Which оf the fоllоwing is а form of ecologicаl degrаdation due to pollution?
Imаgine thаt yоu аsk the patient questiоns (sоme of which you listed above) and she provides the information below. NOTE: This is not an all inclusive list, and you may have come up with other appropriate questions that are not answered below. This is OK. If you are unsure whether one of your questions was appropriate, consider discussing it with a faculty instructor (during lab or via email). Her past medical history includes high blood pressure, high cholesterol, COPD and obesity. She has never had a heart attack, stroke, or other significant cardiovascular event. She smokes ½ ppd. She is not interested in quitting at this time. She recently took a vacation to the beach where she spent a lot of time swimming in the ocean and was around other members of her family who also smoke cigarettes. She developed an ear infection which she thinks began when she was on vacation. She was diagnosed with otitis media a few days after returning home and was prescribed the Bactrim that day. When asked about resolution of symptoms from her ear infection she states she has one day left of her medication but has had no improvement in her symptoms. She still has significant ear pain and is having more trouble hearing than usual. The patient received a course of penicillin-based antibiotics for a previous infection (~1 year ago) and she developed a severe rash while taking this antibiotic. Patient reports having persistent and significant shortness of breath that keeps her from completing some of her daily activities and she is often breathless and experiences chest tightness throughout the day. Her inhaler used to help relieve her shortness of breath, but she feels that it is not helping her as much as it used to, and she is needing it more frequently (most days of the week). Within the past year, she has not had any COPD exacerbations, taken antibiotics related to her COPD, or been hospitalized for COPD. The patient’s blood pressure has been well controlled on lisinopril for years, but she has noticed that over the past few months it has been running higher than normal (~140-150s/90s). She says her heart seems to be beating faster and harder than normal; it feels like her heart is pounding at times. She reports that she has had some weight loss (about 10% total) but she is noticing that her appetite is increasing and returning to how it was before she started taking phentermine. The patient had bloodwork done at her last physical examination and everything came back normal (kidney and liver function, cholesterol levels, etc). She is able to demonstrate proper inhaler technique. She denies any missed doses of medication. She specifically denies: dizziness, lightheadedness, cough, or muscle pain. NOTE: these are a few of the most important side effects to ask about. Can you match each one up with a medication? She received all the necessary childhood vaccines, and she believes she is up to date on all her adult vaccinations as well.