I-HUMAN CASE STUDY A 58 YEAR OLD KEVIN WITH
PROGRESSIVE DYSPNEA EXERTIONAL INTOLERANCE
AND FATIGUE NUR 601 week 5 CHAMBERLAIN
UNIVERSITY
HPI Table
, Patient Response Symptom
# Question (Clinician Asks) Clinical Significance
(Kevin Dale) Category
What brings you to the I’ve been getting short Identifies chief
1 General
hospital today? of breath. complaint
When did the shortness of
2 About 3 weeks ago. Establishes onset Dyspnea
breath start?
Was the onset sudden or Suggests chronic
3 Gradual. Dyspnea
gradual? process
Has it been getting better or
4 It’s getting worse. Indicates progression Dyspnea
worse?
When do you feel short of Mostly when I’m
5 Exertional dyspnea Dyspnea
breath? active.
Do you feel short of breath at
6 Sometimes now. Severity worsening Dyspnea
rest?
Can you walk long Reduced functional
7 Not anymore. Activity
distances? capacity
, Patient Response Symptom
# Question (Clinician Asks) Clinical Significance
(Kevin Dale) Category
I get very tired and
8 Can you climb stairs? Exertional intolerance Activity
breathless.
How far can you walk before
9 Just a short distance. Functional limitation Activity
symptoms start?
10 Do you feel fatigued? Yes, all the time. Low cardiac output General
11 When did the fatigue start? Around the same time. Symptom correlation General
12 Is the fatigue constant? Yes. Chronic symptom General
Not pain, just
13 Do you have chest pain? Cardiac involvement Cardiac
tightness.
Can you describe the chest
14 Mild and not sharp. Non-anginal pain Cardiac
tightness?
Does the pain radiate
15 No. Less likely ischemia Cardiac
anywhere?
, Patient Response Symptom
# Question (Clinician Asks) Clinical Significance
(Kevin Dale) Category
What triggers the chest
16 Activity sometimes. Exertional link Cardiac
tightness?
Suggests cardiac
17 Does rest relieve it? Yes. Cardiac
origin
Do you feel your heart
18 Sometimes. Possible arrhythmia Cardiac
racing?
How often do you get Intermittent
19 Occasionally. Cardiac
palpitations? arrhythmia
20 Do they last long? A few minutes. Rhythm issue Cardiac
21 Do you feel dizzy? No. Rules out syncope Neuro
22 Have you fainted? No. Stability Neuro
Do you have swelling in
23 Yes, a little. Fluid retention Peripheral
your legs?
PROGRESSIVE DYSPNEA EXERTIONAL INTOLERANCE
AND FATIGUE NUR 601 week 5 CHAMBERLAIN
UNIVERSITY
HPI Table
, Patient Response Symptom
# Question (Clinician Asks) Clinical Significance
(Kevin Dale) Category
What brings you to the I’ve been getting short Identifies chief
1 General
hospital today? of breath. complaint
When did the shortness of
2 About 3 weeks ago. Establishes onset Dyspnea
breath start?
Was the onset sudden or Suggests chronic
3 Gradual. Dyspnea
gradual? process
Has it been getting better or
4 It’s getting worse. Indicates progression Dyspnea
worse?
When do you feel short of Mostly when I’m
5 Exertional dyspnea Dyspnea
breath? active.
Do you feel short of breath at
6 Sometimes now. Severity worsening Dyspnea
rest?
Can you walk long Reduced functional
7 Not anymore. Activity
distances? capacity
, Patient Response Symptom
# Question (Clinician Asks) Clinical Significance
(Kevin Dale) Category
I get very tired and
8 Can you climb stairs? Exertional intolerance Activity
breathless.
How far can you walk before
9 Just a short distance. Functional limitation Activity
symptoms start?
10 Do you feel fatigued? Yes, all the time. Low cardiac output General
11 When did the fatigue start? Around the same time. Symptom correlation General
12 Is the fatigue constant? Yes. Chronic symptom General
Not pain, just
13 Do you have chest pain? Cardiac involvement Cardiac
tightness.
Can you describe the chest
14 Mild and not sharp. Non-anginal pain Cardiac
tightness?
Does the pain radiate
15 No. Less likely ischemia Cardiac
anywhere?
, Patient Response Symptom
# Question (Clinician Asks) Clinical Significance
(Kevin Dale) Category
What triggers the chest
16 Activity sometimes. Exertional link Cardiac
tightness?
Suggests cardiac
17 Does rest relieve it? Yes. Cardiac
origin
Do you feel your heart
18 Sometimes. Possible arrhythmia Cardiac
racing?
How often do you get Intermittent
19 Occasionally. Cardiac
palpitations? arrhythmia
20 Do they last long? A few minutes. Rhythm issue Cardiac
21 Do you feel dizzy? No. Rules out syncope Neuro
22 Have you fainted? No. Stability Neuro
Do you have swelling in
23 Yes, a little. Fluid retention Peripheral
your legs?
