what is the anatomy parts in this case? and also the physical
examination in this case
A 56-year-old man with a history of smoking rush to ER at FUMC
with shortness of breathandcough for several days. His symptoms
began 3 days ago with runny nose. He reportsachronicmorning cough
productive of white sputum, which has increased over the past 2
daysPast Medical History
He has had similar episodes each time of raining season for
the past 4 years. Healwaysexperiences fatigue, worsening cough,
increased breathlessness and waking up inthemorningwith headache.
Family History
(+) Tuberculosis
(+) Hypertension
(-) Cancer
Personal and Social History
He has smoked 1 to 2 packs of cigarettes per day for 40 years
and continues tosmoke. Hedenies hemoptysis, chills, or weight loss
and has not received any relief fromover-the-countercough
preparations. Admission Order:
NPO temporarily. Start IVF, PNSS 1L x KVO. Hook to O2 therapy
via nasal cannulaat 2-3LPM.Nebulization of Salbutamol + Ipratropium
now, then every 6 hours. Acetylcysteine(Fluimucil)400mg 1 sachet
dissolved 1/2 of H2O every 6 hours, can be started tomorrowmorning.
Tazobac(Piperacillin sodium) 4.5 g thru soluset dissolved in PNSS
90 cc x 1hr ODANST( ). For Chestx-ray,CBC, FBS, ECG, Urinalysis and
ABG. Please do spirometry and monitor for diseaseprogress. Chest
x-ray shows hyperinflation and right lobe pneumonia. ABGresults
wasPh7.24,PO2-35 mmHg, PCO2 60mmHg, HCO3 30, O2 sat - 85%.
Spirometry with FEVI 35%predictedthat does not change significantly
after inhaled bronchodilators. ECG was ordered. Physical
Examination:
Took vital signs which are: BP: 130/80, T: 37.5 Celsius,
PR:89, RR:30. Examinationdisplayedtachypnea, respiratory distress,
use of accessory muscles, and intercostal retraction. Barrel
chest is a common observation