A provider is reviewing guideline-based referral criteria fo…
A provider is reviewing guideline-based referral criteria for asthma management in both pediatric and adult patients. The following clinical scenarios are being evaluated as potential indications for referral to an asthma specialist. Which of the following is NOT an appropriate indication for referral?
Read DetailsA patient with exercise-induced and mild persistent asthma i…
A patient with exercise-induced and mild persistent asthma is prescribed two puffs of albuterol 15 minutes before exercise and as needed for wheezing. She is also prescribed one puff per day of beclomethasone (Qvar). What key point/s should be included in the teaching regarding her inhaler use?
Read DetailsMr. J., a 67-year-old male with a 40–pack-year smoking histo…
Mr. J., a 67-year-old male with a 40–pack-year smoking history and a diagnosis of moderate COPD, presents for a routine follow-up visit in early October. He reports increased exertional dyspnea but denies recent exacerbations. He has not received vaccinations in the past two years and is unsure which immunizations are recommended for patients with chronic lung disease. He is currently managed with tiotropium daily and uses albuterol as needed. He has had no recent hospitalizations. When reviewing his preventive care needs, the provider notes that COPD places him at increased risk for complications from respiratory infections, and immunizations should be updated accordingly. Based on current preventive care recommendations for patients with COPD, which vaccinations should this patient receive at this time, and what is the recommended frequency for each?
Read DetailsA 22-year-old college student presents to the campus health…
A 22-year-old college student presents to the campus health clinic reporting shortness of breath and wheezing approximately three times per week, especially during intramural soccer. She currently uses albuterol as needed, which provides temporary relief. She has had two urgent-care visits in the past year for asthma symptoms but no hospitalizations. She denies nighttime awakenings. Lung sounds are clear today, and spirometry shows reversible airflow obstruction.
Read DetailsA 72-year-old male with severe COPD presents for evaluation…
A 72-year-old male with severe COPD presents for evaluation of worsening dyspnea. His vital signs include SpO₂ 89% on room air. After resting quietly for 10 minutes, repeat SpO₂ is 87% on room air. An arterial blood gas (ABG) drawn at rest shows a PaO₂ of 54 mmHg. Based on CMS (Medicare) qualification criteria for home oxygen therapy, does this patient qualify, and which value supports your decision?
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