Cardiorespiratory Physiotherapy K

We recommend reading the 'Clinical Assessment Resource Package' prior to viewing any videos. Download the 'Clinical Assessment Resource Package' from: http://www.appeducation.com.au/videos... 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