WestCoast NURS663A Week 5 Discussion Latest 2021 July
NURS663A Primary Care Adult and Geriatric Patient Theory
Week 5 Discussion
Select one of the following case studies to address. In the subject line of your post, please identify which prompt you are responding to, for example, #2 Carl, type 2 diabetes.
Discuss what questions you would ask the patient, what physical exam elements you would include, what further testing you would want to have performed, differential and working diagnosis, treatment plan, including inclusion of complementary and OTC therapy, referrals and other team members needed to complete patient care.
In your peer replies, please reply to at least one peer who chose a different case study.
Case Studies
1. Mason is a 55-year-old homeless man, who you are seeing today for the first time. He is a smoker and states that he has frequent colds and a routine morning cough. He used to be short of breath just walking up hills, but states that he now has difficulty breathing with everyday activities and is having trouble trying to find food because he cannot walk very far. He just wants medicine to help him survive on the streets. On examination, you find him using his accessory muscles to breath. His vital signs are 99°, 100 beats per minute, 28 respirations/min., blood pressure 140/90. Breath sounds are distant with end expiratory wheezes. He has a slight barrel chest and neck vein distention.
2. Debra, a 56-year-old female, comes to the clinic complaining of a cold she has had for several weeks that just will not go away. She states she has a dry hacking cough, muscle aches, and a headache. While it is very hot outside, she is shivering with a sweater on. She has tried many over-the-counter medications with no effect. She looks ill and is very fatigued. On chest auscultation, she has some inspiratory crackles and diminished breath sounds. You note some dullness on percussion over her left lower lobe. Her temperature is 100.5°.
3. Calvin is a 36-year-old lawyer who is coming in today for worsening cough over the past four days. He has had some yellow sputum sporadically throughout the day; he says he has felt hot but has not taken his temperature. He has a history of asthma and has been using his Proventil inhaler every 2 to 3 hours for the past 3 to 4 days. He has no other medication. He says that other than the cough, he feels a little fatigued, and he notices that his energy level is less when he plays hockey with his men’s league twice a week. His SaO2 is 96% HR 102, BP 144/82. He has bilateral wheezes posteriorly on inspiration, worse at the base.
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