Assignment_12.2___Shadow_health___D._O_Connor.

Assignment i12.2: iShadow iHealth-Focused iExam: iCOPD iand iAnti-asthmatics iConcept iLab

Case iStudy

Patient: iDebbie iO’Connor

DOB: i10/05/1964

Height: i5’5

i Weight: i195lbs

i Allergy: iNKDA

Previous idiagnosis: iCOPD iGroup iB i– ichronic ibronchitis

Current idiagnosis: iCOPD iClass iC i– ichronic ibronchitis
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Scenario: iMs. iO’Connor iis ia i55-year iold iCaucasian ifemale iwho ihas icome ito ithe idoctor’s ioffice

i reporting iworsening iof iCOPD isymptoms iand ia irecent, ifrightening iepisode iof ibronchospasm. iShe

is ia ilong-term ismoker i(37 iyears) iand iwould ilike iassistance iwith ismoking icessation.
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Home imedications: iFormoterol iinhaler i12mcg isingle-use iq12 ihours

Vitals: iTemp i37C i(Temporal), iBlood ipressure i129/79 i(Automatic), iHeart irate i90 i(NSR), iO2 isat

92% i(room iair), iRespiratory irate i26.
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Assessment: iMs. iO’Connor iis iin itoday istating ishe ifeels iher ilungs i“are ifalling iapart” idue ito

i worsening ishortness iof ibreath. iShe ireports ithat ithree idays iago ishe ihad ian iepisode iof

i bronchospasm icausing ia icoughing ifit ithat imade iher iapprehensive iabout iher ipulmonary ihealth.

i She ihas ibeen ia ismoker isince ithe iage iof i15 iand ihas ihad itrouble ibreathing ifor iyears ibeing

i hospitalized ifor ia iCOPD iexacerbation itwo iyears iago. iShe icomplains iof ifeeling ivery

i uncomfortable iwith ibreathing idifficulty ibeing ia i6 iout iof i10. iPatient istates isymptoms ihave

i progressed iin ithe irecent i4 imonths ias ishe ihas ibeen igetting imore ifatigued iwith i worsening

i shortness i of i breath i on i minimal i exertion, i and i a i productive i cough i expectorating i phlegm.

i She

, describes ithe icough ias ia iwheezing, icrackling isound iwhich ihappens ia ifew itimes ian ihour

i throughout ithe iday iwith iworsening ifrequency iafter ishe ismokes ia icigarette. iShe ireports ifeeling

i anxious iabout iher ihealth iand iwhen isymptoms iarise ialthough ishe idenies ihaving ian ianxiety

i disorder. iThe ipatient idescribes ithe isputum ias imostly iclear iwith iepisodes iof iyellow, igray iand idark-

colored iexpectoration. iShe idenies iseeing iany iblood ibut idoes idescribe iit ias ithe itexture ibeing ithick

i starting i two i weeks i ago. i Ms. i O’Connor i reports i constant i wheezing i and i a i strong i desire i to

stop ismoking ito ireduce iher ibreathing isymptoms. iShe ireports imultiple iattempts iat iquittingismoking
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i with ithe ilongest ibeing i10 iyears iwhen ishe ihad iher idaughter. iShe ihas itried iusing igum, ipatches iand

i lozenges ibeing iunsuccessful iat imost iattempts idue ito ilack iof irequired icompliance. iReports

i symptoms ihave imade iher iless isocial iwith ino idesire ito igo iout ieven iaffecting iher iactivitiesiof idaily

i living. iDenies ioxygen iuse iout iof ifear iof iigniting ia ifire. iLives iwith iher idaughter iwho iis ia

i nonsmoker iand iis isupportive iof iher imother's idecision ito istop ismoking. iMs. iO’Connor istates iher

i daughter icooks imost iof iher imeals ihowever iwhen ishe iis inot iaround, ithe ialternative iis ifrozen

i meals. i She i reports i a i 30lb i weight i gain i over i the i last i couple i of i months. i She i uses

i Formoterol iinhaler itwice ia iday iand idenies ithe iuse iof iany iother imedications iincluding ivitamins.

i Denies ialcohol iand idrug iuse. iDenies ihaving ia ifever, ihaving icontracted iinfluenza irecently. iShe

i admits ito inot ihaving ithe iflu ishot iin isome itime iand iwas ieducated ion ithe iimportance iof ibeing

i diligent iabout ihaving ithe ishot iyearly ias irecommended iby ithe iCDC. iMs. iO'Connor iuses ian

i incentive ispirometer iat ihome iachieving ian iFEV1 ireading iof i1.37L, iwhich ishe istates iis

i approximately i49% iof iher igoal itherapy. iShe ireports ino iexercise idue ito isymptoms. iReports ino

i major ieyesight iissues iother ithan inearsightedness, i no i surgeries, i one i miscarriage i at i a i young

i age. i Reports i yellow i discoloration i ofithe iskin iaround ithe imouth, iteeth, inails, iand ifingers. iDenies

i any icyanosis. iShe iis ipostmenopausal,inot isexually iactive.