Reference no: EM133562170
Case Study One
A 73-year-old Caucasian male with chronic obstructive pulmonary disease (COPD) presents to the clinic to see the Family Nurse Practitioner with an increase in his chronic cough, blood in his sputum, worsening shortness of breath, gradual weight loss of 15 pounds over the past 6 months, and right-sided pleuritic chest pain. He has noted an increase in left leg edema but attributes the edema to a recent fall. He has smoked one pack of cigarettes daily for the past 50 years. Previous pulmonary function tests demonstrated a decreased FEV1 and FEV1/FVC ratio. On physical exam, he is tachycardic, blood pressure 110/70 mm Hg, has a respiratory rate of 28 breaths/minute, has decreased breath sounds with dullness to percussion at the left lung base, and oxygen saturation is 85% on room air. He is widowed, with no children, and currently lives alone. His source of income is limited to his small social security check. He often goes to the neighborhood food bank for supplemental groceries.
Medications: Albuterol inhaler prn
Allergies: NKDA. Patient has environmental allergies to mold and cat dander
Answer questions based on Diagnosis of COPD exacerbation
Discuss components of a holistic clinical management plan for this patient, including diagnostic and screening tests with appropriate and relevant Current Procedural Terminology (CPT) codes; pharmacological and non-pharmacological interventions; complementary/alternative/integrative therapies; health promotion, health maintenance, and disease prevention; anticipatory guidance; patient and family education; prioritized referrals as applicable; follow-up; and health and community resources.
Support your plan with evidence-based clinical guidelines and standards of care. Consider the pharmacodynamics, pharmacogenetics, pharmacokinetics, and pharmacotherapeutics in selection of pharmacological agents.
Describe cultural, environmental, ethical, genetic/genomic, legal, political, psychosocial, socioeconomic, and spiritual factors considered in the clinical management of this patient. Discuss one age-appropriate primary, secondary, and tertiary prevention intervention for this patient based on the case history and presentation.