6001-W2-D6
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School
Fazaia Degree College, M.R.F, Kamra, Attock *
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Course
6001
Subject
Health Science
Date
Nov 24, 2024
Type
docx
Pages
1
Uploaded by maryamberlas
Mr. Barley is a Caucasian male who is 58 years old, who owns an organic farm and lives with his wife. He
presents with a chief complaint of a productive cough that has progressively gotten worse and amount
to half pack of cigarettes. He previously smoked 1 to 2 packs a day. He has complaints of increased
shortness of breath with increased exertion and walking up the stairs. He also states that he has had a
productive cough with clear phlegm for two winters. To his knowledge he does not have any illnesses
that he is aware of but has chronic illnesses in his family history. His mother had hypertension and father
passed away from a stroke when he was 70 years old. Mr. Barley has 2 siblings that do not have any
illnesses. Due to his occupation, he is at risk of environmental hazards such as microorganisms, dust,
chemicals, other toxins from animal waste, along with other irritants. However, he states he uses
protective equipment such as clothing and a mask.
Based on Mrs. Barley’s assessment, pertinent history, and chief complaint, it could be supported that his
diagnosis is chronic bronchitis. According to the American Lung Association (2023), chronic bronchitis
develops over time and is a serious condition. Bronchitis is defined by inflammation of the bronchi
accompanied with thick mucus that sticks to the airway. Symptoms can fluctuate going through good and
bad periods and cannot be cured but treatments can help. Mr. Barley has several risk factors that
increase his risk to chronic bronchitis such as smoking and his occupation that expose him to
environmental hazards.
Mr. Barley’s assessment should include and head-to-assessment, but with a focused assessment on his
pulmonary and cardiovascular system. Performing a focused assessment on both functions would allow
to determine if his symptoms are pulmonary or cardiac related. His neck should be assessed for any
evidence of jugular vein distention and/or shift in trachea (to ensure it is midline). Inspect his chest for
work of breathing, equal and symmetrical chest rise and fall, no use of accessory muscles, tripoding,
hyperinflation, skin color is appropriate for ethnicity, warm and dry skin, fingers should be assessed for
clubbing and/or capillary refill. Based on the American Lung Association (2023), diagnostic tests include
chest x-ray (CXR), cat scan (CT), and pulmonary function exam (such as an spirometry (measure the
amount of air the lungs can hold), lung volume (precise way to measure lung volume and calculates
residual volume), exercise testing (can evaluate the cause of shortness of breath). Chronic bronchitis
presents with a productive cough, which should occur for 2 years, and last longer than 3 months (which
it has in Mr. Barley’s situation).
Mr. Barley’s education should include the assessment of the readiness to quit smoking. This would allow
for the proper education for him which would include support groups, nicotine patches, As previously
stated above, there is no cure to chronic bronchitis. Treatment options are available for Mr. Barley and
his level of mild bronchitis. These treatments include receiving vaccines regularly such as pneumonia, flu,
COVID; use of short-acting inhalers; and pulmonary rehab. He should be educated on when to seek
medical care (difficulty breathing/SOB with regular daily activities, changes in color or shape of
fingertips, and most importantly when inhalers do not help relieve symptoms). His follow-ups should be
scheduled in 6 months to assess his medication regimen, and his pulmonary function every 3 years.
References Chronic bronchitis. (2023). American Lung Association.
https://www.lung.org/lung-health-
diseases/lungdisease-lookup/chronic-bronchitis
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