Which disorder of the thorax or lung does this best describe?
A 21-year-old college senior presents to your clinic, complaining of shortness of breath and a nonproductive nocturnal cough. She states she used to feel this way only with extreme exercise, but lately she has felt this way continuously. She denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her past medical history is significant only for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on no other medications. She has had no surgeries. Her mother has allergies and eczema and her father has high blood pressure. She is an only child. She denies smoking and illegal drug use but drinks three to four alcoholic beverages per weekend. She is a junior in finance at a local university and she has recently started a job as a bartender in town. On examination she is in no acute distress and her temperature is 98.6. Her blood pressure is 120/80, her pulse is 80, and her respirations are 20. Her head, eyes, ears, nose, and throat examinations are essentially normal. Inspection of her anterior and posterior chest shows no abnormalities. On auscultation of her chest, there is decreased air movement and a high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs.
A) Spontaneous pneumothorax
B) Chronic obstructive pulmonary disease (COPD)
C) Asthma
D) Pneumonia
C) Asthma
Asthma causes shortness of breath and a nocturnal cough. It is often associated with a history of allergies and can be made worse by exercise or irritants such as smoke in a bar. On auscultation there can be normal to decreased air movement. Wheezing is heard on expiration and sometimes inspiration. The duration of wheezing in expiration usually correlates with severity of illness, so it is important to document this length (e.g., wheezes heard halfway through exhalation). Realize that in severe asthma, wheezes may not be heard because of the lack of air movement. Paradoxically, these patients may have more wheezes after treatment, which actually indicates an improvement in condition. Peak flow measurements help to discern this.
You might also like to view...
Appropriate preventive measures for the nurse to take to prevent circulatory overload include: Standard Text: Select all that apply
1. Practice consistent hand hygiene. 2. Monitor infusions frequently. 3. Ensure sterile dressing to the insertion site. 4. Monitor the insertion site routinely. 5. Make accurate fluid calculations.
A podiatrist is a college graduate who completed four additional years of education in a college of podiatric medicine and he or she is licensed to specialize in the treatment of skin disorders
Indicate whether the statement is true or false
Which of the following is most important to monitor for your patient on Clozaril?
A. White blood cell count B. Clozaril blood level C. Urine output D. Vision
The nurse researcher who is involved in conduct of research should plan to accomplish what?
a. Active interchange with active care practitioners b. Dissemination of findings via research reports c. Determining applicability of findings for practice d. Use of randomized controlled trials