The patient is a 68 year old man who has had shortness of breath for the past 2 to 3 days. His past medical history includes a 40 year of smoking a pack as day – history, COPD, and heart failure. He reports that he became concerned when he woke from sleep because he could not breathe. Your physical assessment reveals crackles in the lower lobes bilaterally. His oxygen saturation is 84% without supplement oxygen. What are some areas of focus to assess as part of this patient’s current history? Whom should you contact and why? What are some factors that may affect gas exchange for this patient? What additional referrals might be appropriate for this patient?
Areas to be focused on assessment :
The patient is having crackles in the lower lobe bilaterally it is the indication of heart failure. So assessment includes :
To whom should contact and ehy:
Should contact with pulmonologist and cardiologist. Because patient is having COPD and crackles in the lower lobe. Crackles mostly associated with heart failure. Decrease oxygen levels in the blood leads to extra stress to heart and to fluids get collected in the lungs from the heart. Will cause pulmonary edema and fluid in the alveoli. So both pulmology and cardiology consultation are mandatory.
Factors may affect gas exchange :
Exercise :exercise will improve gas exchange For example breathing and spirometry exercises
Additional referrals :
The patient is a 68 year old man who has had shortness of breath for the...
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