Posted: May 21st, 2015
Paper, Order, or Assignment Requirements
the assignment is about Case Study there is 9 question you have to answer each question exactly the right answer make sure to read the guideline step by step and to add the diagram to support the answer, please see the file the guideline for writing.
Assignment Requirements
A 1500 word, structured response answering the specific questions presented in the following case study.
Weighting : 15%
PARA2001: Integrated Clinical Case
Patient Background
You have been tasked Priority 2 to a 75 year old man with chest tightness and shortness of breath. On your arrival you find a very thin, elderly man sitting on a chair with his arms braced on his knees. He looks very dyspnoeic. His initial observations are:
Respiratory rate | 45 breaths/minute |
Heart rate | 120 beats/minute |
Blood Pressure | 95/50 mmHg |
Oxygen saturation | 82% |
Glasgow Coma Score | 13 (E=3,V=4, M=6) |
The man’s name is Mr Wenham, and he is only able to speak single words. His wife tells you that his breathing is never very good, because he smoked far too much. She says he sometimes struggles to walk around the house.
Symptoms | Shortness of breath, chest tightness, cough |
Onset | “His breathing has been particularly bad for the last two days and much worse for the last hour or so” |
Chest examination | Barrel chested, little chest wall movement |
Breathing sounds | Very quiet breath sounds, occasional wheeze |
Jugular veins | Elevated 5cm |
You form the view that Mr Wenham is suffering from an exacerbation of Chronic Obstructive Pulmonary Disease (COPD). You administer supplemental oxygen, atrovent and salbutamol (following local guidelines), and prepare for the 60 minute journey to hospital.
Mr Wenham’s oxygen saturation improves with supplemental oxygen but he remains tachypnoeic, tachycardic and hypotensive. On arrival at the Emergency Department you go straight to the resuscitation room and an arterial blood gas sample is taken and analysed immediately with the following results:
pH | 7.12 |
PaO2 | 100 mmHg. |
PaCO2 | 110 mmHg |
HCO3 | 38 |
The emergency department staff suggest you may have given Mr Wenham too much oxygen. They say they are going to remove the oxygen.
The emergency department consultant returns from his lunch break to interrupt the oxygen debate. He suggests that Mr Wenham needs BiPAP.
Three days later, after 18 hours of BiPAP, corticosteroids and physiotherapy, Mr Wenham is much improved. The respiratory physician responsible for his care orders spirometry. This shows:
FEV1 | 0.75 litres |
FVC | 1.5 litres |
FEV1/FVC | 50% |
PARA2001: Integrated Clinical Case
Answer Template (cut and paste into a new document).
ANSWER:
DIAGRAM? SOURCE/ TITLE
Place an order in 3 easy steps. Takes less than 5 mins.