Determining the Cause

Chief Complaint: Dyspnea

a. History: Chronic

Pivotal Assessment Findings
History          

 

  • Onset (acute vs. chronic)

  • Triggers (exertion, allergens, lying flat, etc.)

  • Associated symptoms (chest pain, cough, wheezing, swelling, etc.)

Physical Examination

  • Respiratory rate and pattern

  • Use of accessory muscles

  • Auscultation (wheezing, crackles, diminished breath sounds)

  • Cardiovascular exam (murmurs, jugular venous distension, edema)

Diagnostic Tests

  • Pulse oximetry – to assess oxygen saturation

  • Arterial blood gas (ABG) – for oxygenation and acid-base balance

  • Chest X-ray or CT scan – to evaluate lung structure

  • Pulmonary function tests (PFTs) – to differentiate obstructive vs. restrictive lung disease

  • Echocardiogram – to assess heart function

  • D-dimer & CT pulmonary angiography – if pulmonary embolism is suspected

  • Hemoglobin levels – to check for anemia

 

Dyspnea

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