Nursing Related Learning Experience Manual

Name of Student Aira Shane C. Marges Yr & Sec

Clinical Instructor Area
Date of Exposure Hospital Mindanao Med

GORDON’S FUNCTIONAL HEALTH PATTERN

Functional Health Cue Cluster
Pattern
1. Health Perception & S – Patient reported Readiness for enhanced
Management smoking 2-4 cigarettes a self-health management
day during his 20s and he
was also an alcoholic. He
stopped drinking and
smoking when he was
diagnosed with COPD last
July 10, 2023. “Nung
sundalo pa ako walang
araw na di ako naga
sigarilyo, di ko ma consider
ang sarili ko na healthy
dahil sa condition ko
ngayon. Ayaw ko na
lumala pa ito kaya nag pa
check up na ako at ngayon
na admit na ako. I am
expecting na sana maka
recover ako with the help of
the doctors and nurses.
Sinusunod ko naman mg
autos ng doctor. Then the
nurses always give my
medicines on time” as
stated by the patient.
Inference Diagnostic Statement Priority Rationale
Readiness for Low 2 This is rated low 2 since
enhanced self-health the patient regulates and
management integrates into a given
as manifested by therapeutic regimen for
expresses desire to treatment of illness; this
manage the illness can still be strengthened
through further evaluation
and follow-ups for the
patient’s condition and at
the same time, the nurse
can provide education and
encouragement that will
allow the patient to do
more activities and adhere
to treatment to make
himself better.

O – Patient sought medical

attention upon
College of Health Sciences Department of Nursing NOTRE DAME OF DADIANGAS UNIVERSITY

experiencing persistent
symptoms. Observed
patient have willingness
for an effective
management of his health
condition.
Vital signs:
T: 36.2; PR: 82 bpm; RR:
25 cpm; BP: 140/85
mmHg.
2. Nutrition / S - “Since na diagnosed
Metabolism ako with COPD,
nahihirapan ako huminga
and it affected my eating
habit. Di ako makakain ng
maayos kasi parang
masusuffocate ako if
madami nakakain ko or
kahit sa normal lang na
pagkain. Kaya nawawalan
ako ng gana kumain kahit
pa paborito ko yung
pagkain.” As verbalized by
the patient.
O – Alert and responsive.
Fatigue and somehow
lacking of energy; has loss
of muscle mass and tone;
previous weight is 65 kg.
Weight: 58 kg
Height: 162.50 cm
BMI: 22 (normal)
College of Health Sciences Department of Nursing
Nursing Related Learning Experience Manual
Risk for imbalanced Imbalanced High 3 This is rated as high 3
nutrition: less than body nutrition: less than because the patient has
requirements body requirements insufficient intake of
r/t difficulty of nutrients and cannot meet
breathing and or maintain metabolic
decreased food needs based on age and
intake as condition. Proper nutrition
manifested by and healthy eating habits
weight loss and are an essential part of
lack of interest in improving one’s
food condition. Geriatric clients
also need proper intake of
nutrients to meet them
aging demands and at the
same time improve
holistic health. This
should be given
immediate attention and
management because the
patient has respiratory
illness which might be
affected if not enough
nutrients are taken.
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3. Elimination Pattern
4. Activity / Exercise
College of Health Sciences Department of Nursing
Nursing Related Learning Experience Manual
S – No reports of pain and Not a problem Not a problem Not a problem There were no problems
discomfort upon found with the patient’s
elimination. Fluid intake elimination pattern.
was reported to be approx.
1,000 L/day. Reported
stool consistency as soft.
O – Ambulatory with
assistance. Abdomen soft
and non-distended.
Normoactive bowel
sounds. Intake 720
mL/day. Output 550
mL/day. Urine color was
light yellow, Laboratory
results: Creatinine 1.42
mg/dL, Uric acid 5.66
mg/dL, Sodium 133.
mmol/L, Potassium 3.5
mmol/L, ALT 42. U/L, and
BP 145/85 mmHg.
S – “Hinihingal ako kahit Ineffective airway Ineffective Airway High Priority 1 This is rated as a high
sa cr lang ako pupunta”, as clearance Clearance r/t priority because the
reported by the patient. hypersecretion of patient has the inability to
“May iniinom akong mucus and hypersecretion of mucus
gamut para sa ubo.”, inflammation and inflamed bronchi
patient stated. Patient secondary to caused by COPD. There is
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admitted that he was a
former smoker. Reported
family history of
hypertension. Stated
experiencing chest pain,
dyspnea, cough, fatigue,
and weakness. “Sumasakit
ang dibdib ko pag nauubo
ako”, patient verbalized.
Patient reported walking
every day for 30 minutes
to 1 hour. Patient reported
problem with usual activity
and exercise. “Nung na
diagnosed ako with COPD
nahihirapan na ako
gumalaw and gawin yung
mga usual na gawain ko na
di hinihingal”, patient
stated.
O – Wheezing noted.
Labored respiration. Use
of accessory muscle.
Ambulatory with
assistance. Cough was
productive. Temperature
36.2 °C, BP 145/85
mmHg, PR 82 bpm. Radial
pulse regular but weak.
Negative jugular veins
distention. Pale nail beds.
Capillary refill 3 seconds.
Patient has been
undergoing therapy.
College of Health Sciences Department of Nursing
Nursing Related Learning Experience Manual
Chronic also an obstruction from
Obstructive the respiratory tract due to
Pulmonary Disease inflammation and mucus
as manifested by production that affects the
the difficulty of airway clearance of the
breathing and patient. This makes the
persistent cough. patient feel fatigue and
has difficulty breathing
that both interferes his
physical engagement to
ADLs and IADLs .
Ineffective airway
clearance, as well as other
respiratory illnesses, are
typically given top
priority since they directly
influence tissue
oxygenation, necessitating
prompt and decisive
action.
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5. Sleep / Rest S – “Mga 9 tulog nako
pero nagigisong ako
minsan dahil sa ubo ko at
nahihirapan ako huminga”,
patient reported.
O – Patient appeared weak
and tired. Patient
frequently closed his eyes
during assessment.
6. Cognitive / S – Patient-reported that he
Perceptual had experienced chest
pain or a squeezing
feeling when coughing,
and sometimes the pain is
also located at the lower
back. Reported always feel
uncomfortable when
having SOB, while
walking or doing
activities
O – Alert. GCS 15.
Negative Cushing Triad.
Positive sensory function.
Positive motor function.
PERRLA. Oriented to
person, place, time, and
College of Health Sciences Department of Nursing
Risk for disturbed sleep Disturbed Sleep
pattern Pattern r/t difficulty
of breathing and persistent
coughing as manifested by
decreased energy level and
swollen eyes are noted.
Acute pain Acute pain r/t persistent
coughing secondary to
Chronic Obstructive
Pulmonary Disease a.m.b
report of chest pain and
increased BP
Nursing Related Learning Experience Manual
High Priority 2 This is described as high 2
priority because the
patient has been having
time-limited interruptions
of sleep amount and
quality due to
manifestations of his
respiratory condition.
Coughing,
discomfort, and shortness
of breath are all symptoms
of COPD, which can
make sleeping difficult.
This should be managed
since sleep, on the other
hand, is necessary for
resting pulmonary muscles
and for simply functioning
the next day.
Moderate Priority 1 This is rated moderate 1
priority because the
patient has unpleasant
sensory, especially when
coughing. This made the
patient feel uncomfortable
while doing his activities.
This could still be
managed through
treatment and medications
with nursing interventions
to control symptoms that
cause pain to the patient.
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 Nursing Related Learning Experience Manual

pain. Vital signs: T

7. Self – Perception /
Self - Concept
8. Role / Relationship
36.32°C, P 82 bpm, RR 25
cpm, BP 145/85 mmHg.
S – “Mabait ako at Not a problem Not a problem Not a problem There were no problems
found with the patient’s
maalaga sa aking
self-concept since the
pamliya.”, as verbalized by patient was able to
verbalize positive self-
the patient.
image despite his
condition.
O – Patient responded
appropriately and had a
calm tone of voice.
S – “Apat ang anak ko, ang Not a problem Not a problem Not a problem There were no problems
found since the patient
asawa ko naman ay nasa
verbalized satisfaction
bahay. May mga apo na with familial relationship.
din ako, I lived a good life
kasi na provide ko mga
kailangan ng aking
pamilya”, as verbalized by
the patient.

O – Patient was seen being

taken care of by his
daughter and other family
members.
9. Sexuality / S – Patient reported having
Reproductive
4 children.
College of Health Sciences Department of Nursing
Not a problem Not a problem Not a problem No problems were found
since the patient did not
provide much information
about his sexual
relationship and did not
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 Nursing Related Learning Experience Manual

O – Reproductive consent to a reproductive

assessment was not assessment.
performed.
10. Coping – Stress S – Patient reported his Not a problem Not a problem Not a problem Although the patient stated
Tolerance current condition as his concern over his current
stress factor. situation, this is not
“Nakakapagod pala pag considered as a problem
nagkakasakit sana maging since the patient has a
okay na ako”, as positive attitude that he
verbalized by the patient. will be able to overcome
this problem.
11. Value Belief S – “Nag sisimba ako Not a problem Not a problem Not a problem There were no problems
tuwing Sunday kasama ang found because the patient
aking pamilya at kahit showed strong religious
naman nung sundalo pa and spiritual belief through
ako ay nagsisimba talaga active religious
ako kasi every Sunday participation.
may mass na hineheld sa
campo”, as stated by the
patient. Patient reported
being a Roman Catholic.

College of Health Sciences Department of Nursing NOTRE DAME OF DADIANGAS UNIVERSITY


Problem (PES)
1. Ineffective Airway Clearance r/t
hypersecretion of mucus and
inflammation secondary to
Chronic Obstructive Pulmonary
Disease as manifested by the
difficulty of breathing and
persistent cough.
2. Disturbed Sleep Pattern r/t
difficulty of breathing and
persistent coughing as manifested
by decreased energy level and
swollen eyes are noted.
3. Imbalanced nutrition: more than
body requirements r/t Imbalanced
nutrition: more than body
requirements r/t r/t difficulty or
breathing and decreased food
intake as manifested by weight
loss and lack of interest in food.
4. Acute pain r/t persistent coughing
secondary to Chronic Obstructive
College of Health Sciences Department of Nursing
Nursing Related Learning Experience Manual
PROBLEM IDENTIFICATION
Date Identified Time Date Resolved
August 18, 2023 4:00 PM The date of resolution of all of the
problems cannot be provided due to the
fact that the nurse-patient interaction only
happened within one shift due to certain
circumstances.
August 18, 2023 4:00 PM The date of resolution of all of the
problems cannot be provided due to the
fact that the nurse-patient interaction only
happened within one shift due to certain
circumstances.
August 18, 2023 4:000 PM The date of resolution of all of the
problems cannot be provided due to the
fact that the nurse-patient interaction only
happened within one shift due to certain
circumstances.
August 18, 2023 4:00 PM The date of resolution of all of the
problems cannot be provided due to the
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Pulmonary Disease a.m.b report
of chest pain and increased BP.
5. Readiness for enhanced self-
health management as manifested
by expresses desire to manage the
illness
Nursing Diagnosis
Ineffective Airway Clearance r/t hypersecretion of
mucus and inflammation secondary to Chronic
Obstructive Pulmonary Disease as manifested by the
difficulty of breathing and persistent cough.
College of Health Sciences Department of Nursing
Nursing Related Learning Experience Manual
fact that the nurse-patient interaction only
happened within one shift due to certain
circumstances.
August 18, 2023 4:00 PM The date of resolution of all of the
problems cannot be provided due to the
fact that the nurse-patient interaction only
happened within one shift due to certain
circumstances.
PRIORITIZATION OF PROBLEMS
Prioritization Rationale
High Priority 1 This is rated as high priority because the patient has the
inability to hypersecretion of mucus and inflamed
bronchi caused by COPD. There is also an obstruction
from the respiratory tract due to inflammation and
mucus production that affects the airway clearance of the
patient. This makes the patient feel fatigued and has
difficulty breathing that both interfere with his physical
engagement with ADLs and IADLs. Ineffective airway
clearance, as well as other respiratory illnesses, are
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Disturbed Sleep Pattern r/t difficulty of breathing and
persistent coughing as manifested by decreased energy
level and swollen eyes are noted.
Imbalanced nutrition: less than body requirements r/t
difficulty of breathing and decreased food intake as
manifested by weight loss and lack of interest in food
College of Health Sciences Department of Nursing
Nursing Related Learning Experience Manual
typically given top priority since they directly influence
tissue oxygenation, necessitating prompt and decisive
action.
High Priority 2 This is described as a high 2 priority because the patient
has been having time-limited interruptions of sleep
amount and quality due to manifestations of his
respiratory condition. The patient's symptoms worsened
during the night because of his position when sleeping or
lying on the bed in which causes difficulty breathing.
Coughing, 22 discomfort, and shortness of breath are all
symptoms of COPD, which can make sleeping difficult.
This should be managed since sleep, on the other hand,
is necessary for resting pulmonary muscles and for
simply functioning the next day.
High Priority 3 This is rated as high 3 because the patient has
insufficient intake of nutrients and cannot meet or
maintain metabolic needs based on age and condition.
Proper nutrition and healthy eating habits are an
essential part of improving one’s condition. Geriatric
clients also need proper intake of nutrients to meet their
aging demands and at the same time improve holistic
health. This should be given immediate attention and
management because the patient has respiratory illness
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Acute pain r/t persistent coughing secondary to Chronic
Obstructive Pulmonary Disease a.m.b report of chest
pain and increased BP.
Readiness for enhanced self-health management as
manifested by expresses desire to manage the illness
College of Health Sciences Department of Nursing
Nursing Related Learning Experience Manual
which might be affected if not enough nutrients are
taken.
Moderate Priority 1 This is rated moderate 1 priority because the patient has
unpleasant sensory, especially when coughing. This
made the patient feel uncomfortable while doing his
activities. This could still be managed through treatment
and medications with nursing interventions to control
symptoms that cause pain to the patient.
Low Priority 2 This is rated low 2 since the patient regulates and
integrates into a given therapeutic regimen for treatment
of illness; this can still be strengthened through further
evaluation and follow-ups for the patient’s condition and
at the same time, the nurse can provide education and
encouragement that will allow the patient to do more
activities and adhere to treatment to make himself better.
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 Nursing Related Learning Experience Manual

NURSING CARE PLAN

Name of Samson Rm/Bed No. Age 69 Chief

Patient Complaints
Address Admission Sex M Diagnosis
Date

ASSESSMENT HEALTH NURSING DESIRED INTERVENTION EVALUATION REMARKS

PATTERN DIAGNOSIS OUTCOME
S – “Hinihingal ako Activity- Note: Use P-E-S format General: Independent Goal partially Continuous care
kahit sa cr lang ako Exercise 1. Improve or at least • Keep the environment free from met. After 8hrs and evaluation are
pupunta”, as Pattern Ineffective Airway maintain airway dust, pollution, and dirt where the of nursing necessary.
reported by the Clearance r/t clearance and patient is staying. intervention, the -COPD does not
patient. “May hypersecretio n of mucus capability to perform R: Precipitators of an allergic type patient was able go away
iniinom akong and inflammation physical activity of respiratory reactions that can to understand immediately and
gamut para sa secondary to Chronic 2. Continue to perform trigger or exacerbate the onset of an and maintain the requires a
ubo.”, patient Obstructive Pulmonary physical activities acute episode. needs for complete course
stated. Patient Disease as manifested by within limits and • Teach patient some breathing improvement of treatment and
admitted that he difficulty of breathing capacity of breathing exercises such as pursed-lip and consistent management in
was a former and persistent cough pattern. breathing or abdominal exercises participation to order to achieve
smoker. Reported Background Knowledge R: This could help the patient adhere in optimal
family history of Inability to clear Specific: control dyspnea or reduce air- various pulmonary
hypertension. secretions or 1.Demonstrate trapping. respiratory function and
Stated experiencing obstructions from the behaviors to improve • Demonstrate coughing exercises therapy and health of the
chest pain, dyspnea, respiratory airway clearance. and deep breathing techniques. programs as patient.
cough, fatigue, and tract to 2. Continue to R: This will help the patient to well as -The patient is
weakness. maintain a participate in various maximize ventilation. engagement to also, a geriatric
“Sumasakit ang clear airway. physical activities that • Instruct the family to assist patient exercise classes client in which full
dibdib ko pag engage breathing from turning sides and changing for the recovery and
nauubo ako”, capacity. position every 2 hours when at rest. improvement of development of
patient verbalized. 3.Perform alternative R: This method will help the pulmonary condition is quite
Patient reported interventions to patient to facilitate mucus secretion function; also, slow and requires
walking every day promote improved or and at the same time prevent was able to challenging
for 30 minutes to 1 maintained pulmonary sweating at the back that might follow given participation of
hour. Patient function. interventions health care

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 Nursing Related Learning Experience Manual

reported problem result in another discomfort of the and behaviors professionals, the
with usual activity patient. that can patient and the
and exercise. “Nung • Reiterate to the patient the additionally help family.
na diagnosed ako importance of active and his condition;
with COPD continuous participation in shows
nahihirapan na ako respiratory therapy and exercise willingness and
gumalaw and gawin classes. continued
yung mga usual na R: Active participation and participation to
gawain ko na di cooperation of the patient may help given activities
hinihingal”, patient improve his capability to perform and
stated. physical activities that could interventions.
enhance his pulmonary function.
• Instruct patient to always practice
oral hygiene especially when
Objective Cues coughing.
Wheezing noted. R: This is to prevent further
Labored infection and transmission.
respiration. Use of • Demonstrate chest physiotherapy
accessory muscle. such as bronchial tapping when in
Ambulatory with cough, proper postural drainage.
assistance. Cough R: These techniques will prevent
was productive. possible aspirations and prevent
Temperature 36.2 any untoward complications.
°C, BP 145/85 • Administer bronchodilators as
mmHg, PR 82 bpm. prescribed.
Radial pulse R: Pharmacologic treatment could
regular but weak. help manage the secretions and
Negative jugular other respiratory symptoms
veins distention. • Encourage and provide
Pale nail beds. opportunities for rest: limits
Capillary refill 3 activities to level of respiratory
seconds. Patient tolerance.
has been R: To prevent exacerbations and
undergoing fatigue.
therapy.

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 Nursing Related Learning Experience Manual

• Assess the need for the use of

respiratory devices if prescribed.
R: To help improve manifestations.

Dependent:
• Prescribe medications such as
bronchodilators and other
respiratory medications.
R: Medications can help manage
and improve the clinical
manifestations of the patient.
• Continuous follow -ups of
pulmonary function is necessary.
R: This is to evaluate the
improvement of pulmonary
function and see if the patient has
been developing participation and
capability in physical activities.

Collaborative
• Maintain continuous support
groups and therapy for the patient.
R: Respiratory programs or
therapies and exercise classes will
help the patient to improve his
pulmonary function and well -
being.

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 Nursing Related Learning Experience Manual

DIAGNOSTIC EXAMINATIONS

Name of Samson Rm/Bed No. Age 69 Chief Cough and Dyspnea

Patient Complaints
Address Admission 08/16/23 Sex M Diagnosis Chronic Obstructive Pulmonary Disease in
Date Acute Exacerbation Hypertension,
Controlled

Diagnostic Normal
Date Ordered Result Significance
Examination Values
Complete Blood Hemoglobin: Hemoglobin: Hemoglobin (Hb) measures the amount of oxygen-carrying protein in the red blood cells.
Count 120-150 g/L 123 g/L The patient had a low hemoglobin count which may indicate anemia. This can be most
Hematocrit: Hematocrit: likely attributed to the patient’s chronic kidney disease which can interfere with the
0.35-0.49 0.36 production or lifespan of red blood cells, leading to anemia.
RBC: 3.80- RBC: 4.1 cells/mcL Next, hematocrit (Hct) represents the percentage of the blood volume occupied by red
5.20 cells/mcL MCV: blood cells. The patient had a low hematocrit level which can also indicate anemia.
MCV: 80-100 88 As for the red blood cell (RBC) count, this determines the total number of RBCs which
fL MCH: carry oxygen throughout the body. This can be caused by anemia and CKD which can
MCH: 26-34 30 picograms/cell interfere with RBC production and cause a decrease in the RBC count. Since the patient
picograms/cell MCHC: had a low hemoglobin, hematocrit and RBC count, this manifested as fatigue, shortness of
MCHC: 32-36 34.6 g/dL breath, pallor, and cold hands and feet. This finding also warranted the blood transfusion
g/dL WBC: of packed RBCs that the patient received.
WBC: 5.0-10.0 13.5 Next, the mean corpuscular volume (MCV) determines the average size of red blood cells
Neutrophil: Neutrophil: and helps classify different types of anemia. The patient had a normal MCV level which
0.55-0.65 0.84 suggested that the size of the RBCs of the patient was within the normal range.
Lymphocyte: Lymphocyte: Moreover, the mean corpuscular hemoglobin (MCH) measures the average amount of
0.35-0.50 0.11 hemoglobin within red blood cells. The patient had a normal MCH level which indicated
Monocyte: Monocyte: that the amount of hemoglobin in each red blood cell is within the normal range.
0.03-0.06 0.05 Furthermore, the mean corpuscular hemoglobin concentration (MCHC) measures the
Eosinophil: Eosinophil: average concentration of hemoglobin within red blood cells. Since the patient had normal
0.02-0.04 0.0 MCHC level, this indicates that the hemoglobin concentration in the RBCs is normal.
Basophil: 0-0.2 Basophil: The white blood cell (WBC) count measures the total number of WBCs, which are crucial
0.0 for immune function. The patient experienced leukopenia, which is a decrease in the
number of WBCs in the bloodstream. This can be attributed to the patient’s current
respiratory infection which was CAP as manifested by a nonproductive cough and fatigue.

College of Health Sciences Department of Nursing NOTRE DAME OF DADIANGAS UNIVERSITY

 Nursing Related Learning Experience Manual

This was also supported by a low neutrophil count which can also be caused by a viral
infection.
Next, the patient had a normal lymphocyte count which meant that the immune system of
the patient is responding normally to the infection. The patient also had a normal basophil
count because the patient was not experiencing any allergic attack.
Furthermore, the patient had a low monocyte count which was also due to the patient’s
respiratory infection. This was also supported by a low eosinophil and a low platelet
count, all of which can be attributed to an infection.
Clinical Chemistry Creatinine: Creatinine: The patient had an elevated creatinine level in the blood which is an indication of
0.80-1.50 1.42 mg/dL impaired kidney function. Creatinine is a waste product produced by the muscles during
mg/dL Uric Acid: their normal metabolism, and it is filtered out of the bloodstream by the kidneys. An
Uric Acid: 3.5- 5.66 mg/dL elevated creatinine level suggests that the kidneys are not effectively clearing creatinine
8.5 mg/dL Sodium: 133. mol/L from the body. This condition can be caused by CKD where the kidneys are damaged and
Sodium: 137.- Potassium: 3.5 mmol/L lose their ability to function properly over time. As CKD progresses, creatinine levels in
145. ALT: 43. U/L the blood tend to increase.
Potassium: Next, a high uric acid level can be associated with kidney dysfunction. Uric acid is a waste
3.5-5.1 product that is produced when the body breaks down purines, which are found in certain
ALT 0.-50. foods and also occur naturally in the body. The kidneys play a crucial role in filtering uric
acid from the bloodstream and excreting it in the urine. If the kidneys are not functioning
properly, uric acid can build up in the blood, causing hyperuricemia. This can occur as a
result of CKD.
Aside from these, liver function tests (LFTs) are a group of blood tests that provide
information about the health and function of the liver. These tests assess various markers
and enzymes in the blood that indication liver health and potential liver damage. This
includes SGOT/AST and SGPT/ALT.
Alanine aminotransferase (ALT) is an enzyme primarily found in liver cells. A normal
ALT level suggests that the patient did not have conditions such as hepatitis, fatty liver
disease, or alcohol-related liver disease. Next. Aspartate aminotransferase (AST) is an
enzyme found in the liver, heart, muscles, and other organs. A normal AST level indicates
that the patient did not have liver damage, muscle injury, or a heart disease..
HbA1c HbA1c: 3.8- HbA1c: 7.4% HbA1c, also known as glycated hemoglobin, is a blood test that provides an indication of
5.8% a patient’s average blood glucose levels over the past two or three months. This measures
the percentage of hemoglobin that has glucose attached to it. This is also used to monitor
and diagnose diabetes, as well as to assess long-term glucose control in individuals with
diabetes. The patient had a high HbA1c level which indicates a poor control of blood
glucose levels over time.
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 Nursing Related Learning Experience Manual

Chest PA Xray Normal chest - The heart is not Interstitial infiltrates refer to abnormal accumulations of fluid or cells in the interstitial
x-ray. enlarged. spaces of the lungs. Infiltrates in the hilar areas suggest involvement near the lung hilum,
- Aorta is tortous. which can be seen in conditions like pneumonia or congestive heart failure.
- Pulmonary vascular Normal pulmonary vascular markings suggest that the blood vessels supplying the lungs
markings are within are not excessively dilated or constricted. This finding is generally associated with normal
normal. blood flow and can be a reassuring sign in the evaluation of pulmonary conditions.
- Trachea is midline. Trachea is midline. Diaphragm and sinuses are intact. Bony thorax is unremarkable. These
Diaphragm and sinuses findings refer to the normal position and appearance of the trachea, diaphragm, sinuses,
are intact. and bony structures of the chest. No significant abnormalities are noted in these areas.
- There are osteophytes
in the articulating
margins of the
thoracic spine.
- Bony structures are
decreased in bone
density with
thinning of
cortices

Impression
1. Senile Emphysema
2. Tortuous aorta.
3. Spondylosis of the
thoracic spine.
4. Osteoporosis

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