I-HUMAN CASE STUDY: 60-YEAR-OLD FEMALE WITH
SHORTNESS OF BREATH NRNP 6541: Advanced
Practice Care of Adults Advanced DDx | Week [X] |
Complete Case Study Solution
CASE OVERVIEW
Parameter Details
Patient Name Margaret Wilson
Age 60 years
, Gender Female
Height 5'4" (163 cm)
Weight 183.0 lb (83.2 kg)
BMI 31.3 kg/m²
Reason for Encounter Shortness of breath
Setting Outpatient clinic with x-ray, ECG, and laboratory capabilities
Assignment Type Advanced DDx i-Human Case Play
Course NRNP 6541
Academic Year 2026/2027
Patient Identification
Parameter Details
Age 60 years
Gender Female
Setting Outpatient primary care clinic
Source of History Patient (reliable historian)
Height 5'4" (163 cm)
Weight 183.0 lb (83.2 kg)
BMI 31.3 kg/m² (Class I Obesity)
Allergies No known drug allergies (NKDA)
Occupation Retired office administrator
Chief Complaint (CC)
, Patient reports: "I've been having a really hard time catching my breath for the last two
days, and it's getting worse."
History of Present Illness (HPI) – OLD CARTS Format
Component Findings
Onset Shortness of breath began approximately 2 days ago; progressively
worsening since onset
Location Generalized chest/lung area; "difficulty getting enough air into my lungs"
Duration Constant for the past 2 days; worse with activity
Characteristics Described as "suffocating" feeling; tightness in chest; unable to "catch her
breath"
Aggravating Walking, climbing stairs, household chores, lying flat (orthopnea), cold air
Factors
Relieving Factors Sitting upright, resting, sleeping with pillows (currently using 2-3 pillows)
Timing Worse at night and early morning; one nighttime awakening "gasping for
air" (PND)
Severity 6/10 at rest; 8/10 with exertion; moderate to severe
Treatment Tried Rescue inhaler (Albuterol) – ineffective; rest and positioning
Associated Symptoms
Symptom Present? Details
Chest Pain/Pressure ✓ Mild exertional chest tightness; no acute
chest pain
Cough ✓ Persistent dry cough for 3-4 weeks; non-
productive
Wheezing ✓ Occasional wheezing reported
Orthopnea ✓ Requires 2-3 pillows to sleep comfortably
SHORTNESS OF BREATH NRNP 6541: Advanced
Practice Care of Adults Advanced DDx | Week [X] |
Complete Case Study Solution
CASE OVERVIEW
Parameter Details
Patient Name Margaret Wilson
Age 60 years
, Gender Female
Height 5'4" (163 cm)
Weight 183.0 lb (83.2 kg)
BMI 31.3 kg/m²
Reason for Encounter Shortness of breath
Setting Outpatient clinic with x-ray, ECG, and laboratory capabilities
Assignment Type Advanced DDx i-Human Case Play
Course NRNP 6541
Academic Year 2026/2027
Patient Identification
Parameter Details
Age 60 years
Gender Female
Setting Outpatient primary care clinic
Source of History Patient (reliable historian)
Height 5'4" (163 cm)
Weight 183.0 lb (83.2 kg)
BMI 31.3 kg/m² (Class I Obesity)
Allergies No known drug allergies (NKDA)
Occupation Retired office administrator
Chief Complaint (CC)
, Patient reports: "I've been having a really hard time catching my breath for the last two
days, and it's getting worse."
History of Present Illness (HPI) – OLD CARTS Format
Component Findings
Onset Shortness of breath began approximately 2 days ago; progressively
worsening since onset
Location Generalized chest/lung area; "difficulty getting enough air into my lungs"
Duration Constant for the past 2 days; worse with activity
Characteristics Described as "suffocating" feeling; tightness in chest; unable to "catch her
breath"
Aggravating Walking, climbing stairs, household chores, lying flat (orthopnea), cold air
Factors
Relieving Factors Sitting upright, resting, sleeping with pillows (currently using 2-3 pillows)
Timing Worse at night and early morning; one nighttime awakening "gasping for
air" (PND)
Severity 6/10 at rest; 8/10 with exertion; moderate to severe
Treatment Tried Rescue inhaler (Albuterol) – ineffective; rest and positioning
Associated Symptoms
Symptom Present? Details
Chest Pain/Pressure ✓ Mild exertional chest tightness; no acute
chest pain
Cough ✓ Persistent dry cough for 3-4 weeks; non-
productive
Wheezing ✓ Occasional wheezing reported
Orthopnea ✓ Requires 2-3 pillows to sleep comfortably
