rate of 28 breaths per minute. There were equal rise and fall of the chest with no abnormal sounds on auscultation. Her oxygen saturation levels and end-tidal co2 were below normal range respectively at 93% and 3.8 kilopascals (kPa), whilst the capnography waveform showed signs of hyperventilation (South Western Ambulance Service, 2013). Her heart rate would be defined as regular and tachycardic for having

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.

Though all these histological variations has been described in placentae of GDM patients, authorized texts states that it can be histologically normal in about half of the cases .When they are abnormal, diabetic placentae tend to be large and heavy, with large and oedematous umbilical cords. Villi in the larger placentae often show chorangiosis and distal villous immaturity ie, large distal villi with increased central capillaries, macrophages, and interstitial fluid25

Leading to dyspnea, which is defined by the American Thoracic Society (ATS) as ‘a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity’. Almost all patients with IPF experience progressive dyspnea, resulting in a major impact on their quality of life. Dyspnea is a sign of serious disease of the airway, lungs, or heart. The onset of dyspnea should not be ignored; it is reason to seek medical attention. Later leading to more severe symptoms, such as always being tired, from lack of oxygen in the body, resulting in patients contracting pulmonary hypertension, heart failure, and pneumonia. Patients diagnosed with IPF have a long fight ahead, they will need their loved ones full support going through treatment and day to day