CASE STUDY MEDICAL HISTORY Mr. DM is a 69 yr old white male who complains of sho

Question

CASE STUDY MEDICAL HISTORY Mr. DM is a 69 yr old white male who complains of shortness of breath on exertion and occasionally at rest. The patient does not report any symptoms suggestive of myocardial ischemia. Additional findings from the medical history include treatment for hypertension and prostate cancer diagnosed within the past S yr. The patient quit smoking cigarettes approximately 3 yr ago and reports a 102 pack-year smoking history (average of two packs per day for 51 yr). The patient was admitted to a local hospital for an exacerbation of respiratory symptoms approximately 4 mo before enrolling in the exercise program. The remainder of the medical history is unremarkable. The patient did not use supplemental oxygen at the time of entrance into the exercise program; oxygen saturation at rest by pulse oximetry is 95%. The patient's score on the dyspnea subscale of the Chronic Respiratory Disease Questionnaire, a measure of health-related quality of life, is S on a 1-7 scale), corresponding to "some shortness of breath" during performance of activities of daily living The patient also reports a sedentary lifestyle, rarely walking outside the home, and not participating in any sport or recreational activities. Mr. DM reported the following scores for performance of selected activities of daily living and their relation to shortness of air: grooming (2.4), shopping (2.7), driving (1.0), light housework (3.1), and walking (2.8). The scale parameters are as follows: 1 s able to perform without shortness of air 2- able to perform with slight to moderate shortness of air 3- able to perform with severe shortness of air 4- unable to do because of shortness of air (continued)

Explanation / Answer

1, Treadmill measures for nonsmoking group had significantly lower (P<.05) ICD,ACD and baseline peak O2 uptake..similar time to relief of claudication pain and walking economy were similar(P>.05) following exercise rehabilitation both groups similar improvement in ICD,ACD,peak o2 uptake and walking economy..ABI and ischemic window same for both groups..peripheral hemodynamic measurements shows normal calf blood flow under resting,reactive hyperemic and maximal hyperemic conditions..peak )2uptake for nonmoking healthy person 14.2(0.5)ml/kg/min,walking economy for non smokers 11.9(0.4)ml/kg/min..6minute walk pain free distance for nonsmokers 178meters..Daily physical activity nonsmokers 388kcal/d..WIQ stair climbing score 56% for nonsmokers..
2,    For this patient 6min walk test before beginning the exercise program covered 6min walk trial was 948 feet..02 sat 85% with shortness of breath by borg dyspnea scale 7..The patient completed dyspnea rating of 3, 02 sat 86%
    Rehabilitation exercise responses similar for both smokers and nonsmokers..medical history,claudication distances and peak 02 uptake 2mph,0% grade with 2% increase every 2min..ICD,ACD relief of claudication pain after the rest,peak 02 uptake were measured..walking economy treadmill speed of 2mph and grade of 0% claudication pain,for maximum 20min..
3, Pulmonary function test parameters measures included forced vital capacity,and respiratory volume in 1sec,peak expiratory flow rate(PEF)and mean expiratory flow rate..They showed significant negative spirometric functions,height showed positive correlation with the PFT parameters except FEV1 percent while the weight there is not significant correlationwith the parameters except FEV1 percent..ventilatory norms foe men high for FVC and FEV1 age seems to have a lesser negative influence on pulmonary functions..
4,physiological factors like height,weight,age and sex can change pulmonary function test..
5, exercise programs like aerobic training walking can improve patient lung capacity and stretching exercise by joint range of motion and mobility can improve pulmonary function..

Related Questions

Navigate

• Browse (All)
• Browse C
• Subjects

---

---

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.