With the similarity of presenting signs and symptoms, COPD and asthma are subject to be misdiagnosed (Cranston et al., 2008). In this paper, two cases will be discussed separately including the full medical history, laboratory and diagnostic procedure, treatment and care plan in each case…
With the similarity of presenting signs and symptoms, COPD and asthma are subject to be misdiagnosed (Cranston et al., 2008). In this paper, two cases will be discussed separately including the full medical history, laboratory and diagnostic procedure, treatment and care plan in each case. Although these patients showed similar signs and symptoms, the results of diagnostic work- up, especially that related directly to the respiratory status such as Spirometry, bronchodilator test, and chest x- ray revealed that they have different diseases. Case No. 1: Patient with Asthma Chief Complaint Shortness of breath History of Present Illness J.G., 46, male, comes to the health clinic having shortness of breath after doing his normal routine of workout at a fitness gym. He admits having these episodes of SOB after four weeks of having chest cold, but refused to seek medical care. He is also having a non- productive cough. Lately, he had been into “so much stress from work”. Rest and relaxation technique usually alleviates his symptom. Past Medical History Patient claims to and healthy person, although he admits that he had mild asthmatic attacks until he was a teenager. He was never admitted of any disease and has never been surgically operated Family History His mother died from status asthmaticus at 65, while his father died of complications from diabetes at 62. He is the only child in the family. He had not known much about his relatives. Genogram Personal Social History Patient claims to be a very active person. ...
No allergies reported. He denies any pain felt, but says “uncomfortable” with persistent cough and SOB. No changes were noted in his usual bowel and bladder habits. General. Patient is physically fit and has an athletic body. He is anxious for both of his work and health. Vital Signs. T- 36.5 C, RR- 34 cpm (labored breathing), PR- 113 bpm (weak and fast), BP- 126/ 87 mmHg Height/Weight . 5’7”, 72 kg, BMI= 25 Neurologic. Patient is conscious, coherent, oriented to time, person, and place. He has not experienced any changes in his level of consciousness, orientation, and level of functioning, thinking, cognition, and intellect. Eyes, ears, nose, throat. Patient wears his eyeglasses. His conjunctiva appears moist and pink, unicteric. Ears are clean, with minimal amount of cerumen noted upon direct inspection. No mastoid inflammation noted. No hearing difficulties reported. Nose is central and symmetrical. No discharges noted. Nasal flaring was observed in each breathing cycle. Throat is moist even if the patient breaths through his mouth to assist in breathing difficulty. Throat is not deviated to either side. Cardiovascular. No murmurs, rubs, and splits heard upon auscultation of the heart. Upon auscultation of the lower left sternal border, the first heart sound (S1) heard was soft, long, and low pitched. The second heart sound (S2) was shorter and high- pitched. No pulse deficit noted between the heart rate and radial pulse rate. No cyanosis noted. Respiratory. Breathing pattern is notably longer, irregular, and labored. He is unable to complete a sentence with just a few words between breaths. Use of accessory muscles of breathing is noted. Muscular retractions in the sternum, suprasternal ...
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