Clinical Impression & Recommendation for Known Condition

Question 1

Emphysema case example:
- Pt is able to ambulate 10 meter with 4-wheeled walker before experiencing dyspnea rated at 7/10
- The patient is coughing up green sputum
- Bronchial breath sounds are noted in the left lower lobe

Clinical impression?

Answer 1

1. Restate the Pt main Dx:
   - Pt is suffering from an acute exacerbration of emphysema requiring hospitilzation and medical intervention.
2. Highlight the Pt’s main impairment and the impacts on the function:
   - The exacerbation has resulted in severe dyspnea and a dec. in their overall mobility status
3. Comment on recovery: on a normal timeline/delayed recovery
   - Given the nature of COPD, exacerabtations are not uncommon and the Pt’s status should continue to improve as the exacerbation settles
4. Continue to highlight the new finding in additional info
   - Pt has a productive cough with green sputum and broncial breath sound in the Lt LL indicating potential pneumonia

Question 2

Will Pt benefit from PT intervention?

Answer 2

Link the impairment to the goal of Rx to explain:

I think that the Pt would benefit from PT
- To increase their overall functional mobility and help them *return to home independently *

• For secretion clearance to help manage the pneumonia

Question 3

General Treatment recommendation

Answer 3

List out the problems and assign treatment for them

• Given the acute exacerbation of their respiratory condition and possible pneumonia–>important to monitor their respirtaory status

Dec. Fx mobility
- Gait aid when mobilizing–>ensure their safety while mobilizing independently
- Fx strengthening in their program to maximize their Fx mobility potential in order for them to safely return home

Dyspnea & presence of sputum
- teach patient secretion removal techniques and teach the Pt PLB to aid in dyspnea

Treatment frequency/refer to others?(PTA)
- I would classify this Pt as someone who should be seen daily in order to reach their goal of returning home independently
- I feel that this Pt would benefit from working with a PTA to assist with daily exercises as a way to inc. their conditioning