Pulmonary Problem Solving I


Scenario Eight


Patient Chart
JL is a 58-year-old male who presents to the urgent care center complaining of malaise and shortness of breath of recent onset. He was recently diagnosed with Stage One COPD and was prescribed Spirva 1 puff QD and albuterol 2 puffs PRN. He also admits to smoking ‘about a half pack’ of cigarettes a day.

Examination reveals a slightly cachectic male who appears to be older than his stated age. He is alert and oriented and in moderate respiratory distress. He has an occasional moist nonproductive cough. His vital signs are: respiratory rate 30 and slightly labored, temperature 102F. SpO2 (on room air) 95%.

Use the Blood Pressure and Auscultation tabs to complete the physical assessment.



Heart Rate:
Blood Pressure: /

Auscultation:




Diagnosis
Which of the following would be the most useful diagnostic test to perform at this time?