Critical Pathway: Idiopathic Pulmonary Fibrosis Essay

Critical Pathway: Idiopathic Pulmonary Fibrosis Essay

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Mr. B is a 65 year old Caucasian male, presenting in the ER with complaints of shortness of breath, and non-productive cough for the past 8 months. He states the shortness of breath worsens with activity and frequent “coughing spells”.
Mr. B has been treated for Pneumonia and Bronchitis over the past 8 months with oral antibiotics and steroids. Mr. B noticed slight improvement of symptoms while on medication; however, the symptoms never resolved, and seem to be progressively worsening.
Mr. B is growing concerned because he has unintentionally lost weight, he tires easily, and he is unable to preach entire sermons without getting “out of breath”. Upon examination, Velcro-like rales are auscultated in bilateral better to use after lungs.lower lungs bilaterally. When talking, the patient is noted to have rapid, shallow breathing. Slight clubbing of the fingers noted. Initial vital signs were (bold indicates abnormal values):
Height- 5 ft 8 in
Weight- 170 lbs
Blood pressure- 122/78
Pulse- 100
Respirations- 28
Oxygen Saturation- 90%
Temperature- 97.6 (oral)
Blood was drawn for routine laboratory tests, and no abnormal values were noted:no ABGs ?
Comprehensive Metabolic Panel
Potassium- 3.3 low 3.5-5.5 mEq/L not addressed in paper
Sodium- 137 135-148 mEq/L
Chloride- 102 96-112 mEq/L
Carbon Dioxide- 34 21-34 mEq/L
Glucose- 73 65-99 mg/dL
Blood Urea Nitrogen- 15 8-25 mg/dL
Creatinine- 0.9 0.6-1.5 mg/dL
Calcium- 8.3 8.0-11 mg/dL
Magnesium- 1.7 1.5-2.5 mg/dL
Phosphorous- 3.3 2.2-4.8 mg/dL
Albumin- 4.3 3.5-5.0 gm/dL
AST- 13 7-21 U/L
ALT- 11 0-30 U/L
Complete Blood Count
RBC- 4.8 4.2-5.6 M/L
WBC- 8 3.8-11.0 K/mm3
Hematocrit- 42 39-54%
Hemoglobin- 16 14-18 g/dL

... middle of paper ...

...sis. Retrieved from
Raghu, G., Narayanan, A., & Khalil, N. (2014). Pathogenesis of idiopathic pulmonary fibrosis. In D. S. Basow (Ed.), UpToDate. Retrieved from
Sarkar, M., Mahesh, D. M., & Madabhavi, I. (2012). Digital clubbing. Lung India, 29(4), 354-362. doi: 10.4103/0970-2113.102824.
Spagnolo, P., Tonelli, R., Cocconcelli, E., Stefani, A., & Richeldi, L. (2012). Idiopathic pulmonary fibrosis: diagnostic pitfalls and therapeutic challenges. Multidisciplinary Respiratory Medicine, 7, 1-10. doi: 10.1186/2049-6958-7-42
WebMD. (2012, September 4). Obstructive and restrictive lung disease. Retrieved on March 15, 2014 from:

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