Case Discussion Pulmonary – Part 2 Follow up Visit
The purpose of this assignment is for students to:
1. Improve their ability to formulate diagnoses based on clinical presentation of patients
2. Improve their ability to understand and apply National Guidelines for the diagnosis and treatment of Pulmonary disorders
3. Design a relevant treatment plan
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
1. Utilize healthcare delivery system resources in a fiscally responsible manner in the diagnosis and treatment of patients and families across the lifespan. (PO 5)
2. Develop management plans based on current scientific evidence and national guidelines. (PO 5)
3. Educate patients on treatment decisions (WO1)
4. Select an evidence-based article to support the plan of care for the case study patient. (WO2)
5. Analyze national guidelines and apply them to specific case study situations. (WO3)
6. Review appropriate antibiotic prescribing guidelines. (WO4)
Michelle continues to work in the bakery and her asthma has been well controlled on a low-dose inhaled corticosteroid inhaler, Singular 10mg daily, and Albuterol prn which she uses 1-2 times per week. Michelle presents to the clinic with an acute illness that developed 2 days ago and has a respiratory rate of 24, mild SOB with exertion, O2 saturation of 94%, and complaint of inspiratory and expiratory wheezing. She is able to speak and states her temperature over the last 2 days has been 101 to 102 F.
Cough is productive of white sputum. Influenza A is going around the bakery. Exam findings show a woman who appears her stated age and is alert and oriented and though calm, is having mild work of breathing. AR 110 BPM, BP is 150/85, RR: 24, Temp 101.4. She has a nonproductive, dry cough, is mildly short of breath, fair chest expansion, + inspiratory/expiratory wheezes, no rales, no rhonchi. Auscultation reveals no thrills, gallops or extra heart sounds. Apical rate is elevated at 110. Physical exam is otherwise unremarkable. The MA has swabbed her for Influenza A- test is positive.
Discussion Questions Part Two:
1. Determine appropriate treatment plan for Michelle. Discuss medications, doses, Durable Medical Equipment, and any testing, and apply these directly to her case. Provide your rationale with evidence.
2. Decide whether she is safe to return home, include any prescriptions, or if a referral to a higher level of care is required. Discuss the criteria used to make your decision, how a referral is made and defend your position.
3. Discuss relevant education and follow up plan