NR603 - Week 3 iHuman (Joseph camella 66 years,
Dyspnea)
Good Questions:
1.How can i help you today
• Im having trouble breathing. My wife made me come in.
She’s worried about me.
2.Do you have any other symptoms or concerns we should discuss
• An allergic cough and runny nose. I get the cough every year
during this season.
3.Do you wheeze?
• Normally just when my allergies act up. Lately I ve sort
of noticed wheezing at night. Thats fairly new I guess.
4.Are you short of breath when lying down?
• Im always SOB
5.Do you sleep with pillows to help you breathe?
• Just 1 pillows
6.Does anything make your cough better or worse?
• My coughing is worse when the trees shed pollen
7.Are you taking any prescription medications?
• Yes indeed. I brought my list with me here. Lisonopril 10mg
daily, HCTZ 25mg daily, glipizide 5mg daily. Also use a CPAP
machine, though it’s not really a medicine.
8.Are you taking any OTC or herbal medications?
• Aleve for shoulder pain and Allergra for the allergies
9.Do you have any allergies?
• Sulfa drugs, I am pretty sure im allergic to tree and grass
pollen and ragweed
10. Do you now or have you ever smoked or chewed tobacco
• I was a big time smoker in the past. Started when I was 16. A
pack a day, but i stopped 10 years ago. That was hard to do.
11. Do you have a problem with fatigue/tiredness
• I sure do. I get tired when i exert. I think im really out of shape,
but i also dont sleep great due to sleep apnea, and this makes
me tired during the day too
12. Have you been having fevers?
• no
13. Is there any swelling in your ankles?
• Sometimes. Not bad though
14. Do you have a problem with generalized weakness?
• Weakness? No, I dont think i’d call it that really
15. Do you have a cough?
• Not normally, but i have been coughing for the last couple of
months
16. Are you coughing up any sputum?
• Occasionally, like now. I get a cold, then bronchitis with
coughing up stuff, then it goes away. Sometimes clear.
Sometimes not. Its been worse the past 2 months - coughing up
this gooey white stuff in the morning. Maybe like a few
teaspoons worth. Disgusting.
17. When did your difficulty breathing start?
• About 10 years ago. Past 5 years its affected me more and more
18. Does anything make your difficulty breathing better or worse?
, • Sitting still is the best for my breathing. Also it helps if i
purse my lips when i breathe out
19. Do you become short of breath with exertion?
• Yes definitely. I can walk slowly to the postbox or from room
to room ok, but im out of breath going upstairs to the
bedroom or just lifting stuff
20. Are you short of breath at rest?
• Yes just these past couple months
21. Do you have any pain or other symptoms associated with
your difficulty breathing?
• Symptoms? Like cough with runny nose. What else do you
mean?
22. Has there been any change in your difficulty breathing over time?
• Big time! I used to be able too walk, work, and run with the
best of them. But not now
23. Do you have unusual heartbeats / palpitations?
• No.
24. Do you have any pain in your chest?
• No.
25. Can you tell me about any current or past medical problems?
• High blood pressure, sleep apnea, and type 2 DM. Ive had the
blood pressure thing for maybe 25 years now. The DM was
maybe 5 years ago. But all these are under control. I guess
thats all i can think of thats important.
26. Any recent acute or chronic infections?
• No.
27. Any previous medical, surgical, or dental procedures?
• I had my gall bladder removed 20 years ago. I had an accident
30 years back and i had a surgery to fix my shoulder and for the
wound in my leg. I guess thats the big stuff
28. Have you ever been hospitalized?
• Just when i had to have some surgery
29. Do you have a family history of heart disease?
• My father died of a heart attack when he was 52. He had HTN
and DM and was a smoker. My brother had HTN and heart
disease too but passed from cancer
30. Do you drink alcohol?
• A beer with my supper sometimes a couple more when im
watching a game
31. Tell me about your work
• Construction… master carpenter, then rose to foreman. I
retired at 59. Too tough to continue
32. Does your chest feel tight or heavy?
• No.
33. How severe is your difficulty breathing?
• It seems pretty bad to me. I mean, its affecting my life too much
34. Does anyone in your family have difficulty breathing?
• Not that ive noticed
35. Are you coughing up blood?
• No thank god
36. Do you have a history of lung disease?
• Never evaluated for it, though probably should be. I was
exposed to asbestos years ago - and we now know thats bad
stuff. Of course there
, were the usual fumes from stuff around you on the job site, like
welding and stuff like that
37. Do you now or have you ever had cancer?
• No thank god
38. Have you had TB?
• Not that ive been told
39. Do you have asthma?
• Not been diagnosed but im starting to think maybe thats whats
wrong with me now.
40. Do you have a family history of blood clots in your legs or lungs?
• no
41. Do you have a history of deep vein thrombosis or pulmonary
embolism?
• I do have ugly varicose veins. Is that the same thing?
42. Do you have heart disease and/or have you ever had a heart
attack?
• Never had a heart attack, but sometimes i worry about it a bit
43. Is there any swelling in your legs?
• Havent noticed that at all
44. Have you ever been diagnosed with thyroid problems?
• no
45. Do you awaken at night short of breath?
• Not so far
46. Do you recently travelDo
• no
47. Is there any swelling in your feet?
• Yeah, and my shoes dont fit
48. Have you ever been told that you have a heart murmur or valve
problem?
• Yes a murmur. Ive had it all my life but they said not to worry
about it
49. Do you have a history of heart failure?
• No one has ever told me that. Is that different than a heart
attack
50. Do you have high cholesterol?
• I dont think so. No one has ever told me that one
51. Do you have chills?
• no
52. Do you have a history of cystic fibrosis?
• no
53. Do you have a history of valvular heart disease?
• no
54. Have you been diagnosed with a bleedi57. Do you have
muscle pain or cramping?
• No
58. Do you have a sensation of a pounding heart in your chest?
• Nong disorder?
• No
55. Have you had chicken pox, measles mumps or rheumatic
fever?
• Not that I recall
56.Are you eating alot of salty
food? Not really
Dyspnea)
Good Questions:
1.How can i help you today
• Im having trouble breathing. My wife made me come in.
She’s worried about me.
2.Do you have any other symptoms or concerns we should discuss
• An allergic cough and runny nose. I get the cough every year
during this season.
3.Do you wheeze?
• Normally just when my allergies act up. Lately I ve sort
of noticed wheezing at night. Thats fairly new I guess.
4.Are you short of breath when lying down?
• Im always SOB
5.Do you sleep with pillows to help you breathe?
• Just 1 pillows
6.Does anything make your cough better or worse?
• My coughing is worse when the trees shed pollen
7.Are you taking any prescription medications?
• Yes indeed. I brought my list with me here. Lisonopril 10mg
daily, HCTZ 25mg daily, glipizide 5mg daily. Also use a CPAP
machine, though it’s not really a medicine.
8.Are you taking any OTC or herbal medications?
• Aleve for shoulder pain and Allergra for the allergies
9.Do you have any allergies?
• Sulfa drugs, I am pretty sure im allergic to tree and grass
pollen and ragweed
10. Do you now or have you ever smoked or chewed tobacco
• I was a big time smoker in the past. Started when I was 16. A
pack a day, but i stopped 10 years ago. That was hard to do.
11. Do you have a problem with fatigue/tiredness
• I sure do. I get tired when i exert. I think im really out of shape,
but i also dont sleep great due to sleep apnea, and this makes
me tired during the day too
12. Have you been having fevers?
• no
13. Is there any swelling in your ankles?
• Sometimes. Not bad though
14. Do you have a problem with generalized weakness?
• Weakness? No, I dont think i’d call it that really
15. Do you have a cough?
• Not normally, but i have been coughing for the last couple of
months
16. Are you coughing up any sputum?
• Occasionally, like now. I get a cold, then bronchitis with
coughing up stuff, then it goes away. Sometimes clear.
Sometimes not. Its been worse the past 2 months - coughing up
this gooey white stuff in the morning. Maybe like a few
teaspoons worth. Disgusting.
17. When did your difficulty breathing start?
• About 10 years ago. Past 5 years its affected me more and more
18. Does anything make your difficulty breathing better or worse?
, • Sitting still is the best for my breathing. Also it helps if i
purse my lips when i breathe out
19. Do you become short of breath with exertion?
• Yes definitely. I can walk slowly to the postbox or from room
to room ok, but im out of breath going upstairs to the
bedroom or just lifting stuff
20. Are you short of breath at rest?
• Yes just these past couple months
21. Do you have any pain or other symptoms associated with
your difficulty breathing?
• Symptoms? Like cough with runny nose. What else do you
mean?
22. Has there been any change in your difficulty breathing over time?
• Big time! I used to be able too walk, work, and run with the
best of them. But not now
23. Do you have unusual heartbeats / palpitations?
• No.
24. Do you have any pain in your chest?
• No.
25. Can you tell me about any current or past medical problems?
• High blood pressure, sleep apnea, and type 2 DM. Ive had the
blood pressure thing for maybe 25 years now. The DM was
maybe 5 years ago. But all these are under control. I guess
thats all i can think of thats important.
26. Any recent acute or chronic infections?
• No.
27. Any previous medical, surgical, or dental procedures?
• I had my gall bladder removed 20 years ago. I had an accident
30 years back and i had a surgery to fix my shoulder and for the
wound in my leg. I guess thats the big stuff
28. Have you ever been hospitalized?
• Just when i had to have some surgery
29. Do you have a family history of heart disease?
• My father died of a heart attack when he was 52. He had HTN
and DM and was a smoker. My brother had HTN and heart
disease too but passed from cancer
30. Do you drink alcohol?
• A beer with my supper sometimes a couple more when im
watching a game
31. Tell me about your work
• Construction… master carpenter, then rose to foreman. I
retired at 59. Too tough to continue
32. Does your chest feel tight or heavy?
• No.
33. How severe is your difficulty breathing?
• It seems pretty bad to me. I mean, its affecting my life too much
34. Does anyone in your family have difficulty breathing?
• Not that ive noticed
35. Are you coughing up blood?
• No thank god
36. Do you have a history of lung disease?
• Never evaluated for it, though probably should be. I was
exposed to asbestos years ago - and we now know thats bad
stuff. Of course there
, were the usual fumes from stuff around you on the job site, like
welding and stuff like that
37. Do you now or have you ever had cancer?
• No thank god
38. Have you had TB?
• Not that ive been told
39. Do you have asthma?
• Not been diagnosed but im starting to think maybe thats whats
wrong with me now.
40. Do you have a family history of blood clots in your legs or lungs?
• no
41. Do you have a history of deep vein thrombosis or pulmonary
embolism?
• I do have ugly varicose veins. Is that the same thing?
42. Do you have heart disease and/or have you ever had a heart
attack?
• Never had a heart attack, but sometimes i worry about it a bit
43. Is there any swelling in your legs?
• Havent noticed that at all
44. Have you ever been diagnosed with thyroid problems?
• no
45. Do you awaken at night short of breath?
• Not so far
46. Do you recently travelDo
• no
47. Is there any swelling in your feet?
• Yeah, and my shoes dont fit
48. Have you ever been told that you have a heart murmur or valve
problem?
• Yes a murmur. Ive had it all my life but they said not to worry
about it
49. Do you have a history of heart failure?
• No one has ever told me that. Is that different than a heart
attack
50. Do you have high cholesterol?
• I dont think so. No one has ever told me that one
51. Do you have chills?
• no
52. Do you have a history of cystic fibrosis?
• no
53. Do you have a history of valvular heart disease?
• no
54. Have you been diagnosed with a bleedi57. Do you have
muscle pain or cramping?
• No
58. Do you have a sensation of a pounding heart in your chest?
• Nong disorder?
• No
55. Have you had chicken pox, measles mumps or rheumatic
fever?
• Not that I recall
56.Are you eating alot of salty
food? Not really
