Clinical Case Study Analysis - The University of Notre Dame

Assignment Task

The objective of this assessment is to assess your knowledge and application of the principles for non-invasive ventilation in the context of a deteriorating patient.

Instructions

Refer to the case study below and answer questions 1 and 2.

Case study - Patient clinical presentation

Martha Lee is a 65-year-old female admitted to the emergency department via ambulance with acute onset shortness of breath. Martha Lee states the shortness of breath commenced approximately two (2) days ago, progressively worsening with an associated cough and increase in sputum production. Patient documentation identifies a similar presentation two (2) years earlier secondary to acute exacerbation of chronic obstructive pulmonary disease (COPD).

Martha Lee denies any wheezing, chest pain, palpitations, abdominal pain, nausea, vomiting or fevers. Further, there have been no known contacts with Martha Lee that have been ill.

Background information

Martha Lee’s medical history includes:

• Coronary artery disease (2016 percutaneous coronary intervention to insert one (1) stent to right anterior descending coronary artery)
• Myocardial infarction (2016)
• COPD
• Pulmonary hypertension
• Hypertension
• Hyperlipidaemia
• Type 2 Diabetes Mellitus

Currently prescribed medications

• Aspirin 100mg PO daily
• Clopidogrel 75mg PO daily
• Hydralazine 50mg PO BD
• Metformin 500mg PO BD
• Simvastatin 20mg PO daily
• Albuterol-Ipratropium inhalation 4th hourly and PRN

Paramedics arrived having initiated the following interventions:

• 100% O2 non-rebreather mask
• 18-gauge IV cannulas in left and right cubital fossa

Assessment findings

Blood results

Question one (Word count recommendation: 800 words)

Analyse the data provided and explain the relationship between the pathophysiology of Chronic Obstructive Pulmonary Disease (COPD) and Martha Lee's:

1. clinical presentation
2. assessment findings
3. blood results

Question two (Word count recommendation: 800 words)

Discuss the most appropriate non-invasive ventilation setting for Martha Lee’s clinical presentation. In this response, outline three (3) SMART goals for Martha Lee’s treatment that you would include in your plan of care.

Additional instructions

• You must use current evidence and research to support your answers
• An introduction and conclusion is recommended
• A minimum of ten (10) research pieces must be used
• Research must be no older than ten (10) years old

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