Patient, a 71-year-old, retired truck driver, presented to Prince of Wales Hospital (POWH) due to an exacerbation of COPD (chronic obstructive pulmonary disease) of 2 days presenting as dyspnea on the background of 5-year history of COPD with 1 or 2 exacerbations a year, previous peripheral venous insufficiency with ulcers, previous solitary pulmonary nodule and an ex-smoker with 100 pack-year history. Initial examination presented with respiratory rate of 22 breaths/minute, oxygen saturation of 94%, dull percussion at lower zones bilaterally, regular lump at the back midline and near the shoulder.
Presenting Complaint
Patient had presented to GP (general practitioner) a week ahead for dyspnea and had only worsen. Patient presented to POWH …show more content…
Patient was also started on corticosteroids, Prednisone, to reduce inflammation and would be weaned off at discharge to avoid community acquired infections. Patient was to continue taking bronchodilators and inhaled steroids as before. An example of multimodal approach to management was when the patient was also prescribed physiotherapy to increase exercise tolerance and endurance which would lead to faster recovery and better prognostics. Patient was also referred to the social workers and occupational therapy as he expressed concerns going back to living alone. Patient was to have a follow-up with his GP in 3 …show more content…
The action to be taken in management should be to increase the dosage of inhaled short-acting bronchodilators, especially in this patient it would be proven useful to combat the presenting symptom as to relieve dyspnea. Oral corticosteroids are likely beneficial to lessen the respiratory burden on patients with purulent sputum. However, a hospitalized patient would benefit from continuous supplemental oxygen, antibiotics, and systemic corticosteroids (Evensen, 2010). This patient received antibiotics, immunosuppressant, bronchodilators, oral corticosteroids and a multimodal approach including, mental assessment, physiotherapy and an ASET (Aged-care Services Emergency Team)
Presenting Complaint
Patient had presented to GP (general practitioner) a week ahead for dyspnea and had only worsen. Patient presented to POWH …show more content…
Patient was also started on corticosteroids, Prednisone, to reduce inflammation and would be weaned off at discharge to avoid community acquired infections. Patient was to continue taking bronchodilators and inhaled steroids as before. An example of multimodal approach to management was when the patient was also prescribed physiotherapy to increase exercise tolerance and endurance which would lead to faster recovery and better prognostics. Patient was also referred to the social workers and occupational therapy as he expressed concerns going back to living alone. Patient was to have a follow-up with his GP in 3 …show more content…
The action to be taken in management should be to increase the dosage of inhaled short-acting bronchodilators, especially in this patient it would be proven useful to combat the presenting symptom as to relieve dyspnea. Oral corticosteroids are likely beneficial to lessen the respiratory burden on patients with purulent sputum. However, a hospitalized patient would benefit from continuous supplemental oxygen, antibiotics, and systemic corticosteroids (Evensen, 2010). This patient received antibiotics, immunosuppressant, bronchodilators, oral corticosteroids and a multimodal approach including, mental assessment, physiotherapy and an ASET (Aged-care Services Emergency Team)