NR 603 Week 2: Case Discussion Pulmonary – Part 1. Complete

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NR 603 Week 2: Case Discussion Pulmonary – Part 1. Complete.1. What is your primary diagnosis for Michelle given the pattern of occurrence of symptoms, exam results, and recent history? Include the ... rationale and a reference for your diagnoses. Diagnosis: Mild to moderate persistent asthma with episode of shortness of breath (SOB) related to occupational problems/ work circumstances. ICD code: J45.30 and Z56.9 Asthma Asthma is a chronic airway inflammation characterize by respiratory symptoms such as SOB, coughing, wheezing and tightness of the chest, along with a variable of expiratory airflow limitation. A diagnosis of asthma be confirmed by a history of various respiratory symptoms and pulmonary function test (PFT). A diagnosis of asthma can be diagnosed by the patient past respiratory symptoms and a FEV1 greater than 12% difference between a pre-and-post PFT (GINA, 2020). Rationale: The patient has a history of seasonal allergies, recent episodes of SOB and a few months ago visited an urgent care for her SOB. The patient’s physical exam presents slight wheezing on inspiration and forced expiration with wheezing that does not clear with forceful coughing. The patient pre-PFT resulted in a FEV1/FVC of 60% and the post- PFT resulted in a FEV1/FVC of 75%, which is greater than 12% improvement indicating a diagnosis of asthma as per the GOLD guidelines (GINA, 2020). Occupational asthma is an exposure of substance(s) that causes an exacerbation or contribute to worsening of preexisting condition in the workplace. Classic symptoms of occupational asthma may include coughing, difficulty breathing, wheezing, and tightening of the chest (Bepko and Mansalis, 2016). Rationale: HPI: The patient reports SOB mostly occurs at work and resolves before arriving home. Upon returning to work, the patient reports her SOB returns. The episodes of SOB do not occur on the weekends. Based on her HPI the patient symptoms are associated with occupational asthma. 2. What is your first-line treatment plan for Michelle including medications, labs, education, referrals, and follow-up? Identify the drug class of each [Show More]

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