Case Study on Shortness of Breath
Order ID: 89JHGSJE83839 Style: APA/MLA/Harvard/Chicago Pages: 5-10 Instructions:
Vicky Jeffrey, who is 78 years old, was diagnosed with asthma when she was 15 years old. Despite using her inhalers, she has recently complained to her doctor about constant breathlessness. She usually uses a metered dosage inhaler (MDI) to provide Clenil® 100mcg 2 puffs BD and a spacer device to administer salbutamol as needed. (Clenil® is a brand name for the inhaled corticosteroid beclometasone dipropionate.) Mrs. Jeffrey’s GP has sent her to a specialist respiratory clinic for evaluation and treatment of her persistent shortness of breath. She has never smoked, but formerly worked in a pub and lived with a husband who was a heavy smoker and died of lung cancer, according to the patient referral. Mrs Jeffrey is finding it increasingly difficult to complete her regular household responsibilities, and she can only walk 60 meters on a flat surface outside.
To determine whether the patient’s symptoms vary during the day and if she has been trained to step up and down her inhaler during an acute asthma attack, a thorough history of the patient’s symptoms is required. It’s also important to figure out if the patient has a regular peak flow, as this will help determine how much therapy to increase or decrease.Mrs Jeffrey’s symptoms do not change during the day, and she has no allergies. A history of allergies is significant since, in the majority of asthma patients, an allergic reaction can cause an asthma exacerbation. We know from the patient’s history that she never smoked but lived with a heavy smoker who used to work in a pub when smoking was not prohibited in public areas in the United Kingdom. According to the literature, nonsmokers can develop COPD as a result of passive smoking the risk is highest with environmental tobacco exposure in numerous contexts such as the home and workplace (Hagstad et al. 2014).
There was no evidence of heart failure, hypertension, atrial fibrillation, DVT, pulmonary embolus, or previous cardiac surgery in his medical history. Other causes of breathlessness can be ruled out using this information.
Clenil 100mcg MDI 2 puffs BD, salbutamol 100mcg MDI as needed, simvastatin 20mg at night, and paracetamol 500mg as needed are all part of my drug history.
Investigations were taken out in the following areas:
X-ray of the chest revealed bilateral hyperinflation
PH 7.37, PCO2 4.8 kpa, PaO2 11 kpa, SaO2 99 percent, HCO3 23, BE -2
CRP 3mg/l, Na+ 138mmol/l, K+ 4.2mmol/l, Hb 12.5g/dL, BNP 30pg/ml, WCC 7 x 109/l, INR 0.9, Troponin 10 blood test
There is no discomfort in the chest.
Pulse oximetry: SpO2 96 percent HR 85 beats per minute
Spirometry – FEV1 was 40% anticipated, FEV1/FVC ratio was 45 percent, and the flow volume curve had the typical concave form.
4 MRC
Exacerbations occur 34 times per 12 months.
RUBRIC
Excellent Quality
95-100%
Introduction 45-41 points
The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.
Literature Support
91-84 points
The background and significance of the problem and a clear statement of the research purpose is provided. The search history is mentioned.
Methodology
58-53 points
Content is well-organized with headings for each slide and bulleted lists to group related material as needed. Use of font, color, graphics, effects, etc. to enhance readability and presentation content is excellent. Length requirements of 10 slides/pages or less is met.
Average Score
50-85%
40-38 points
More depth/detail for the background and significance is needed, or the research detail is not clear. No search history information is provided.
83-76 points
Review of relevant theoretical literature is evident, but there is little integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are included. Summary of information presented is included. Conclusion may not contain a biblical integration.
52-49 points
Content is somewhat organized, but no structure is apparent. The use of font, color, graphics, effects, etc. is occasionally detracting to the presentation content. Length requirements may not be met.
Poor Quality
0-45%
37-1 points
The background and/or significance are missing. No search history information is provided.
75-1 points
Review of relevant theoretical literature is evident, but there is no integration of studies into concepts related to problem. Review is partially focused and organized. Supporting and opposing research are not included in the summary of information presented. Conclusion does not contain a biblical integration.
48-1 points
There is no clear or logical organizational structure. No logical sequence is apparent. The use of font, color, graphics, effects etc. is often detracting to the presentation content. Length requirements may not be met
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