What findings would you expect to be reported

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Reference no: EM133999976

Assignment

Case Study: A 68-year-old With Tachycardia and Coughing

Ms. Baker is a 68-year-old female who is brought to your office today by her daughter Rebecca. Ms. Baker lives with her daughter and is able to perform all activities of daily living (ADLs) independently. Her daughter reports that her mother's heart rate has been quite elevated at home occasionally, sometimes 110 beats per minute. She has also been coughing a lot over the last 2 days. Ms. Baker has a 30-pack per year history of smoking cigarettes but quit smoking 3 years ago. Other known history includes chronic obstructive pulmonary disease (COPD), hypertension, vitamin D deficiency, and hyperlipidemia. She also reports some complaints of intermittent pain/cramping in her bilateral lower extremities when walking and has to stop walking at times for the pain to subside. She also reports some pain to the left side of her back, and some pain with aspiration.

Ms. Baker reports she has been coughing a lot lately, and notices some thick, brown-tinged sputum. She states she has COPD and has been using her albuterol inhaler more than usual. She says it helps her "get the cold up." Her legs feel tired but denies any worsening shortness of breath. She admits that she has some weakness and fatigue but is still able to carry out her daily routine.

Vital Signs: Temp 99.2, BP 126/78, Pulse 90, RR 22, 02 Sat 98%
Labs: Complete Metabolic Panel and CBC done and were within normal limits

CMP Component	Value	CBC Component	Value
Glucose, Serum	86 mg/dL	White blood cell count	5.0 x 10E3/uL
BUN	17 mg/dL	RBC	4.71 x10E6/uL
Creatinine, Serum	0.63 mg/dL	Hemoglobin	10.9 g/dL
EGFR	120 mL/min	Hematocrit	36.4%
Sodium, Serum	141 mmol/L	Mean Corpuscular Volume	79 fL
Potassium, Serum	4.0 mmol/L	Mean Corpus HgB	28.9 pg
Chloride, Serum	100 mmol/L	Mean Corpus HgB Conc	32.5 g/dL
Carbon Dioxide	26 mmol/L	RBC Distribution Width	12.3%
Calcium	8.7 mg/dL	Platelet Count	178 x 10E3/uL
Protein, Total, Serum	6.0 g/dL
Albumin	4.8 g/dL
Globulin	2.4 g/dL
Bilirubin	1.0 mg/dL
AST	17 IU/L
ALT	15 IU/L

Allergies: Penicillin

Current Medications:

1. Atorvastatin 40mg p.o. daily
2. Multivitamin 1 tablet p.o. daily
3. Losartan 50mg p.o. daily
4. Albuterol inhaled 90mcg 2 puffs q4-6 hrs. prn
5. Caltrate 600mg+ D3 1 tablet p.o. daily

Diagnosis: Pneumonia

Question I: What findings would you expect to be reported or seen on her chest x-ray results, given the diagnosis of pneumonia?

Question II: Define further what type of pneumonia Ms. Baker has, HAP (hospital-acquired pneumonia) or CAP (community-acquired pneumonia)? What's the difference/criteria?

Question III:

i. What assessment tool should be used to determine the severity of pneumonia and treatment options?

ii. Based on Ms. Baker's subjective and objective findings, apply that tool and elaborate on each clinical factor for this patient.

Question IV: Ms. Baker was diagnosed with left lower lobe pneumonia. What would your treatment be for her based on her diagnosis, case scenario, and evidence-based guidelines? Get the instant assignment help.

Question V: Ms. Baker has a known history of COPD. What is the gold standard for measuring airflow limitation?

Question VI: Ms. Baker mentions intermittent pain in her bilateral legs when walking and having to rest to stop the leg pain/cramps. Which choice below would be the best choice for a potential diagnosis for this? Explain your reasoning.

i. DVT (Deep Vein Thrombosis)
ii. Intermittent Claudication
iii. Cellulitis
iv. Electrolyte Imbalance

Question VII: Ms. Baker mentions intermittent pain in her bilateral legs when walking and having to rest to stop the leg pain. What test could be ordered to further evaluate this?

Question VIII: Name three differentials for Ms. Baker's initial presentation.

Question IX: What patient education would you give Ms. Baker and her daughter? What would be your follow-up instructions?

Question X: Would amoxicillin/clavulanate plus a macrolide have been an option to treat Ms. Baker's Pneumonia? Explain why or why not.

Reference no: EM133999976

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