WEEK 2: COPD CASE STUDY: PART 1
NR-601 PRIMARY CARE OF THE MATURING AND AGED FAMILY Q
&A
Tests and Procedures to narrow differential:
1. Spirometry:
Spirometry is the measurement of the rate at which the lung volumes change
during forced breathing maneuvers. The test begins with a complete full
inhalation, and then a rapid forced expiration; the expiration is maintained as long
as it is possible or until an exhaled plateau volume is achieved. The results are
transmitted and recorded on a graph. The three most significant indications
obtained from spirometry are the forced vital capacity (FVC), the forced
expiratory volume in one second (FEV1), and the ratio of FEV1/FVC. When the
FVC is less than lower limits of normal and the FEV1/FVC ratio is also decreased
it is indicative with the diagnosis of an obstructive airway disease. A diagnosis of
asthma is determined if the FEV1/FVC ratio is less than 0.7 in adults and less
than
, 0.85 in children (Irvin, 2018). Additionally, a FEV1/FVC ratio of less than
0.7 constitutes a diagnosis of COPD in symptomatic patients (GOLD, 2017).
2. Chest radiography:
A chest x-ray is not for diagnostic purposes but can identify potential
comorbidities and or rule out other etiologies. Additionally, a chest x-ray can
identify the size of the heart and recognize enlargement potentially related to HF
(Hollier, 2018). In early COPD the chest x-ray will appear normal (Dunphy et al.,
2019). However, as COPD progresses the chest s-ray can identify abnormalities
such as, hyperinflation, hyperlucency, and tapering of vasculature (GOLD,
2017).
3. 12 lead electrocardiogram:
A 12 lead ECG is to assess for arrhythmias, left ventricular hypertrophy, or recent
myocardial infarction, as a underlying cause of possible HF (Hollier, 2018).
Additionally, an ECG is recommended for patients with reports of dyspnea,
especially upon exertion, as well as for patients who are of the male gender,
history of smoking, HTN, overweight or obese, and or have a family history of
cardiac disease (Jin, 2019).
NR-601 PRIMARY CARE OF THE MATURING AND AGED FAMILY Q
&A
Tests and Procedures to narrow differential:
1. Spirometry:
Spirometry is the measurement of the rate at which the lung volumes change
during forced breathing maneuvers. The test begins with a complete full
inhalation, and then a rapid forced expiration; the expiration is maintained as long
as it is possible or until an exhaled plateau volume is achieved. The results are
transmitted and recorded on a graph. The three most significant indications
obtained from spirometry are the forced vital capacity (FVC), the forced
expiratory volume in one second (FEV1), and the ratio of FEV1/FVC. When the
FVC is less than lower limits of normal and the FEV1/FVC ratio is also decreased
it is indicative with the diagnosis of an obstructive airway disease. A diagnosis of
asthma is determined if the FEV1/FVC ratio is less than 0.7 in adults and less
than
, 0.85 in children (Irvin, 2018). Additionally, a FEV1/FVC ratio of less than
0.7 constitutes a diagnosis of COPD in symptomatic patients (GOLD, 2017).
2. Chest radiography:
A chest x-ray is not for diagnostic purposes but can identify potential
comorbidities and or rule out other etiologies. Additionally, a chest x-ray can
identify the size of the heart and recognize enlargement potentially related to HF
(Hollier, 2018). In early COPD the chest x-ray will appear normal (Dunphy et al.,
2019). However, as COPD progresses the chest s-ray can identify abnormalities
such as, hyperinflation, hyperlucency, and tapering of vasculature (GOLD,
2017).
3. 12 lead electrocardiogram:
A 12 lead ECG is to assess for arrhythmias, left ventricular hypertrophy, or recent
myocardial infarction, as a underlying cause of possible HF (Hollier, 2018).
Additionally, an ECG is recommended for patients with reports of dyspnea,
especially upon exertion, as well as for patients who are of the male gender,
history of smoking, HTN, overweight or obese, and or have a family history of
cardiac disease (Jin, 2019).
