Breathlessness Case study Assignment
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages to Order 5-10 Pages Description/Paper Instructions
Vicky Jeffrey is a 78-year-old woman who was first diagnosed with asthma when she was
15. She has recently complained of continuous breathlessness to her GP, despite taking her inhalers. She is normally on Clenil® 100mcg 2 puffs BD via a
metered dose inhaler (MDI) and salbutamol as needed, both via a spacer device. (Clenil® is a formulation of beclometasone dipropionate, an inhaled
corticosteroid.) Mrs Jeffrey has been referred by her GP to a specialist respiratory service for assessment and management of her continuous
breathlessness. The patient referral also states that she has never smoked but previously worked in a pub and lived with a husband who was a heavy smoker
and died of lung cancer. Mrs Jeffrey finds it increasingly difficult to do her daily domestic chores and can only manage 60 metres walking outdoors on a flat
surface.
A careful history of the patients symptoms is required to understand whether or not she has a diurnal variation of her symptoms and if she has been taught
to step up and step down her inhaler during an acute asthma attack. It is also necessary to establish whether the patient carries out a regular peak flow, which
will help to determine step up and step down of therapy.
Mrs Jeffrey has no diurnal variation in symptoms and no allergies. A history of allergies is important, as an allergic reaction can trigger an exacerbation of
asthma in the majority of asthma patients. We know from the patients history that she never smoked but lived with her husband who was a heavy smoker
and used to work in a pub when smoking was not banned in public places in the UK. From the literature, we know that COPD can occur as a result of passive
smoking in non-smokers the risk is highest with environmental tobacco exposure in multiple settings such as home and work (Hagstad et al. 2014).
Past medical history revealed none of the following: heart failure, hypertension, atrial fibrillation, DVT, pulmonary embolus and no previous cardiac surgery.
This information will help to rule out other causes of breathlessness.
Drug history: Clenil 100mcg MDI 2 puffs BD, salbutamol 100mcg MDI as required, simvastatin 20mg at night, and paracetamol 500mg when needed.
The following investigations were carried out:
Chest X-ray showed bilateral hyperinflation
Arterial blood gases PH 7.37, PCO2 4.8 kpa, PaO2 11kpa, SaO2 99%, HCO3 23, BE -2
Blood test CRP 3mg/l, Na+ 138mmol/l, K+ 4.2mmol/l, Hb 12.5g/dL, BNP 30pg/ml, WCC 7 x 109/l, INR 0.9, Troponin 10
No chest pain
Pulse oximetry SpO2 96% HR 85b/min
Spirometry result showed FEV1 40% predicted, FEV1/FVC ratio 45%, with the usual concave shape of the flow volume curve
MRC 4
Frequency of exacerbation: 34 in 12 months
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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