COPD Case Study Adapted from Lewis VCE Lesson 11, Emphysema & Pneumonia

COPD Case Study Adapted from Lewis VCE Lesson 11, Emphysema & Pneumonia Patricia Newman, 61 admitted with dyspnea at rest, cough, and fever Smoker x 45 years; 2ppd Multiple hospitalizations for pneumonia in past 2 years Osteoporosis x 8 years HTN x 15 years Divorced x 15 years; 2 adult children live out of state Mother d at 63 of MI; father d at 59 of stroke Medications at Home: Calcium carbonate 600 mg 4 times per day Estrogen patch twice a week Chlorothiazide 500 mg daily Atenolol 50 mg daily Sleeps on 2 pillows at night Emphysema for 12 years Frequent cough productive of moderate amount of yellow sputum Short of breath when walking 20 feet HTN well controlled on meds; no other known cardiovascular problem Objective: T – 101.1; B/P – 162/90; R – 26, regular, slightly labored; P – 108, regular O2 sat 89% on room air Lungs – coarse crackles throughout lungs; using accessory muscles to breathe Mental status – alert oriented to person, place, time; cranial nerves intact; PERRLA Abomen flat, nontender; bowel sounds active; pulse 2+ all extremities Q1 Which of the clinical manifestations are abnormal and why? What would normal findings be? High temperature, high pulse, high respirations, low O2 saturations, crackles are also abnormal, accessory muscles, labored reparations because they are all out of normal ranges, some of the normal findings would be a 2+ pulse, flat nontender abdomen, and active bowel sounds. Normal vital signs, being able to walk 20 feet Chest x-ray – right middle and upper lobe infiltrates, consistent with pneumonia; hyperinflation consistent with emphysema ............................................continued..................................................