dyspnoea, increased sputum volume and increased sputum purulence. This essay may contain factual inaccuracies or out of date material. Behavioural interventions include counseling programs that teach problem-solving skills and support groups. There is also evidence of mildly raised JVP as well as mild pittint ankle oedema. Initially, he appeared to do well with the nifedipine with improved symptoms but presented back for evaluation 2 months later with worsening shortness of breath with minimal activity. The shortness of breath worsened over the 4 days and was associated with noisy breathing. Provide supplemental oxygen via nasal prong 3L/min and maintain SpO2 above 90%. This concurs with a Cochrane metaanalysis by Lacasse et al [8] which strongly support respiratory at least four weeks of exercise training as part of the of management for patients with COPD. An echocardiogram is examples to evaluate for left examples ejection fraction, right ventricular function, pulmonary study pressure, valvular function, pericardial effusion and any hypokinetic area. Citation: Teixeira PJZ, Lumi C. Pulmonary rehabilitation in COPD: a case study. There is a strong family history of hypertension in that his mother as well as two other siblings are also hypertensive. Another proposed mechanism is increased cytokine production due to chronic hypoxia. COPD Case Study Assignment. *You can also browse our support articles here >. Results: ECG with sinus rhythm. An ECG may be done to look for right atrial hypertrophy. No other abnormalities seen. On physical examination, coarse crepitations would be heard in bronchiectasis as opposed to the fine crepitations heard in Mr TLT. There was no guarding or tenderness. Mr TLT then proceeded to have shortness of breath for the past one year. He was given an appointment with the medical outpatient department in one month time in order to review his symptoms after being given MDI ipratropium bromide. A chest plain radiograph may be done in order to look for evidence of heart failure such as cardiomegaly. Study for free with our range of university lectures! Free resources to assist you with your university studies! Chronic obstructive lung disease has long been known as a localized pulmonary disorder. The following case studies outline the different ways in which Mitchell Physiotherapy can assist you. ii) patients with exacerbation of COPD with two of the cardinal symptoms if increased, purulence of sputum is one of the two symptoms, iii) patients with severe exacerbations of COPD that requires mechanical ventilation. In conclusion, it was appropriate that Mr TLT was not given antibiotics as he did not have the cardinal signs as mentioned by the GOLD guidelines and further supported by the systemic review. The sputum produced by Mr TLT is mucoid in nature and not purulent which is typical in bronchiectasis. Sputum culture may not be useful as even in the clinical stable state, some patients have sputum positive for bacteria. He had mild ankle oedema but no other signs of heart failure such as orthopnoea or paroxysmal nocturnal dyspnoea. Pulmonary rehabilitation has been shown to be very effective in counteracting these consequences in patients with more advanced COPD. Independent of the loss of muscle mass is the reduced muscle endurance. His breathlessness improved after nebulization with ipratropium bromide, salbutamol and normal saline for one day. Studies have also shown that there is increased apoptosis of muscle cells at the cellular level. All work is written to order. Is thought to be more common among men, it now affects women nearly as equally developed. Was warded for a total of 3 days hypertensive for the past 1 year especially on exertion respiration and is... 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