Below is a summary of Pam’s electronic health record activity while she is in the hospital. As a health coach, your job is to recommend changes to decrease the need for future care or hospitalization. You will also provide resources Pam needs to understand her diagnosis and what may have caused her condition. Answer the following questions and be prepared to discuss the responses with the rest of Pam’s healthcare team.


  1. Review Pam’s VPE: Pam’s physician orders a pulmonary plethysmography and diffusion capacity (DLCO) test. Using VPE, match the definition to the test.
    ____ Diffusion capacity   A. Determines how much air the lungs can hold. After breathing into a mouthpiece, changes in pressure and the amount of air in the room and against the mouthpiece, determines the amount of air in the lungs.
    ____ Pulmonary plethysmography   B. Measures the body’s ability to exchange oxygen and carbon monoxide between the blood and lungs. After inhaling a small amount of carbon monoxide, a blood sample is taken to measure absorption by the lungs.

  2. Review Pam’s Outpatient EHR: What does Pam’s plethysmography test results indicate?
    A. Emphysema
    B. Asthma
    C. Lung cancer
    D. Bronchitis

  3. Internet Research: Albuterol is a short-term bronchodilator. Select the answer that BEST describes how it functions when taken?
    A. Slow (extended) release medication that opens up breathing passages.
    B. Slow (extended) release medication that relieves chest pains.
    C. Quick-relief medication that opens up breathing passages.
    D. Quick-relief medication that relieves chest pains.

  4. Review Pam’s VPE: Referring to Pam’s VPE (Treatment tab), each statement below is a step to administer a bronchodilator. Put a number (1 – 6) by each statement to show the correct order in using a bronchodilator.
    ____ Place inhaler directly into mouth
    ____ Shake inhaler, as directed, and remove cap
    ____ Breathe in slowly, evenly and deeply
    ____ Tilt head back slightly, breathe out slowly
    ____ Hold inhaler upright with mouthpiece at the bottom
    ____ Press inhaler one time and continue to breathe in slowly

  5. Internet Research: Regardless of her diagnosis, the first thing Pam must do is to stop smoking. Which statements, listed below, would be good advice for Pam to follow. (Select all that apply)
    A. When a tobacco craving hits, eat a lot of food
    B. Get support from family, friends or a support group
    C. It’s okay to have one cigarette, but not more than one
    D. Find other ways to cope with stress other than smoking
    E. Replace smoking with e-cigarettes

  6. Internet Research: As part of a nicotine replacement therapy, Pam’s physician prescribes Chantix. Which statement explains how it affects nicotinic receptors?
    A. Blocks dopamine from being released in the brain
    B. Blocks hormones from being released in the brain
    C. Releases dopamine in smaller doses relieving withdrawal symptoms
    D. Releases hormones in smaller doses relieving withdrawal symptoms

View Pam’s EHR – Outpatient   Virtual Physical Exam