Case Study:
Barbara is 61 years old and has been smoking since she was 22 years old. Despite numerous attempts, she has been unable to break her pack-a-day habit.
During her annual examination at her physician's office, Barbara reports being "constantly out of breath" and tired. She is wheezing slightly and states this is because she has recently been fighting a cold.
On assessment, her physician notes several symptoms, including clubbing of the fingers. Barbara has a barrel-shaped chest, breathes with pursed lips, and uses accessory muscles to breathe. She has difficulty catching her breath while speaking. Inspection reveals peripheral edema.
Vital signs include a heart rate of 82 beats per minute and respiratory rate of 12 breaths per minute. Oxygen saturation is 82%. Spirometry results show reduced vital lung capacity and reduced forced vital capacity.
Q1. What may explain the clubbing of Barbara's fingers?
Q2. Is Barbara's oxygen saturation value normal?
Q3. Why has Barbara developed a barrel-shaped appearance to her chest?
Q4. Why is Barbara using pursed-lip breathing?
Q5. What is the significance of the spirometry test results?
Q6. Given Barbara's pulmonary issues, why may she have developed peripheral edema?