2. Chapter 6: COPD
Question 1
The patient should be asked if she is currently smoking, is around someone that is smoking or has a closely-related person (a parent in particular) that does. The patient should be asked if she or anyone in her family has a history of heart issues (due to the ankle swelling combined with the shortness of breath). Should be asked if there have been any notable changes in weight in either direction and whether there is any sputum or other symptoms (Brasher, 2012).
Question 2
The patient should be asked how long she smoked and whether anyone smoked in her presence, especially family. Ask her if smoking improved her condition or if it made no difference (or got worse). The variation and quantity of the sputum should also be asked about. Whether there was any blood or other coloration would be relevant. Would also be a good idea to question whether occupational exposure occurred and the family history of pulmonary issues (heart issues were already addressed)
Question 3
The patient could have a pulmonary disorder like COPD but it could also be heart-related. Both should be checked out thoroughly as both could be quite deadly. At this point, it seems to be a pulmonary issue (Brasher, 2012).
Question 4
The yellowed teeth are not a good sign. If the patient quit smoking five years ago, it is odd for her to still have yellowed teeth unless she's made no attempt to clean up the teeth after she stopped. The barrel chest is also a negative. Her pursing of her lips when she breathes is not a good sign and neither is the distention. Her dyspnea when climbing the table was also a bad sign. The dyspnea along with the accessory muscle use would indicate COPD or something along those lines. Having a shortness of breath when just climbing a table is a sign of strong lack of breathing function, whatever the reason for it may be. Plus signs include the fact that she has no cyanosis or clubbing and that she's alert. She has no rashes or masses and her strength seems to be good overall (Brasher, 2012).
Question 5
Testing of the sputum contents should be done to confirm no presence of PMN's or bacterial cells....
The patient should drink less, participate in more physical activity and should eat a better diet. The blood pressure and cholesterol both need to come down immediately. Question 6 The patient needs to take the recommendations in question 5 or he likely has a very dim future if his BP and cholesterol is not lowered a lot. Blood pressure should be measured after the patient has rested for at least five
There is also aneed to discontinue all the nephrotoxic drugs as well as the elimination of exposure to any form of nephrotoxins. All forms of electrolyte abnormalities must be properly corrected.Uric acid and pigments can be treated using alkaline dieresis. Alcohol drip and fomepizole should be used for treating methanol or ethyl glycol poisoning. Postrenal acute renal failure is caused by the obstruction of the urinary collection system which is
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