DPT-772: PULMONARY ASSESSMENT LECTURE EXAM
QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS
Patient Interview
Chief Complaint
SOB
Loss of function
What can't you do that you used to be able to do and is really important to you?
SOB
what causes your SOB
what makes it worse
what makes it better
how is it at rest
during activity
symptoms presentation
,Loss of Function
patients tend to connect more when you start to talk about their ADLs and function, can
give a clear picture
What can't you do that you used to be able to do and is really important to you?
provides more insight in the level of function and can pull out the details such as SOB,
dyspnea, coughing, difficulty with airway clearance, the need for oxygen that they
disclose to further your hypothesis
History of Present Illness
initial onset
progression
worse or better
It is important to remember that the baseline of chronic disease does not
go away and we kind of see these cycles between exacerbation and baseline
What additional information do you want to get from looking at the progression portion
of history of present illness?
look at progression over a long period of time but also recently their exacerbations,
when did the symptoms start, what does the progression look like at the point you are
using them, are things getting better, are their symptoms getting worse
History
past medical history
occupational history
family history
, medications
cough and sputum production
What additional information might we get from occupational history?
if MSK, want to know physical demands and repetitive injury but with pulmonary
populations, exposure to various irritants that can cause long term lung damage
What additional information might we get from family history?
some genetic components to some of our pulmonary diseases such as cystic fibrosis,
some subsets or emphysema
What additional information might we get from medications?
maintenance and rescue, can be telling of past medical history that they might not
disclose or realize the medical conditions that they have although being medically
managed
Not only do we like to identify the meds they are on from a maintenance and rescue
standpoint but also want to
assess the frequency of using their rescue inhaler as it can indicate if their maintenance
plan needs to be changed and if their respiratory conditions are being well managed
and or the status of their exacerbation
Maintenance Medication
meds that they take everyday, some of their inhalers and pills
Rescue Medication
for those periods of exacerbation when they need an additional boost, beta agonists are
most common, typically inhaled for them to be quick acting and have direct access to
the lungs
QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS
Patient Interview
Chief Complaint
SOB
Loss of function
What can't you do that you used to be able to do and is really important to you?
SOB
what causes your SOB
what makes it worse
what makes it better
how is it at rest
during activity
symptoms presentation
,Loss of Function
patients tend to connect more when you start to talk about their ADLs and function, can
give a clear picture
What can't you do that you used to be able to do and is really important to you?
provides more insight in the level of function and can pull out the details such as SOB,
dyspnea, coughing, difficulty with airway clearance, the need for oxygen that they
disclose to further your hypothesis
History of Present Illness
initial onset
progression
worse or better
It is important to remember that the baseline of chronic disease does not
go away and we kind of see these cycles between exacerbation and baseline
What additional information do you want to get from looking at the progression portion
of history of present illness?
look at progression over a long period of time but also recently their exacerbations,
when did the symptoms start, what does the progression look like at the point you are
using them, are things getting better, are their symptoms getting worse
History
past medical history
occupational history
family history
, medications
cough and sputum production
What additional information might we get from occupational history?
if MSK, want to know physical demands and repetitive injury but with pulmonary
populations, exposure to various irritants that can cause long term lung damage
What additional information might we get from family history?
some genetic components to some of our pulmonary diseases such as cystic fibrosis,
some subsets or emphysema
What additional information might we get from medications?
maintenance and rescue, can be telling of past medical history that they might not
disclose or realize the medical conditions that they have although being medically
managed
Not only do we like to identify the meds they are on from a maintenance and rescue
standpoint but also want to
assess the frequency of using their rescue inhaler as it can indicate if their maintenance
plan needs to be changed and if their respiratory conditions are being well managed
and or the status of their exacerbation
Maintenance Medication
meds that they take everyday, some of their inhalers and pills
Rescue Medication
for those periods of exacerbation when they need an additional boost, beta agonists are
most common, typically inhaled for them to be quick acting and have direct access to
the lungs
