\u2022\tReflect on the patient\u2019s symptoms and aspects of disorders that may be present.
\n\u2022\tConsider how you might assess, perform diagnostic tests, and recommend medications to treat patients presenting with the symptoms in the case study.
\nThe Assignment:
\nAfter reviewing the case and the accompanying case analysis questions, included in the document, answer the 10 questions directly in the Case Assignment document. When providing evidence to support your answers, be sure they evidenced-based, current (no more than 5 years old), and follow current standards of care. Follow APA 7th edition formatting. 5 citations<\/p>\n
NRNP 6540 Week 5 Case Assignment
\nCase Title: A 67-year-old With Tachycardia and Coughing
\nMs. Jones is a 67-year-old female who is brought to your office today by her daughter Susan. Ms. Jones lives with her daughter and is able to perform all activities of daily living (ADLs) independently. Her daughter reports that her mother\u2019s heart rate has been quite elevated, and she has been coughing a lot over the last 2 days. Ms. Jones 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.
\nMs. Jones 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 \u201cget the cold up.\u201d 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. She also reports some symptoms of intermittent discomfort and cramping in both of her lower limbs when walking, and she has to stop walking at times in order for the pain to lessen. She believes that this may be related to her condition. She also reports experiencing some pain on the left side of her back, as well as some pain when she is aspirating.
\nMs. Jones says that she has been coughing a lot recently, and she observes some sputum that is thick and has a brownish tint to it. She claims that she suffers from COPD and that she has been making more frequent use of her albuterol inhaler than usual. She claims that it makes it easier for her to “get the cold up.” She says that her legs are fatigued, but she denies that her shortness of breath is getting worse. She acknowledges that she is experiencing some weakness and exhaustion but asserts that she is still able to carry out her day-to-day activities.
\nVital Signs: 99.2, 126\/78, 96, RR 22
\nLabs: Complete Metabolic Panel and CBC done and were within normal limits
\nCMP Component\tValue\tCBC Component \tValue
\nGlucose, Serum\t86 mg\/dL\tWhite blood cell count\t5.0 x 10E3\/uL
\nBUN\t17 mg\/dL\tRBC\t4.71 x10E6\/uL
\nCreatinine, Serum\t0.63 mg\/dL\tHemoglobin\t10.9 g\/dL
\nEGFR\t120 mL\/min\tHematocrit\t36.4%
\nSodium, Serum\t141 mmol\/L\tMean Corpuscular Volume\t79 fL
\nPotassium, Serum\t4.0 mmol\/L\tMean Corpus HgB\t28.9 pg
\nChloride, Serum\t100 mmol\/L\tMean Corpus HgB Conc\t32.5 g\/dL
\nCarbon Dioxide\t26 mmol\/L\tRBC Distribution Width\t12.3%
\nCalcium\t8.7 mg\/dL\tPlatelet Count\t178 x 10E3\/uL
\nProtein, Total, Serum\t6.0 g\/dL
\nAlbumin\t4.8 g\/dL
\nGlobulin\t2.4 g\/dL
\nBilirubin\t1.0 mg\/dL
\nAST\t17 IU\/L
\nALT\t15 IU\/L<\/p>\n
Allergies: Penicillin
\nCurrent Medications:
\n\u2022\tAtorvastatin 40mg p.o. daily
\n\u2022\tMultivitamin 1 tablet daily
\n\u2022\tLosartan 50mg p.o. daily
\n\u2022\tProAir HFA 90mcg 2 puffs q4\u20136 hrs. prn
\n\u2022\tCaltrate 600mg+ D3 1 tablet daily
\nDiagnosis: Pneumonia<\/p>\n
Directions: Answer the following 10 questions directly on this template.
\nQuestion 1: What findings would you expect to be reported or seen on her chest x-ray results, given the diagnosis of pneumonia?
\nQuestion 2: Define further what type of pneumonia Ms. Jones has, HAP (hospital-acquired pneumonia) or CAP (community-acquired pneumonia)? What\u2019s the difference\/criteria?
\nQuestion 3:
\n\u2022\t3A) What assessment tool should be used to determine the severity of pneumonia and treatment options?
\n\u2022\t3B) Based on Ms. Jones\u2019 subjective and objective findings, apply that tool and elaborate on each clinical factor for this patient.
\nQuestion 4: Ms. Jones was diagnosed with left lower lobe pneumonia. What would your treatment be for her based on her diagnosis, case scenario, and evidence-based guidelines?
\nQuestion 5: Ms. Jones has a known history of COPD. What is the gold standard for measuring airflow limitation?
\nQuestion 6: Ms. Jones 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.
\na.\tDVT (Deep Vein Thrombosis)
\nb.\tIntermittent Claudication
\nc.\tCellulitis
\nd.\tElectrolyte Imbalance
\nQuestion 7: Ms. Jones 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?
\nQuestion 8: Name three (3) differentials for Ms. Jones\u2019 initial presentation.
\nQuestion 9: What patient education would you give Ms. Jones and her daughter? What would be your follow-up instructions?
\nQuestion 10: Would amoxicillin\/clavulanate plus a macrolide have been an option to treat Ms. Jones\u2019 Pneumonia? Explain why or why not.<\/p>\n","protected":false},"excerpt":{"rendered":"
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