KINGDOM OF GOD HOSPITAL LOS ANGELES ,CALIFORNI A 900000.
Age/Sex 80years old man 🧓
Account number Q006543299.
MR # Q00049593422.
Admitted 06/19/2021@ 0930am.
Status: Inpatient admit.
Attending doctor Tommy Holbib.
Patient name Coconute,David.
Resuscitation Status: Full code.
Primary diagnosis COPD Exacerbation.
Secondary Diagnosis:DM, Hypertension, CHF,Pacemaker, Hx pancreatitis. Coughing out whitish secretions, on breathing treatment.,Shortness of breath. Ejection fraction of 40%. Shortness of breath excertion,wheezing.
Ambulates with front wheel walker.
Azithromax 250mg po Q12hours.
Solumedro 125mg IV Q12hours.
Saline lock right Ac intact and clean 20guage. Flush Q8hours.
Metoprolol for blood pressure 10mg po Bid.
Nebulizer without atrovent added.
Breathing treatment with Respiratory therapist Q4hours.
Tylenol 500mg po Q4hours prn pain.
Pancreanase 1capsule before meals.
Humalin 15units Bid.
NKDA, Alert and oriented ×4.
Wife at his bedside .
Phone number 900- 00- 0000.
Discharge home with wife in two days when medically stable. Home health nurse x3/ week.
Patient has short of breath with exertion,has thin,clear secretions chest Xray was done.Upon assessment of the patient the nurse noticed that patient has a barrel-shaped chest.How do you describe your findings?.
B.Posterior and anterior displacement of sternum.
C.An increased anteroposterior diameter of the chest wall.
Correct answer C.
Rationale: In some patients the chest wall becomes chronically expanded which is because of the expansion of the lungs with time 🫁 will result in a barrel-shaped chest.A,B,and D are all wrong.