COMPREHENSIVE CASE STUDY2
Comprehensive Case Study on COPD, Heart Failure, Hypertension and Diabetes Mellitus
M.K. is a 45 years old, overweight female who has smoked almost half her life and also
has a poor diet. Given M.K.’s age, weight, smoking habit and poor diet she is at increased risk
for many chronic illnesses. M.K. doesn’t seem to be very active, so lack of exercise also plays a
role in her current health condition. She sees dull from drug usage and the poor diet. Her current
state of health is a direct correlation and result of her lifestyle. The only risk factor for M.K. that
she cannot change is her age. Every other aspect she has direct control over, to improve and
prevent further health deterioration. M.K.’s lifestyle has led her to develop chronic bronchitis,
heart failure, and hypertension and Type II diabetes.
Smoking is the major risk factor for developing chronic bronchitis. M.K.’s 20 plus years
of smoking and her 45 years of age puts her at high risk for developing COPD. It is evident M.K.
has chronic bronchitis from many of her symptoms. M.K. presents with a chronic productive
cough, hypoxemia PaO2 48mmHg, hypercapnia PaCO2 52mmHg, and peripheral edema which
would suggest there is right sided heart involvement.
Drug therapy is used to manage symptoms of chronic bronchitis, increase capacity to
exercise and reduce the number of exacerbations. M.K. should be on a long-acting
bronchodilator and an inhaled corticosteroid given the stage of her disease process. M.K. should
also be started on oxygen therapy to treat her hypoxemia as evident by her PaO2 of 48 mmHg.
M.K. should also be referred to RT and PT to include activities in her care such as breathing
retraining, effective cough techniques, and chest physiotherapy. (Lewis, 2007)
M.K. presents with a blood pressure of 158/98 mmHg. Given this blood pressure, she
most likely has stage 1 hypertension. Stage 1 hypertension is categorized by an SBP 140-159 or
DBP 90-99. She has been prescribed Lotensin and Lasix for treatment of hypertension. Lotensin
