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Case Study
A 42-year-old man has been an inpatient for 7 days. He was admitted for a presumed COPD exacerbation. This is the patient's first hospital admission. He is a 46-pack-per-year smoker but has never been diagnosed with COPD. He is now stable and is ready for discharge.
As a COPD navigator, you have already instructed the patient extensively on tobacco cessation. Additionally, the patient has received flu and pneumonia vaccinations. You will be calling the patient after his discharge to ensure that he follows his discharge instructions and treatment regimen. You are attempting to anticipate the patient's medication and equipment needs.
Oxygen therapy for home use must meet specific criteria in order for insurance to cover the expense. Two of the criteria that must be met are for the patient to have at room air a resting Spo2 ≤ 88% or a resting Pao2 ≤ 55 mm Hg. His resting Spo2 on room air is 94%. Bedside spirometry has revealed a postbronchodilator FEV1/FVC ratio of < 0.65 and an FEV1 less than 70% of predicted value, indicating that he has moderate COPD. The consulting pulmonologist has designated him as GOLD group B.
Questions:
1. Assuming that the ordering physician abides by GOLD recommendations, what respiratory medications do you think will be prescribed?
2. What equipment needs should be communicated to the discharge planner?
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