Diagnosis and Treatment COPD Case Study

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What is your primary diagnosis for this patient at this time (Support the decision for your diagnosis with pertinent positives and negatives from the case)?The primary diagnosis for the presenting client is moderate to severe chronic obstructive pulmonary disease (COPD) (ICD-10-J44.9). A COPD diagnosis is given if the FEV1/FVC predicted is less than 0.7 percent (Haynes, 2018). The client reports an FEV1/FVC of 0.52, which is indicative of diagnostic airflow obstruction. The FEV1/FVC ratio of

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Clinical trials have shown LABA/ICS combination therapy to be more effective than either medication alone in improving lung function, reducing exacerbations and improving health status in patients moderate to severe COPD (Global Initiative for COPD, 2018). The clinician thus initiates therapy as follows:Medication #1Rx: Formoterol 12mcg capsule (LABA)Sig: 2 puffs daily, 12 hours apart, inhaled via nebulizerDisp: #90Refills: 3Rationale: Formoterol is a LABA with extended duration of action maintained 12 hours after installation of a single dose (Global Initiative for COPD, 2018). Its speed of action and potency make it effective for both quick relief and prolonged effect (Global Initiative for COPD, 2018).Medication #2Rx: Budesonide 180mcg inhaler (ICS)Sig: 2 puffs dailyDisp: #90Refills: 3Rationale: Anti-inflammatory agents help to reduce inflammatory biomarkers during exacerbations and to improve symptoms of phlegm and cough (Putcha, 2018). Budesonide is preferred to other ICS because it is less lipophilic and hence, more soluble in airway mucus and more rapidly absorbed into the tissues of the airways (Putcha, 2018).Influenza vaccine, which decrease the risk of lower respiratory tract infection, once annuallyPneumococcal polysaccharide vaccine (PPSV23), which is recommended for adults aged between 19 and 65 and helps to reduce the incidence of community-acquired pneumonia in COPD patients (Global Initiative for COPD, 2018).Any Additional Testing Necessary for this DiagnosisSpirometry testing is the classical diagnostic test for COPD. The classical diagnostic….....

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