Cardiorespiratory Physiotherapy K

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Background information for video vignette .

Diagnosis:
Bronchiectasis

Context:  
Patient admitted to ward via ED with acute chest infection secondary to Bronchiectasis

TABLE 4: Background information for cardiorespiratory vignette

DEMOGRAPHIC INFORMATION

Setting:
Acute medical ward

Gender:
Female

Patient age:
35 ‐ 45

Cultural background:
Aboriginal or Torres Straight Islander

Occupation:
Part‐time at a support shelter

Main Presentation:
Acute chest infection secondary to bronchiectasis

Student Name:
Amy

Educator Name:
Tom

Patient Name:
Polly Carter

CLINICAL HISTORY

Reason for attending physiotherapy:
Shortness of breath, pain on coughing, sputum retention and reduced exercise tolerance

History of presenting condition:
Patient reported to ED with increased SOB and generally feeling unwell. Past 6 days reports increasing symptoms of SOB, coughing and declining exercise tolerance. Reports development of productive cough with green thick sputum greater in the am. Current observations include, afebrile, HR 105, RR 26 and saturation 93%

Investigations:
Haematology reported increased WCC and CRP, arterial blood gasses reported PaO2 65, ph. 7.3, PaCO2 55 and HCO3 normal, indicating respiratory acidosis. Chest x‐ray revealed evidence of shadowing in the right middle/lower lobe

Past Medical History:
Diabetes and Bronchiectasis

Past Surgical History:
nil

Medications
Diabex, Metformin

Alcohol and Drug:
nil

Social History :
Lives with husband and 4 kids in supportive home environmen t. 4 stairs at rear of house only, nil other home modifications.

Functional History:
Previously independent with nil aids, exercise tolerance 3 00m limited by SOB

Patient Goals:
To return to work and managing family responsibilities