Gretchen, a 65-year-old female, came into the clinic for follow-up care related
ID: 127299 • Letter: G
Question
Gretchen, a 65-year-old female, came into the clinic for follow-up care related to her chronic bronchitis. She has had bronchitis for several years and had an acute episode of respiratory distress 2 months ago. Treatment for the acute respiratory symptoms included the corticosteroid prednisone. She was initially given a high dose of prednisone, but was able to tolerate a reduced dose of 10 mg per day since that time. A review of Gretchen’s medical history revealed that she smokes one pack of cigarettes per day, a habit that she has had for 50 years. She indicated that she was healthy and didn’t see the need for any other medications. She stated that her diet was good, although she had difficulty digesting dairy products and therefore avoided them. She recently was experiencing low back pain, but otherwise has no complaints. Physical examination showed that Gretchen’s BMI was 17, her weight reduced by 5 pounds since her last visit. Her height was 0.5 in. less than the previous visit 6 weeks prior. Her posture appeared to be stooped and she had difficulty standing up straight. A DEXA scan indicated a T score of –2.5, compared to her score of –2.0 twelve months before. An X-ray indicated the presence of a vertebral fracture at L3.
1. What is the pathophysiology associated with Gretchen’s clinical presentation?
2. What are the risk factors associated with the condition?
3. What are the clinical manifestations that Gretchen demonstrates?
4. How can Gretchen be diagnosed?
5. What is the treatment for Gretchen?
Please answer all questions.
Explanation / Answer
1. ANS: Pathophysiology: Gretchen is a 65-year old female suffering with bronchitis from several years, a series of attacks of acute bronchitis can leads to chronic bronchitis. Gretchen’s medical history revealed that she smokes one pack of cigarettes per day, a habit that she has had for 50 years, so the chronic bronchitis can evolve gradually because the bronchial lining mucus producing layer has probably narrows, thickened the airways to the point where breathing becomes increasingly difficult. The cilia immobilization can leads to irritation and the further infection can became bronchial passages more vulnerable and causes tissue damage.
2. ANS: Risk factors:
The main risk factor of chronic bronchitis is tobacco smoking. Gretchen’s medical history revealed that she smokes one pack of cigarettes per day, so it is the main risk factor according to the given situation.
3. ANS: Clinical manifestations:
During the chronic bronchitis the most common symptoms are Cough and sputum production.
Shortness of breath (Dyspnea)
Fatigue
Wheezing
Slight fever and chills
Chest discomfort
4. ANS: Diagnosis:
Based on the patient medical history, diagnostic tests and physical examination chronic bronchitis was diagnosed by Health care professionals.
Blood tests (Usually not necessary)
Pulmonary function testing
Chest X-ray (If pneumonia is suspected)
Oxygen saturation
Bacterial infection microscopic examination
5. ANS: Treatment:
Usually within a couple of weeks acute bronchitis can get better without treatment in most cases.
Based on the alleviation symptoms of patient Therapy was generally preferred.
Medication combinations can help to open obstructed bronchial airways and thin obstructive mucus so that it can be coughed up more easily. Ex: Cough medicine.
Care for acute bronchitis is primarily supportive and should ensure that the patient is oxygenating adequately.
Bed rest is recommended.
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