Olga Bloomfield Case Summary

Patient Condition: Amateur astronomer, Olga Bloomfield, is 38 years old with a history of hypertension and smoking. She has been a smoker since she was 18 and in the last 6 months, has experienced shortness of breath during exercise. She reports having a cough for a year which has worsened in the last 3 to 4 months and is now producing phlegm. For the last 20 years, she has had a habit of smoking 1 pack of cigarettes per day. Olga is also currently taking medication for her hypertension which includes a physical exam with a post-bronchodilator study. Her results were as followed: FEV1 – 85% predicated, and FEV1/FVC (forced expiratory volume in 1 sec/forced vital capacity) – 65%. These numbers contribute to her diagnosis of mild COPD (Chronic Obstructive Pulmonary Disease). Risks for obtaining …show more content…
Teach her breathing techniques to use during her shortness of breath. One of the options is the huff cough, demonstrate with patient to sit with her head slightly flexed, forearms on pillows. Then inhale through the mouth slowly using the diaphragm, hold breath for 2-3 seconds and exhale forcefully. After doing this a couple of times, then cough. This will allow mucus to come up the throat and be expelled clearing the lungs (Lewis p.594). Other breathing techniques are pursed lip breathing. This can help her slow breathing down during acute episodes/anxiety. Demonstrate with patient to inhale slowly through the nose and then exhale through lips and are pressed as if to cup a straw, repeat 8-10 times. This will slow breathing and allow air exchange of CO2 and O2 (Lewis, p. 579). As the disease progresses, the tripod position is helpful and will relieve the pressure on chest if a bronchodilator or corticosteroid inhaler has been prescribed during acute exacerbation. Demonstrate with patient to sit at the edge of chair and lean forward to relieve chest