- Read the case study listed below.
- Refer to the rubric for grading requirements.
- Utilizing the Week 3 Case Study TemplateLinks to an external site., provide your responses to the case study questions listed below.
- You must use at least one scholarly reference to provide pathophysiology statements. For this class, use of the textbook for pathophysiology statements is acceptable. You may also use an appropriate evidence-based journal.
- You must use the current Clinical Practice Guideline (CPG) for the management and prevention of COPD (GOLD Criteria) to answer the classification of severity and treatment recommendation questions. The most current guideline may be found at the following web address: https://goldcopd.org/Links to an external site.. At the website, locate the current year’s CPG and download a personal copy for use. You may also use a medication administration reference such as Epocrates to provide medication names.
- Proper APA format (in-text citations, reference page, spelling, English language, and grammar) must be used.
Case Study Scenario
A.C., is a 61-year old male with complaints of shortness of breath.
History of Present Illness
A.C. was seen in the emergency room 1 week ago for an acute onset of mid-sternal chest pain. The event was preceded with complaints of fatigue and increasing dyspnea for 3 months, for which he did not seek care. He was evaluated by cardiology and underwent a successful and uneventful angioplasty prior to discharge. Despite the intervention, the shortness of breath has not improved. Since starting cardiac rehabilitation, he feels that his breathlessness is worse. The cardiologist has requested that you, his primary care provider, evaluate him for further work-up. Prior to today, his last visit with your practice was 3 years ago when he was seen for acute bronchitis and smoking cessation counseling.
Past Medical History
- Atherosclerotic coronary artery disease
- Father deceased of acute coronary syndrome at age 65
- Mother deceased of breast cancer at age 58.
- One sister, alive, who is a 5 year breast cancer survivor.
- One son and one daughter with no significant medical history.
- 35 pack-year smoking history; he has cut down to one cigarette at bedtime following his cardiac intervention.
- Denies alcohol or recreational drug use
- Real estate agent
- No Known Drug Allergies
- Rosuvastatin 20 mg once daily by mouth
- Carvedilol 25 mg twice daily by mouth
- Hydrochlorothiazide 12.5 mg once daily by mouth
- Aspirin 81mg daily by mouth
Review of Systems
- Constitutional: Denies fever, chills or weight loss. + Fatigue.
- HEENT: Denies nasal congestion, rhinorrhea or sore throat.
- Chest: + dyspnea with exertion. Denies productive cough or wheezing. + Dry, nonproductive cough in the AM.
- Heart: Denies chest pain, chest pressure or palpitations.
- Lymph: Denies lymph node swelling.
General Physical Exam
- Constitutional: Alert and oriented male in no apparent distress.
- Vital Signs: BP-120/84, T-97.9 F, P-62, RR-22, SaO2: 93%
- Wt. 180 lbs., Ht. 5’9″
- Eyes: Pupils equal, round and reactive to light and accommodation, normal conjunctiva.
- Ears: Tympanic membranes intact.
- Nose: Bilateral nasal turbinates without redness or swelling. Nares patent.
- Mouth: Oropharynx clear. No mouth lesions. Dentures well-fitting. Oral mucous membranes dry.
- Neck supple without JVD.
- No lymphadenopathy, masses or carotid bruits.
- Bilateral breath sounds clear throughout lung fields. + Bilaterally wheezes noted with forced exhalation along with a prolonged expiratory phase. No intercostal retractions.
- S1 and S2 regular rate and rhythm, no rubs or murmurs.
- Skin cool, pale and dry. Nail beds pink without clubbing.
- Lungs are hyper-inflated bilaterally with a flattened diaphragm. No effusions or infiltrates.
Discussion: an A.C Case study
The spirometry results consistent with obstructive or restrictive pulmonary disease
The spirometry outcomes of A.C. are steady with a disruptive pulmonary ailment. The sick person’s FVC is bigger than 80%, which signifies no restraint (Hira, 2021). Besides, the FEV1/FVC proportion being lower than 0.7 is constant with disruptive pulmonary disease. The most probable pulmonary analysis for that patient is Chronic Obstructive Pulmonary Disease. With the FEV1 only growing by 2% after bronchodilator prescription, the airways are non-responsive, recommending an analysis of asthma (Hira, 2021).
The pathophysiology associated with the chosen pulmonary disease There are seven medically significant phenotypes of Chronic Obstructive Pulmonary Disease that have been noted can assist in personalized treatment. However, there exist only two types of COPD; emphysema and chronic bronchitis (Hira, 2021). To get a clear explanation of the pathophysiology of Chronic Obstructive Pulmonary Disease, we have to break down the developments that transpire, separately or at times with overlap….Kindly click the purchase icon to purchase the full solution at $10