The results of her pulmonary function tests

Posted: February 3rd, 2024

Darla Thomas, a 25 y.o. African-American, previously well-woman, presents to her primary care Nurse Practitioner’s office with complaints of episodic shortness of breath and chest tightness. She has had the symptoms on and off for about 2 years but states that they have worsened lately, occurring two or three times a month.

She notes that the symptoms are worse during the spring months. She has no exercise-induced or nocturnal symptoms. The family history is notable for a father with asthma. She is single and works as a secretary in a high-tech firm.

She lives with a roommate, who moved in approximately 2 months ago. The roommate has a cat. The patient smokes occasionally when out with friends, drinks socially, and has no history of drug use. Examination is notable for mild end-expiratory wheezing.

Pulmonary function tests are ordered to confirm the diagnosis.

In this discussion:

  1. Discuss what you think this patient’s likely diagnosis is. Why do you support this “likely” diagnosis?
  2. Identify the pathogenetic mechanisms that are responsible for this patient’s symptoms of wheezing, shortness of breath, and chest tightness.
  3. What might you expect the results of her pulmonary function tests to be? Why?
  4. Provide and discuss a plan of care for her. What would be your priority patient education outcomes? How would you achieve these outcomes?

Include citations from the text or the external literature in your discussions.

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