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Case Study

This document provides 4 case studies involving patients with respiratory disorders, including chronic obstructive pulmonary disease (COPD), tuberculosis, and pneumonia. I have chosen to summarize Case 1 and Case 3. For Case 1, a 71-year-old male with COPD is admitted for worsening dyspnea and cough despite antibiotics. For Case 3, a 46-year-old man with a history of tuberculosis presents with recurrent atypical Mycobacterium Avium Complex infection due to non-compliance with medications.

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39 views

Case Study

This document provides 4 case studies involving patients with respiratory disorders, including chronic obstructive pulmonary disease (COPD), tuberculosis, and pneumonia. I have chosen to summarize Case 1 and Case 3. For Case 1, a 71-year-old male with COPD is admitted for worsening dyspnea and cough despite antibiotics. For Case 3, a 46-year-old man with a history of tuberculosis presents with recurrent atypical Mycobacterium Avium Complex infection due to non-compliance with medications.

Uploaded by

zoie ziazzette
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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RESPIRATORY DISORDERS: OBSTRUCTIVE AND INFECTIOUS

CASE STUDY

Instruction: 
You are given the liberty to choose two cases from the following given cases.

a. For each case study, create a 500-word case discussion on the management of


each case. There should be at least 1 book and 1 journal reference for each case study
document. For formatting guidelines, refer to the case study template sent with this
guideline. 
b. Identify 3 priority nursing diagnoses for the case. Create a Nursing Care Plan out
of the top-prioritized Nursing Diagnosis that you will formulate. There should be at
least one (1) reference, specifically cited on the Scientific Analysis section. Utilize
the NCP format of the SPUD-CON. 
 
 
CASES 

1. M.B.L. is a 71 year-old male who was admitted to the hospital from his long-term care
facility after 2 weeks of dyspnea and cough. He was seen by a physician at the long-term
care facility and was diagnosed with a COPD exacerbation. He was prescribed
azithromycin, but has not improved after 3 days of antibiotics. He has a history of
dyslipidemia, COPD, alcoholic cirrhosis, and HTN. He routinely takes lisinopril,
atorvastatin, tiotropium and fluticasone/salmeterol, and has recently had a heavier
reliance on his rescue albuterol inhaler. Review of systems reveals fever, chills, cough
(sometimes productive) and dyspnea (worse than baseline).
2. Patient A.B.C. is a 33-year-old male who was admitted to the hospital from home after 1
week of cough, profuse nocturnal sweating, loss of appetite and hyposomnia. He was
seen by an emergency room physician who noted signs of depression. The patient has a
history of intravenous drug abuse and hepatitis B.
3. A 46-year-old man presented to the TB Clinic with symptoms of progressive shortness of
breath and cough with greenish sputum production. His sputum test results showed that
he had atypical TB (Mycobacterium Avium Complex MAC infection). He was HIV
negative at this time. Past history revealed that he was in good health till 2003 when he
was diagnosed to have active typical tuberculosis (TB) and treated successfully with the
regular TB drugs at that time. As he showed clinical signs of disease, he was prescribed
other antibiotics specific for this infection. It was recommended that he take these
medications for at least a year with regular medical follow-up. Due to the cost of the
medicines and personal financial constraints, he was not compliant with his medications
and took only some of his medications intermittently. He complained of subjective fever,
night sweats, weight loss, shortness of breath on exertion and chest pain during his
follow-up. Although he periodically sought medical attention due to persistent symptoms,
his treatment regimen was unsatisfactory due to compliance and availability issues.
The Chest X-ray showed progressive deterioration. (He himself described his condition
as “being eaten inside”.) Attempts to obtain medications from various social services
sources were temporarily successful and when he took the prescribed medicines for two
months at a stretch he showed clinical improvement. Later, once again due to financial
constraints and lack of availability of all medicines, he took some of his medications
some of the time, and not only deteriorated clinically but subsequently developed
resistant and multi drug resistant disease (MDRMAC).

4. A 66-year-old male presented to an urgent care clinic with a 4-day history of dry cough,
progressing to rusty colored sputum, sudden onset of chills the previous evening,
subjective fever, and malaise. Originally, the man thought he had a cold, but the
symptoms had worsened and he “barely slept last night with all this coughing.” He
denied experiencing shortness of breath but suggested he may be breathing “a little faster
than normal.” He related that, on the way to the clinic, he felt some sharp right-sided
chest pain after a particularly long bout of coughing. He denied any leg swelling,
orthopnea, or left-sided/substernal chest pain. He also denied any gastrointestinal
symptoms (no nausea, vomiting, or diarrhea). His past medical history included
hypertension and hypercholesterolemia. He reported no antibiotic use in the previous
three months. He was anxious to “get something to clear this up” as he had plans to
attend his first granddaughter’s destination-wedding in the Caribbean in one week’s time.

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