R. W. is a 64-year-old Caucasian postal clerk who has smoked a pack of cigarettes a day for the past 35 years

R. W. is a 64-year-old Caucasian postal clerk who has smoked a pack of cigarettes a day for the past 35 years. He reports to his CNP in his family practice clinic. He presents with progressive difficulty getting his breath while doing simple tasks. He is having difficulty doing any manual work, but he has no symptoms when working behind his desk. He also reports a cough, fatigue, and weight loss. He has been treated for three respiratory infections a year for the past 3 years and feels like another one is developing now. On physical examination, you notice clubbing of his fingers, use of accessory muscles for respiration, wheezing in the lungs, and hyperresonance on percussion of the lungs. Pulmonary function studies show an FEV1 of 58%. R. W. is a 64-year-old Caucasian postal clerk who has smoked a pack of cigarettes a day for the past 35 years.

Advanced Physiology and Pathophysiology

In a paper not to exceed six pages, excluding title and reference pages, please answer the following:

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1. What is R. W.’s likely diagnosis?
2. What stage of disease does RW have?
3. List specific pharmacotherapeutic treatment goals for R. W.
4. What drug therapy would the CNP likely prescribe? Why?
5. What are the parameters for monitoring the success of the therapy?
6. Describe specific patient education based on the prescribed therapy.
7. List one or two adverse reactions for the selected agent that would cause the CNP to change therapy.
8. What would be the choice for second-line therapy?
9. What health promotion activities should be recommended for this patient?
10. If RW was currently taking metoprolol for “headaches” would a change be recommended?
11. R. W. is a 64-year-old Caucasian postal clerk who has smoked a pack of cigarettes a day for the past 35 years

Please use the Case Study Analysis rubric provided to guide you in completing this assignment. It will be used to evaluate your submitted work.

Title: Case Study: R.W.’s Respiratory Health

R. W. is a 64-year-old Caucasian postal clerk who has been smoking a pack of cigarettes every day for the last 35 years. He visits his CNP at a family practice clinic. He’s experiencing increasing difficulty breathing during simple tasks. Manual work is challenging for him, but he feels fine when working at his desk. He also has a persistent cough, fatigue, and weight loss. He’s been treated for respiratory infections three times a year for the past three years and thinks he might be developing another one now. During a physical exam, his fingers appear clubbed, he uses extra muscles to breathe, his lungs wheeze, and they sound hollow when tapped. His pulmonary function tests show an FEV1 (a measure of lung function) of 58%.

In a paper not exceeding six pages (excluding title and reference pages), please address the following:

1. R. W.’s Likely Diagnosis: What do you think R. W.’s health condition is?
2. Disease Stage: What stage of the illness is R. W. experiencing?
3. Pharmacotherapeutic Treatment Goals: What are the specific goals for R. W.’s medication treatment?
4. Prescribed Drug Therapy: Which medication would the CNP probably recommend? Why?
5. Monitoring Success: What criteria will show that the treatment is effective?
6. Patient Education: What should R. W. know about his prescribed therapy?
7. Adverse Reactions: Name one or two potential side effects of the prescribed medication that might lead the CNP to change treatment.
8. Second-Line Therapy: If needed, what alternative treatment could be considered?
9. Health Promotion: What activities should R. W. follow to improve his health?
10. Metoprolol Use: If R. W. is currently taking metoprolol for headaches, would the CNP suggest a change?

Please refer to the Case Study Analysis rubric provided to help you complete this task. It will be used to evaluate your work.

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