Description

NR 603 Week 3 iHuman Case – Joseph Camella

J.C. is a 66 y.o. W.M. who presents with complaints of worsening SOB and cough. Onset of symptoms approximately 10 years ago but becoming progressively worse in the last 5 years. PMH pertinent for HTN, D.M. (controlled), and Seasonal allergies. He is a 40-pack-year former smoker with a known occupational history of asbestos exposure. He reports associated symptoms of wheezing, persistent productive cough (thick white sputum) that is worse at night, bilateral pedal edema, increased fatigue, and worsening exertional dyspnea. States his SOB is now impacting his functional ability and QOL. He denies C.P., palpitations, syncope, dizziness, numbness, recent illness, and exposure to sick contact. No recent travel. Denies fever/ chills, H.A., numbness/ tingling, and GI/GU symptoms. Patient is afebrile on arrival with O2 sats 94% on R.A. at rest. B.P. elevated. Exam reveals increased work of breathing with accessory muscle use and persistent cough. No hyperresonance or evidence of hyperinflation or clubbing is noted, but he exhibits BLL wheezing and diffuse crackles. HR regular with Mitral valve regurgitation noted on auscultation. There is a family hx significant for heart disease, his brother is deceased from CA.

NR 603 Week 3 iHuman Reflection – Pulmonary Assessment

Reflection: Address the following questions:

1. 1. Which diagnostic tests did you select for this client? Using the estimated national average cost for each diagnostic test from a website such as MD save (https://www.mdsave.com/) calculate the total cost for diagnostic testing for this client if he was uninsured. How might this information change your decision to order diagnostic tests for the client?
      • Data indicate that clients with chronic lung disease and low income have increased utilization of acute care services (Melillo, 2021). What questions should the primary provider ask when providing education to clients with these diagnoses to ensure they have the resources they need to follow up with appropriate care?

1. 2. Include the following components:
      • write 150-300 words in a Microsoft Word document
      • demonstrate clinical judgment appropriate to the virtual patient scenario
      • cite at least one relevant scholarly source as defined by program expectations
      • communicate with minimal errors in English grammar, spelling, syntax, and punctuation