M.B. is a 65-year-old male who is being admitted from the emergency department to the cardiopulmonary unit with an exacerbation of chronic obstructive pulmonary disease (COPD). M.B. has been using ipratropium (Atrovent) and albuterol (Proventil) metered-dose inhaler for control of his symptoms. His admission vital signs are as follows: blood pressure 158/86 mm Hg, heart rate 118 beat/min, respiratory rate 36 breaths/min, temperature 38.4 C, and SaO2 85%. He is 5 ft 10 in tall, weighs 180 lb, and has a marked barrel chest. Clinical Features COPD Asthma Onset usually less than 40 Long history of smoking History of allergies Clinical symptoms intermittent Smoking not a cause Thick tenacious sputum Progressive worsening of disease Onset usually 40-50 years old Infrequently associated with allergies Dyspnea during exertion Stable disease course Infrequent sputum Slowly progressive clinical symptoms MD orders Clinical Features COPD Asthma Onset usually less than 40 Long history of smoking History of allergies Clinical symptoms intermittent Smoking not a cause Thick tenacious sputum Progressive worsening of disease Onset usually 40-50 years old Infrequently associated with allergies Dyspnea during exertion Stable disease course Infrequent sputum Slowly progressive clinical symptoms.

1. M.B. is a 65-year-old male who is being admitted from the emergency
department to the cardiopulmonary unit with an exacerbation of chronic
obstructive pulmonary disease (COPD).
M.B. has been using ipratropium (Atrovent) and albuterol (Proventil)
metered-dose inhaler for control of his symptoms. His admission vital
signs are as follows: blood pressure 158/86 mm Hg, heart rate 118
beat/min, respiratory rate 36 breaths/min, temperature 38.4 C, and SaO2
85%. He is 5 ft 10 in tall, weighs 180 lb, and has a marked barrel chest.
Clinical Features
COPD
Asthma
Onset usually less than 40
Long history of smoking
History of allergies
Clinical symptoms intermittent
Smoking not a cause
Thick tenacious sputum
Progressive worsening of disease
Onset usually 40-50 years old
Infrequently associated with allergies
Dyspnea during exertion
Stable disease course
Infrequent sputum
Slowly progressive clinical symptoms
MD orders
Clinical Features COPD Asthma
Onset usually less than 40
Long history of smoking
History of allergies
Clinical symptoms
intermittent
Smoking not a cause
Thick tenacious sputum
Progressive worsening of
disease

2. Onset usually 40-50 years old
Infrequently associated with
allergies
Dyspnea during exertion
Stable disease course
Infrequent sputum
Slowly progressive clinical
symptoms