This week discussion is about a 65-year-old male with chronic obstructive pulmonary disease. He is seen in a medical facility related to symptoms of fever and a cough lasting for 2 weeks. The patient denies chest pain and night sweats. With his age, I would ask the patient does he have any other chronic conditions. If so, what medications is he currently prescribed. With COPD, it is the third leading cause of death in the United States. Tobacco smoke is a key factor in the development and progression of COPD; with exposure to air pollutants in the home and workplace, genetic factors, and respiratory infections also play a major role (CDC, 2019).
The objective findings I would assess is the patient’s lungs sounds which would display wheezing, a productive cough and shortness of breath with movement. Some may experience fatigue, edema to bilateral lower extremities, chest tightening and loss of appetite due to inability to breath. Increased respiratory rate will be observed with a decreased oxygen saturation level.
The diagnostic test used to diagnose COPD is a Lung (pulmonary) function tests. These tests measure the amount of air you can inhale and exhale, and whether your lungs deliver enough oxygen to your blood. During the most common test, called spirometry, you blow into a large tube connected to a small machine to measure how much air your lungs can hold and how fast you can blow the air out of your lungs. Other tests include measurement of lung volumes and diffusing capacity, six-minute walk test, and pulse oximetry. A chest X-ray can show emphysema, one of the main causes of COPD.
An X-ray can also rule out other lung problems or heart failure. A CT scan of your lungs can help detect emphysema and help determine if you might benefit from surgery for COPD. CT scans can also be used to screen for lung cancer. Arterial blood gas analysis measures how well your lungs are bringing oxygen into your blood and removing carbon dioxide (CDC, 2019). There are many chronic conditions that can affect the airway that has similar symptoms such as Upper Respiratory infections.
URI is a common viral infection that affects the nose, throat, and airways. The symptoms may include fever, fatigue, cough, headache and difficulty breathing. Adult onset-Asthma is a condition in which your airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing and Shortness of breath. This condition will not occur until you are an adult. Symptoms include Coughing, especially at night, during exercise or when laughing, Difficulty breathing, Chest tightness, Shortness of breath and Wheezing.
Moreover, another chronic condition that can have similar symptoms is pneumonia. Pneumonia is an infection that inflames the air sacs in one or both lungs. The symptoms an individual may experience with pneumonia are fever, a dry cough, headache, muscle pain, and weakness. The symptoms typically get worse within one or 2 days, with increasing cough, shortness of breath and muscle pain (Jarvis, 2016). A chest X-ray will be used to diagnose this disorder and based on your lab test, antibiotic therapy will be initiated.
Centers for Disease Control and Prevention. National Vital Statistics System detailed mortality data at Wonder Database website. http://wonder.cdc.gov. Accessed July 3, 2019.
Jarvis, C. (2016). Physical Examination & Health Assessment (7th ed.). St. Louis, Missouri: Elsevier. ISBN: 9781455728107