This condition occurs because of airflow limitation when the bronchial tree and air sacs lose their elasticity and cannot promote appropriate breathing (Reuben et al., 2015). It may include emphysema and chronic bronchitis (Touhy & Jett, 2012). This diagnosis is appropriate for the case of S.F. regarding his past medical history, smoking experience, and complaints of increased dyspnea on exertion, yellow-green sputum, frequent coughing, fever, and chill. A cough may be explained by irritation of the upper and lower airways (Seller & Symons, 2012) or by the inability to use his inhaler on a regular basis because of its current disappearance. The patient was diagnosed with COPD before, and the absence of the inhaler may be the reason why this disease starts bothering the man again.
Plan for Chronic Obstructive Pulmonary Disease
Rx: Prednisolone 5mg and Fluticasone as an inhaler twice daily Dips: #28, Refill: not necessary.
It is expected the patient takes the prescribed medicines for one month, observes the changes that may take place, and reports on them to the doctor. Still, as the patient has no evident allergies and good vaccination history and regarding the fact that the man feels like he is getting better, the prescription should be effective in this situation.
Additional Diagnostic Tests
It is important to understand the reasons for the sputum and a temporary fever of the patient. Besides, the patient has a long smoking history and earlier diagnoses of COPD (Kane, Ouslander, Abrass, & Resnick, 2013). Therefore, it is recommended to take several tests. First, a pulmonary function test should be used during which a person blows into a tube to calculate how much air is in the lungs of a person. The advantageous point of this test is that even if the doctor thinks that the symptoms are not enough to state COPD as the main disease, this test should help to identify its possible progression. Second, a chest X-ray should be taken to clarify if there are some problems with the lungs or even the heart. As emphysema may be one of the possible outcomes of COPD, it is possible to take CT scan. This test also helps to identify if the patient may have cancer predisposition. Finally, arterial blood gas analysis is used to identify how the patient’s lungs work and complete their function in bringing oxygen to the blood.
The patient should be instructed about the threats of smoking and its possible consequences on a human organism. Besides, he is suggested spending more time on fresh air and paying more attention to the usage of products that are full of vitamin C. To decrease the heart load, it is possible to try some diets with the help of which more vitamins can be delivered to the organism. The last point that has to be explained to the patient is the possibility of inconvenience. The fact is that not many people are able to unite COPD and incontinence (Green, 2012). However, lack of air in lungs (the outcome of COPD) may lead to this problem, and patients should know about it.
The patient is suggested to consult a cardiologist and a pulmonologist.
The next visit is planned within two weeks to evaluate the quality of a cough and the possibility to breathe freely. The doctor should investigate the effectiveness of the prescribed medicines. In case another case of difficulties with breathing takes place, the patient should address the hospital immediately.
Green, D. (2012). Encouraging independence in continence management. Nursing & Residential Care, 14(6): 272.
Kane, R., Ouslander, J., Abrass, I., & Resnick, B. (2013). Essentials of clinical geriatrics. China: McGraw Hill.
Reuben, D. B., Herr, K. A., Pacala, J. T., Pollock, B. G., Potter, J. F., & Semla, T. P. (2015). Geriatrics at your fingertips. New York, NY: The American Geriatrics Society.
Seller, R. H. & Symons, A. (2012). Differential diagnosis of common complaints. Philadelphia, PA: Saunders.
Touhy, T. & Jett, K. (2012). Ebersole and Hess’ toward healthy aging: Human needs and nursing response. St. Louis, MO: Elsevier.