Case Study on Shortness of Breath solution

Case Study on Shortness of Breath

Order ID	53563633773
Type	Essay
Writer Level	Masters
Style	APA
Sources/References	4
Perfect Number of Pages to Order	5-10 Pages

Description/Paper Instructions

 

Vicky Jeffrey, who is 78 years old, was diagnosed with asthma when she was 15 years old. Despite using her inhalers, she has recently complained to her doctor about constant breathlessness. She usually uses a metered dosage inhaler (MDI) to provide Clenil® 100mcg 2 puffs BD and a spacer device to administer salbutamol as needed. (Clenil® is a brand name for the inhaled corticosteroid beclometasone dipropionate.) Mrs. Jeffrey’s GP has sent her to a specialist respiratory clinic for evaluation and treatment of her persistent shortness of breath. She has never smoked, but formerly worked in a pub and lived with a husband who was a heavy smoker and died of lung cancer, according to the patient referral. Mrs Jeffrey is finding it increasingly difficult to complete her regular household responsibilities, and she can only walk 60 meters on a flat surface outside.
To determine whether the patient’s symptoms vary during the day and if she has been trained to step up and down her inhaler during an acute asthma attack, a thorough history of the patient’s symptoms is required. It’s also important to figure out if the patient has a regular peak flow, as this will help determine how much therapy to increase or decrease.

Mrs Jeffrey’s symptoms do not change during the day, and she has no allergies. A history of allergies is significant since, in the majority of asthma patients, an allergic reaction can cause an asthma exacerbation. We know from the patient’s history that she never smoked but lived with a heavy smoker who used to work in a pub when smoking was not prohibited in public areas in the United Kingdom. According to the literature, nonsmokers can develop COPD as a result of passive smoking — the risk is highest with environmental tobacco exposure in numerous contexts such as the home and workplace (Hagstad et al. 2014).

There was no evidence of heart failure, hypertension, atrial fibrillation, DVT, pulmonary embolus, or previous cardiac surgery in his medical history. Other causes of breathlessness can be ruled out using this information.

Clenil 100mcg MDI 2 puffs BD, salbutamol 100mcg MDI as needed, simvastatin 20mg at night, and paracetamol 500mg as needed are all part of my drug history.

Investigations were taken out in the following areas:
• X-ray of the chest revealed bilateral hyperinflation
• PH 7.37, PCO2 4.8 kpa, PaO2 11 kpa, SaO2 99 percent, HCO3 23, BE -2
• CRP 3mg/l, Na+ 138mmol/l, K+ 4.2mmol/l, Hb 12.5g/dL, BNP 30pg/ml, WCC 7 x 109/l, INR 0.9, Troponin 10 blood test
• There is no discomfort in the chest.
• Pulse oximetry: SpO2 96 percent HR 85 beats per minute
• Spirometry – FEV1 was 40% anticipated, FEV1/FVC ratio was 45 percent, and the flow volume curve had the typical concave form.
• 4 MRC
Exacerbations occur 3–4 times per 12 months.

 

RUBRIC QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points:  Student failed to submit the final paper. 20 points out of 50:  The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50:  The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately.  Elements of the required response may also be lacking. 40 points out of 50:  The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples.  The answer is complete. 50 points:  The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples.  No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points:  Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points:  Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points:  References to scholarly sources are occasionally given; many statements seem unsubstantiated.  Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points:  Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented.  APA 6th Edition is used with only a few minor errors.  There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points:  Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented.  APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points:  Student failed to submit the final paper. 5 points out of 20:  The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors  10 points out 20:  The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20:  The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points:  The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points:  Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements.  The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper.
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