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The ability to communicate your knowledge in oral and written formats is a core academic skill set you should acquire whilst at University.
Learning Outcomes
Successful completion of this assignment should allow you to:
 
Assignment Requirements
 
A 1500 word, structured response answering the specific questions presented in the following case study.
 
     
 
 Integrated Clinical Case
 
Patient Background
You have been tasked Priority 2 to a 75 year old man with chest tightness and shortness of breath.  On your arrival you find a very thin, elderly man sitting on a chair with his arms braced on his knees.  He looks very dyspnoeic.  His initial observations are:
 
 
The man’s name is Mr Wenham, and he is only able to speak single words.  His wife tells you that his breathing is never very good, because he smoked far too much.  She says he sometimes struggles to walk around the house.
 
 
You form the view that Mr Wenham is suffering from an exacerbation of Chronic Obstructive Pulmonary Disease (COPD).  You administer supplemental oxygen, atrovent and salbutamol (following local guidelines), and prepare for the 60 minute journey to hospital.
 
 
 
Mr Wenham’s oxygen saturation improves with supplemental oxygen but he remains tachypnoeic, tachycardic and hypotensive.  On arrival at the Emergency Department you go straight to the resuscitation room and an arterial blood gas sample is taken and analysed immediately with the following results:
 
 
 
 
 
The emergency department staffsuggest you may have given Mr Wenham too much oxygen. They say they are going to remove the oxygen.
 
 
 
The emergency department consultant returns from his lunch break to interrupt the oxygen debate.  He suggests that Mr Wenham needs BiPAP.
 
 
Three days later, after 18 hours of BiPAP, corticosteroids and physiotherapy, Mr Wenham is much improved.  The respiratory physician responsible for his care orders spirometry.  This shows:
 
 
 
 
 
 
 
 Integrated Clinical Case
Answer Template (cut and paste into a new document).
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
REFERENCES
Harvard
 
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Unlimited Free Revisions,Pathophysiology for respiration