Chronic Obstructive Pulmonary Assignment Help: How to Answer This Question
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Key Explanation
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Original Question
Chronic Obstructive Pulmonary Disease Recognize Cues Review the electronic health record and answer the question that follows. Progress Notes Date/Time ​ Provider Progress Notes ​ 11/22/20XX ​ 0845 ​ Chief Complaint: headache, dizziness, dyspnea with cough ​ History of Present Illness: Nae Iglesias (pronouns she/her/hers) is a 72-year-old female who presents with complaints of headache, dizziness, dyspnea, and a productive cough. Diagnosed with sinusitis 3 days ago. Vaccinations are not up to date. Nae lives with her daughter and reports increased confusion over the last 24 hours. Medications: Multivitamin, metoprolol, atorvastatin, calcium carbonate, salmeterol/fluticasone meter-dose inhaler (MDI), albuterol nebulizer PRN. Continuous oxygen 2-4L NC at home PRN, decongestant PRN for nasal congestion Past Medical History: COPD, hypertension (HTN), osteoporosis, hypercholesteremia, Type 2 Diabetes Mellitus ​ Review of Systems: ​ General: Clean, well-groomed appearance ​ Neurological: Alert and oriented to person only, confused ​ Cardiovascular: Tachycardic. S1 and S2 are present, and the capillary refill is less than 3 seconds. ​ Respiratory: Respirations shallow and rapid at rest; inspiratory crackles ​ Gastrointestinal: Reports regular, daily bowel movements. Denies abdominal pain ​ Genitourinary: Denies any GI symptoms ​ Musculoskeletal: Denies any pain. Ambulates unassisted. ​ Integumentary: Bluish tint to lips and fingers, skin warm and dry. ​ Allergies: None reported ​ Social History: Retired; lives with daughter; previous 2-pack per day smoker of cigarettes; quit 3 years ago. Daughter smokes in the home. ​ Family History: No significant family history was reported ​ Vital Signs: Temperature: 101.4 °F (38.6 °C); Heart rate: 102 bpm; Respiratory rate: 32 breaths per minute; Blood pressure: 136/84 mmHg; Pulse oximetry: 86% on 2LNC Based on clinical manifestations, the nurse practitioner (NP) suspects the client is experiencing ventilation/perfusion mismatchautoimmunityanaphylaxis due to chronic obstructive pulmonary diseasesinusitisacute respiratory failure.
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