NR507 Week3 Case Study: A.C., Is a61-year old male
with complaints of shortness of breath
Chief Complaint
A.C., is a 61-year old male with complaints
... [Show More] 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.
Pathophysiology & Clinical Findings of the Disease
1. Are the spirometry results consistent with obstructive or restrictive pulmonary
disease? What is the most likely pulmonary diagnosis for this patient?
The spirometry results are consistent with obstructive pulmonary disease since
the patients forced expiratory volume in 1 second (FEV1) is decreased as seen
in obstructive pulmonary disease, the normal range is >80%. Also the patient’s
FEV1/FVC ratio is less than 70% at a pre-bronchodilator prediction of 69% and a
post-bronchodilator prediction of 64%. The TLC is 125 and the qualifications for
Obstructive pulmonary disease has a TLC range that is considered normal at
>120% (Van Dijk, W., Tan, W., Li, P., Guo, B., Li, S., Benedetti, A., & Bourbeau,
J., 2015). The most likely pulmonary diagnosis for this patient is chronic
obstructive pulmonary disease.
2. Explain the pathophysiology associated with the chosen pulmonary disease.
Individuals who are diagnosed with chronic obstructive pulmonary disease
experience the symptom of shortness of breath because they have difficulty
exhaling all the air from their lungs. This is caused by the airway narrowing inside
of their lungs due to damage to their lungs, therefore exhaled air is more slowly
expelled. After fully exhaling, the individual will still have an abnormally higher
amount of air left lingering in their lungs (Asp, K. C., 2020). COPD is a mixture of
small airway diseases like obstructive bronchiolitis and emphysema and may
differ between patients depending on their history, risk factors and exposure to
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Week 3 Case Study Template
pollutants. Chronic inflammation causes structural changes which narrow the
airways causing limitation to airflow and mucociliary dysfunction (Global Initiative
for Chronic Obstructive Lung Disease, 2018).
3. Identify at least three subjective findings from the case [Show Less]