Case study one

History of COPD presents to a clinic in Warragul Hospital emergency department with complaints of worsening shortness of breath, cough with clear-white sputum production, and fatigue. The patient reports a kilogram weight loss in the last month and increased dyspnoea with activity. Vital signs are as follows: blood pressure mmHg, heart rate beats per minute, respiratory rate breaths per minute, temp and oxygen saturation of on room air. The patient appears tired and uncomfortable, using pursed-lip breathing. Mr Brown’s usual medications are salbutamol times a day (and prn) and Budesonide times a day. Mr Brown doesn’t use a spacer because “I am not a child!”. After medical review, the diagnosis is exacerbation of COPD. The recommendations are oxygen via nasal specs at and sputum specimen for investigation.

Case study two

The emergency department with sudden onset of right-sided weakness and slurred speech. Her medical history includes hypertension and Atrial Fibrillation. She currently takes atenolol mane and warfarin daily. Upon assessment, Mrs. Smith was found to have right-sided weakness and reduced sensation. She was also found to have slurred speech and difficulty in understanding language. Her blood pressure was elevated at mmHg, HR of bpm, temp and SpO2 of on room air. She also confides in you that she sometimes forgets to take her warfarin. Her INR is Mrs Mettaring is given alteplase IV and recommenced on oral warfarin once a day with daily INR

Case study three

History pravastatin nocte has presented to the emergency room with sudden onset of chest pain radiating to the left arm. He also reported shortness of breath and diaphoresis.

Case study four

Emigrated to Australia when she was. She is widowed, and her children live interstate. She presented to her GPs office with increased shortness of breath and “heavy feet”. He has a history of hypertension, but no other significant cardiac history.