Chapter 37

A 67-year-old female patient presents to the emergency room you work at complaining of shortness of breath and pain on the right side of her chest. Upon auscultation of the lung field during the physical exam, you note flatness and diminished breath sounds over the right lung. Her temperature is 101.3°F.

a.            What are possible causes of her symptoms and what tests might you expect to be ordered to determine the specific cause of this patient’s symptoms? Why?

b.            This patient’s husband tells you he does not understand why she feels short of breath. How might you explain to him the lung physiology that underlies her symptoms?

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Dicusss a disease , condition, or procedure of the respiratory system — 2 page report 

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This week’s topic  is :  The case of  “I can’t catch my breath”

John, a healthy twenty-eight year old electrical engineer, was driving home from work one evening when he experienced sudden stabbing pain in his right pectoral and right lateral axillary regions. He began to feel out of breath and both his respiratory rate and heart rate increased dramatically. As luck would have it, John passed a hospital each day on his way home and was able to get himself to the hospital’s emergency room. The emergency room physician listened to John’s breathing with a stethoscope and requested blood gas analysis and a chest x-ray. John answered a few of the doctor’s questions. The doctor noted that John had no history of respiratory problems but was a heavy smoker.

After viewing the chest radiograph, the doctor informed John that he had experienced a spontaneous pneumothorax, or what is commonly called a collapsed lung. The doctor explained that a hole had opened in John’s right lung and that this hole had allowed air to leak into the cavity surrounding the lung. Then, as a result of the lung’s own elastic nature, the lung had collapsed. The doctor said he could not be certain of the cause of thepneumothorax, but smoking cigarettes had certainly increased the likelihood of it happening. He told John he was fortunate the pneumothorax was small, which meant that relatively little air had escaped from the lung into the surrounding cavity, and it should heal on its own. He instructed John to quit smoking, avoid high altitudes, flying innon pressurized aircraft, and scuba diving. He also had John make an appointment for a re-check and another chest x-ray.

Case Background

Spontaneous pneumothorax occurs when a blister on the surface of the lung opens, allowing air from the lung to move into the pleural cavity. This occurs because alveolar pressure is normally greater than the pressure in the pleural cavity. As air escapes from the lung, the lung tissues will recoil, and the lung will begin to collapse. The lung will continue to collapse until the difference between the alveolar pressure and pleural pressure disappears or until the collapsing of the lung causes the opening to seal.

The pneumothorax decreases the efficiency of the respiratory system, which in turn results in decreased blood oxygen concentration, increased respiratory rate, and increased heart rate. If the pneumothorax is small, the air that escapes into the pleural cavity can be reabsorbed into the lung once the opening has sealed shut. If thepneumothorax is large, a needle or chest tube may have to be inserted into the pleural cavity to draw the air out and allow for the re expansion of the lung.

Utilizing the med terms you learned this week answer the following questions

Why was John instructed to avoid high altitudes and flying in non pressurized aircrafts?

That is, what are the effects of high altitudes and or decreased air pressures on the respiratory system.

Here are the discussion board requirements.

• The initial discussion post must be at least 250 words of content, referencing the reading of the week, and include a scholarly source.
• classmates. 
• Plagiarism of any kind will result in a “0”.

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Atleast 500 words needed.

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 1.

It was very nice meeting with you and learning more about the LPN position in Family Medicine that you have interviewed me for. I appreciate you taking the time out of your day to meet with me and get to know me a little more, while looking through my resume at my qualifications. The job that you have posted and interviewing for seems like it would be a very good match for my knowledge and interests. After looking over and talking with you more in depth about the job description, allowed me to confirm that I would enjoy working at Park Nicollet and would be a great addition to your health care teams. With my 9+ years of experience working in the health care field, I believe that I have valuable qualities that will help provide your patients with the best quality of care possible. I am very honored and appreciative that you chose to interview me and hope we will have the opportunity to work together in the near future. Thank you again.

Tawna Postel

I feel that it is a good idea to send a thank you letter to a company who has taken the time to interview you. Not only does it show that you respect them and their company, but that you are interested in the job itself. I also feel that sending a thank you letter will make a canidate stand out amongst others. I dont feel that just because someone sends a thank you letter, that they will receive the job; that is based off how qualified the employee is. 

2.

Good Afternoon Mrs. Anderson,

I wanted to take a moment in time to express my gratitude to you for allowing me the opportunity to meet you. It was an absolute pleasure to enter the clinic as I was greeted with a warm welcome from the staff and the uplifting ambiance. It was lovely to see all the employees work well together as a team.  I appreciate you taking the time to explain the hiring process and how the training program works at your clinical. I am very impressed with the opportunity you have available here and I would be delighted to add to your team as an LPN. 

It would be a honor to be considered for a LPN position at this clinic. I am very much looking forward to hearing from you in regards to the next steps. Please do not hesitate to contact me if you need any additional information than I provided or if you have any further questions. I hope to hear from you soon!

Sincerely,

Morgan Koivisto,

When I first watched the videos, I thought writing a thank you letter would be rather simple and quick. I do think that less words are better than more words and it leaves a lasting impression. However, when I sat down looking at a blank slate, I had a hard time coming up with the right words to say. I wanted my letter to be genuine and not too scripted. I thought this was a very good experience as this is something we will be needing to write to our potential employers. I liked it. 

i just need a respond for these two post

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