NR 603 Week 3 iHuman Case - Joseph camella 66 years, Dyspnea
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| Institution | Chamberlain |
| Contributor | Hartnett Kara |
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Physical exam:
- Auscultate lungs- expiratory wheeze bilaterally, possible crackles heard but only able to choose one answer
- Inspect mouth and pharynx
- Look up nostrils
- Visual inspection anterior/posterior chest ( did palpate and percuss also)
- Auscultation heart sounds- mitral valve regurgitation
- Visual inspection of extremities
- Palpate extremities
- Capillary refill ?
- BP - 144/92, normal pulse pressure, hypertensive ( the video at the end has his vitals as follows : BP- 145/90 RR20 HR 96 sa02 95%) Ed
- Eyelid ice pack test
- Inspect-????
- Fundoscopic exam
KEY FINDINGS:
- Dyspnea MSAP
- Cough
- BLE Edema +2
- Bilateral Expiratory Wheezing
- White sputum production
- Cobblestoning oropharynx
- Asbestos exposure
- Smoking history 40 years one pack a day
- Sleep apnea
- Fatigue
- Elevated BP
- Use of accessory muscles
- Hx of HTN and DM controlled
Lead diagnosis: COPD Differential Diagnoses:
- Emphysema
- Chronic Bronchitis
- Anemia
- Pneumonia - community acquired
- Heart failure
- Asbestosis
- Lung cancer
- Mitral regurgitation?( I would not put that one, I can not find any resources that states it as a differential)
- Bronchiectasis? ( I agree)
- Pulmonary embolism?
- Asthma ? ( i agree)
- Tuberculosis
- Pulmonary HTN
- Myasthenia gravis
- Lou Gehrig disease?
……….. Continue
| Instituition / Term | |
| Term | Nursing |
| Institution | Chamberlain |
| Contributor | Hartnett Kara |
