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Primary DiagnosisEmphysema(ICD-10: J43.9) Emphysema is a progressive and permanent distention of the alveoli in the lungs that leads to destruction of the alveolar walls and impairment in oxygen and carbon dioxide (CO2) gas exchange (March & Schub, 2016). Smoking is the primary risk factor for emphysema (March & Schub, 2016). The initial symptom of emphysema is usually dyspnea (March & Schub, 2016). Coughing, wheezing, and expectoration can occur (March & Schub, 2016). Persons with this disease breathe through pursed lips and use accessory respiratory muscles as they try to empty CO2 from the lungs (March & Schub, 2016). Barrel chest can occuras the lungs overinflate, and the patient may sit in a forward and hunched position to relieve chest pressure (March & Schub, 2016). The rationale for this diagnosis is LJ’s 65 pack year smoking history, and shortness of breath.TreatmentTreatment includes broncodilators, inhaled corticosteroids, supplemental oxygen, and lung transplant (March & Schub, 2016). Differential DxCOPD (ICD-10: J44.9) Chronic obstructive pulmonary disease (COPD) is a debilitating and potentially life-threatening disease and is characterized by persistent airflow limitation that is usually progressive and associated with enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases (Beddoe & Schub, 2016). The course of COPD is invariably marked by exacerbation characterized by dyspnea, cough, and/or increased mucus production (Beddoe & Schub, 2016). Patients can experience severe breathlessness with activity(Beddoe & Schub, 2016).
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Chronic obstructive pulmonary disease, mg PO QD, Schub