Physical Assessment and Application of Clinical Judgment

Physical Assessment and Application of Clinical Judgment

Case Study#1

Prioritized Health History and Physical Assessment

As Mr. Bubba Redfern is suffering from morbidly obese and is feeling short of breath due to coughing. In adults, obesity could increase the risk of catching whooping cough. Obesity is also known to predispose adults to various infections such as flu and the pneumonia. The morbidly obesity is supposed to be the main reason for sever cough that Redfern had during half way through eating his lunch.

During the physical assessment of Mr. Redfern, it was found that he was going through the problem of cough and breathing problem most of the time when he had his meal. It did not happen for the first time. The main reason for difficulty in breathing while coughing was due to suffering of Mr. Redfern from obesity (Live Science, 2012).

According to the physical assessment of Mr.Redfern, the problem of coughing and difficulty in breathing could be linked with silent reflux, when partially digested food escapes from his stomach and go back to his foodpipe. Going back of food in foodpipe of Mr. Redfern created a problem of coughing during eating and therefore the severity of cough is making him difficult to breathe (Elkins, 2009).

Implementation of Interventions

The interventions that need to be implemented for relieving Mr. Redfern with cough includes giving him with medication and testing if it works well or not. If he will be feeling same after the dose of medicines, he would be asked to undergo a gastric bypass. In first step of implementing the intervention, he will be given Gaviscon that will help him to stop the food from rising and entering to his foodpipe. Moreover with Gaviscon, he will be treated with morphine tablets that are considered to be helpful in dealing with chronic cough. The medication of Gaviscon and morphine tablets will help to control the cough and breathing problem in the short run but, it cannot be assured that he will not experience such problem in future.

In order to provide a complete relieve with cough and breathing problem, Mr. Redfern will be asked to undergo a gastric bypass. As gastric bypass considered being a healthy treatment for those who are overweight and Mr. Redfern is also suffering with morbidly obesity which means that it would be ideal treatment. The operation of gastric bypass will help in reflux coughs and it will help to prevent food and fluid from escaping the stomach and will also help him in losing weight. However, after having the operation of gastric bypass, Mr. Redfern would not be able to take heavy meal again (Feng et al, 2003).

Effectiveness of Intervention

The gastric bypass will help the acid reflux in stomach to stop escaping up the foodpipe and will result in relieving Mr. Redfern from cough and breathing problem. In gastric bypass there is a 90 percent success rate in those who had a cough with other reflux symptoms, and a 50 percent success rate in those who ...