Below is your patient visit: Brad is
Below is your patient visit: Brad is a 65-year-old, male Source: Self, reliable source Subjective: Chief complaint: “I am short of breath.” HPI: Brad is here to discuss his shortness of breath. He states this has been going on for years but has been worsening over the past few months. He feels short of breath with exertion, such as mowing his lawn, ascending steps and walking around the neighborhood. His shortness of breath is often accompanied with a productive cough. His symptoms are alleviated with rest. He denies any chest pain, peripheral edema, nausea or vomiting. Allergies: NKA Current Mediations: Olmesartan, 20 mg HCTZ, 50 mg Propranolol XL, 80 mg Pertinent History: Hypertension Health Maintenance. Immunizations: Immunizations up to date Family History: Father with history of myocardial infarction (passed at age 79) Mother with hypertension and diabetes (living) Social History: Patient lives with his wife. He smokes 1 pack per day (40 pack year history) and drinks approximately one beer a night. ROS: Incorporated into HPI Objective: VS – BP: 141/92 mmHg, HR: 91, RR: 16, temp 98.6, oxygenation 94%, weight: 260 lbs, height: 74 inches. Brad is alert, awake, oriented x 3. Patient is clean and dressed appropriate for age. ENT: The right ear canal is clear and tympanic membrane is patent. Left ear canal is clear and tympanic membrane patent. The nasal mucosa is not edematous. The oropharynx is pink with no tonsillar erythema or exudate. There is no evidence of abnormal masses or leukoplakia. There is no anterior or posterior cervical lymphadenopathy present. Cardiac: No cardiomegaly or thrills; regular rate and rhythm, no murmur or gallop. No peripheral edema or jugular vein distention Respiratory: Decreased breath sounds all lobes; no rhonchi or rales Chest x-ray shows no consolidation or masses Spirometry shows FEV1/FVC < 0.7 and FEV1 of 65% predicted; no significant reversibility of obstruction is shown with use of bronchodilator Assessment: Diagnosis: Moderate chronic obstructive pulmonary disease Please answer the following: Utilizing the guidelines mentioned in your lecture, what is your prescribed treatment plan (include specific dosage, frequency) (2 points)? Why did you choose this treatment plan? In your answer, please describe, briefly, the pharmacodynamics (2 points) and pharmacokinetics (2 points) of your treatment choices and how they influenced your choices. Do you need to switch any of his medications? If so, what do you change the medication(s) to (1 point)? Document the education you would provide for this patient, specific to the prescribed medication(s) and when you would want to re-evaluate this patient (1 point).
******CLICK ORDER NOW BELOW AND OUR WRITERS WILL WRITE AN ANSWER TO THIS ASSIGNMENT OR ANY OTHER ASSIGNMENT AND SEND IT TO YOUR EMAIL BEFORE YOUR DEADLINE. OUR PAPERS ARE PLAGIARISM FREE*******."
