iHuman Case Study Week 10: 68-
Year-Old Male with Shortness of
Breath ('I Can't Catch My Breath') -
Latest 2025/2026 Study Guide
## iHuman Case Study Week 10: 68-Year-Old Male with Shortness of Breath – Complete SOAP Note &
Management Guide
### Case Overview
| Feature | Details |
| :--- | :--- |
,| **Patient Name** | Mr. James Whitaker / Mr. Robert Jenkins |
| **Age** | 68 years |
| **Gender** | Male |
| **Ethnicity** | Caucasian or African American |
| **Height/Weight** | 5'10" (178 cm) / 210-215 lbs (95-97.5 kg) |
| **BMI** | 31 (Obese Class I) |
| **Occupation** | Retired |
| **Setting** | Outpatient clinic with lab, ECG, and chest X-ray capability |
| **Course** | NURS 6550 / NUR 2026 – Advanced Practice Care of Adults |
| **Week** | 10 (2025/2026) |
| **Chief Complaint** | "I can't catch my breath." |
### Subjective Data (History Collection)
#### Chief Complaint in Patient's Own Words
> *"I can't catch my breath. It's been getting worse over the past few days."*
#### History of Present Illness (HPI) – OLDCARTS Format
| Feature | Finding | Clinical Significance |
| :--- | :--- | :--- |
| **Onset** | Gradual onset 5 days ago; progressive worsening | Gradual onset suggests HF over PE |
| **Location** | Chest (no focal pain); "air hunger" sensation | Non-focal supports cardiac/pulmonary
etiology |
, | **Duration** | Persistent; worsens with exertion | Chronic process with acute decompensation |
| **Character** | "Tightness" and inability to draw full breath; no wheezing | Absence of wheezing
argues against COPD |
| **Aggravating Factors** | Walking short distances (20-30 feet), climbing stairs, lying flat | Orthopnea
– classic for left heart failure |
| **Relieving Factors** | Sitting upright, rest, elevating head of bed | Positional relief supports HF over
pulmonary causes |
| **Timing** | Worse in evenings and at night; constant during day | PND pattern – hallmark of HF |
| **Severity** | 4/10 at rest, 7-8/10 with minimal exertion | Moderate-severe functional impairment |
#### Associated Symptoms (Positive Findings)
| Symptom | Details | Clinical Significance |
| :--- | :--- | :--- |
| **Orthopnea** | Uses 3 pillows to sleep; cannot lie flat | Hallmark of left heart failure |
| **Paroxysmal Nocturnal Dyspnea (PND)** | Wakes up 2x/week gasping, needs to sit at bedside 10-15
min | Classic for left heart failure |
| **Lower Extremity Edema** | Bilateral swelling worsening over 1 week | Right heart failure |
| **Weight Gain** | 6 lbs (2.7 kg) in 7 days | Fluid retention |
| **Fatigue** | Decreased exercise tolerance | Low cardiac output |
| **Dry Cough** | Mild, non-productive | Pulmonary congestion |
| **Nocturia** | Some versions present | Fluid redistribution when supine |
#### Critical Denials (Rule-Out Findings)
| Denied Symptom | Significance |
| :--- | :--- |
Year-Old Male with Shortness of
Breath ('I Can't Catch My Breath') -
Latest 2025/2026 Study Guide
## iHuman Case Study Week 10: 68-Year-Old Male with Shortness of Breath – Complete SOAP Note &
Management Guide
### Case Overview
| Feature | Details |
| :--- | :--- |
,| **Patient Name** | Mr. James Whitaker / Mr. Robert Jenkins |
| **Age** | 68 years |
| **Gender** | Male |
| **Ethnicity** | Caucasian or African American |
| **Height/Weight** | 5'10" (178 cm) / 210-215 lbs (95-97.5 kg) |
| **BMI** | 31 (Obese Class I) |
| **Occupation** | Retired |
| **Setting** | Outpatient clinic with lab, ECG, and chest X-ray capability |
| **Course** | NURS 6550 / NUR 2026 – Advanced Practice Care of Adults |
| **Week** | 10 (2025/2026) |
| **Chief Complaint** | "I can't catch my breath." |
### Subjective Data (History Collection)
#### Chief Complaint in Patient's Own Words
> *"I can't catch my breath. It's been getting worse over the past few days."*
#### History of Present Illness (HPI) – OLDCARTS Format
| Feature | Finding | Clinical Significance |
| :--- | :--- | :--- |
| **Onset** | Gradual onset 5 days ago; progressive worsening | Gradual onset suggests HF over PE |
| **Location** | Chest (no focal pain); "air hunger" sensation | Non-focal supports cardiac/pulmonary
etiology |
, | **Duration** | Persistent; worsens with exertion | Chronic process with acute decompensation |
| **Character** | "Tightness" and inability to draw full breath; no wheezing | Absence of wheezing
argues against COPD |
| **Aggravating Factors** | Walking short distances (20-30 feet), climbing stairs, lying flat | Orthopnea
– classic for left heart failure |
| **Relieving Factors** | Sitting upright, rest, elevating head of bed | Positional relief supports HF over
pulmonary causes |
| **Timing** | Worse in evenings and at night; constant during day | PND pattern – hallmark of HF |
| **Severity** | 4/10 at rest, 7-8/10 with minimal exertion | Moderate-severe functional impairment |
#### Associated Symptoms (Positive Findings)
| Symptom | Details | Clinical Significance |
| :--- | :--- | :--- |
| **Orthopnea** | Uses 3 pillows to sleep; cannot lie flat | Hallmark of left heart failure |
| **Paroxysmal Nocturnal Dyspnea (PND)** | Wakes up 2x/week gasping, needs to sit at bedside 10-15
min | Classic for left heart failure |
| **Lower Extremity Edema** | Bilateral swelling worsening over 1 week | Right heart failure |
| **Weight Gain** | 6 lbs (2.7 kg) in 7 days | Fluid retention |
| **Fatigue** | Decreased exercise tolerance | Low cardiac output |
| **Dry Cough** | Mild, non-productive | Pulmonary congestion |
| **Nocturia** | Some versions present | Fluid redistribution when supine |
#### Critical Denials (Rule-Out Findings)
| Denied Symptom | Significance |
| :--- | :--- |
