Respiration Problems Case Study

Respiration Problems Case Study

Aging is a natural process that has many challenges associated with it health wise especially. Many people tend to develop new complications or the worsening of current conditions. Indeed, regular checkups are recommended to cope with the health challenges of aging and the likes. Among the aging adult population, heart and respiratory problems the most common as these two systems continue to slow in performance. In this case study, the patient is having respiratory problems which could point to many complications since the respiratory system is a very complex and involves many components are constantly working to sustain the body’s oxygen needs. The patient’s activities and lifestyle including their history are usually analyzed in order to determine the exact cause of their problems since most often, their current complications are brought upon or made worse by the factors mentioned above.


According to the patient’s medical history, it is likely she is suffering from a serious form of emphysema that is aggravated by the patient’s age and previous heart problems. Emphysema is a disease in the COPD (Chronic Obstructive Pulmonary Disease) group of diseases where the alveoli are damaged, these alveoli are the tissue responsible for exchanging of oxygen and carbon dioxide gasses in the lungs[ CITATION Sha08 l 1033 ]. The disease is a progressive one and as such, it can get worse over time. The patient in the case study exhibits signs of a serious emphysema such as shortness of breath and tiredness. Her strong and regular pulse seems to indicate that there is no immediate concern with the heart. However, her high blood pressure is a cause of concern as it may further aggravate the already worrying emphysema. The improper functioning of the lung tissues could be a cause of the delusions that the patient is experiencing due to a lack of enough oxygen supply to the brain. Her shortness of breath seems to indicate the extent of the destruction of the lung tissue that needs to be addressed as soon as possible. Lack of enough oxygen is also responsible for the peripheral cyanosis that is exhibited by the patient. The patient also shows signs of heart problems that may be caused by a development of her Marfan syndrome. Asthma and lung cancer cannot be ruled out as differential diagnosis since some of the symptoms associated with COPD are eerily similar to the two diseases


An ABCDE assessment is an important approach in medicine to be able to determine the level of seriousness of any medical emergency[ CITATION Thi12 l 1033 ]. This approach is widely used in the medical profession to help determine the sort of immediate treatment that can be offered to the patient at that moment to safeguard the patient’s life. It is a systematic way of assessing the patient’s condition and the need for emergency treatment or help. ABCDE is a mnemonic for Airway, Breathing, Circulation, Disability and Exposure, this approach allows medical professionals to diagnose a patient before a definitive diagnosis can be made. This approach is commonly referred to as the A to E-assessment. The following is the A to E assessment of the patient:

  1. The patient’s speaking indicates that there is a partial obstruction of the airway. The shortness of breath and the mild wheeze are the prime indicators.

  2. The patient has a very rapid respiration rate due to the difficulty of breathing caused by the obstruction. She is using her auxiliary lung muscles to assist in breathing, therefore, requiring assisted breathing.

  3. The patient has a regular and strong pulse indicating that her blood pumping mechanism is functioning normally. Her blood pressure is abnormally high and requires attention

  4. The patient cannot move and is confined to the bed although

  5. The patient has been involved in a stressful ordeal recently


Apart from COPD, there are other types of respiratory diseases the most common include; Asthma, bronchitis, pneumonia, lung cancer, emphysema, and allergies. They vary in degree but if left unchecked these diseases could get worse especially if they have triggers. Among them, asthma has the most in common with COPD since thy both involve the swelling and blockages of the airways. Although they are similar they have a number of differences such as permanency, COPD is a permanent condition, mucus often fills in the airways causing the blockages whereas in asthma there are certain triggers that cause the swelling and blockages[CITATION Man l 1033 ]. Asthma often develops at a young age while COPD is often found in the older populace since it involves the wearing out of certain lung tissues. For people with COPD and a hypoxic drive, it is ill-advice to give supplementary oxygen as it can increase the content of carbon dioxide in a patient’s blood which could prove toxic in the long run, it may also affect the person’s breathing stimulus[ CITATION Abd12 l 1033 ]. The delusions and tiredness experienced by the patient causing her to stick in bed can be in part caused by the buildup of carbon dioxide in the blood.


I recommend that the patient undergoes some tests to determine the extent of the COPD to be able to determine the best course of action. The patient should take a chest X-ray to rule out the Lung Cancer as a differential diagnosis and to generally see the extent of the tissue damage in the patient’s lungs. I would also suggest that the patient undertakes Lung functioning tests to be able to establish the air amount in and speed of flow in and out of the lungs. Additionally, I would suggest that transfer factor and Oximetry tests be carried out to understand the effect of the COPD on the patient’s blood oxygen levels. Lastly, I would recommend an echocardiogram be carried out to better understand the high blood pressure and any other heart conditions bearing in mind the patient’s history of Marfan syndrome.


Damage to the lung tissues is an irreversible condition but patients can be able to manage COPD and prolong life and be able to bear the complications associated with the disease. To ease the breathing problems Ventolin is used to deal with the spasms and blockages in the airways. Blood pressure medicine can be prescribed to deal with the patient’s high blood pressure that puts her at risk of a heart complication. Lack of enough oxygen can be addressed by specialized assisted breathing techniques appropriate for people with a hypoxic drive to avoid complications [ CITATION Gup13 l 1033 ]. Her condition also demands that she be placed under specialized COPD surveillance to avoid further progression of the disease as it would be life threatening


The patient requires immediate and specialized medical treatment and would, therefore, require being taken to the hospital. I would suggest that the husband takes her to a medical facility that specializes in respiratory diseases since the patient’s condition seems to be worsening especially with the onset of this new and persistent cough caused by the emphysema[ CITATION Cra17 l 1033 ]. A pulmonologist is better placed to handle such conditions and is in the best position to provide advice related to the patient’s condition. In this case, with all medical care and proper treatment I believe the patient would recover without fail. Therefore, there is a need for an appropriate check-up, to ensure accurate diagnosis and assessment followed by the right treatment on time.


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