Chapter 20, Problem 1MITC

Sylvia Gaylord works as a legal aide on the 12th floor of a tall glass-and-steel monument to modern architectural technology. On clear days, the views are spectacular. From her cubicle, Sylvia's eye catches the edge of the beautiful blue-and-white skyscraper as she reaches for her inhaler. This is the third attack since she returned from lunch four hours ago—her asthma is really bad today. But if she leaves work early again, her boss will write her up for it. Sylvia concentrates on breathing normally. Her roommate, Kelly, is a respiratory therapist at the county hospital. Kelly says Sylvia's asthma attacks are probably triggered by the city's high level of air pollution. That can't be true. They both run in the park every morning before work, and Sylvia rarely needs to use her inhaler. The problems start when she gets to work. The wheezing and coughing were so bad today that by the time she got up the elevator and into her cubicle, she could hardly breathe. Last night, the cable news…

Mrs. Aguilar is a 78-year-old Caucasian woman who lives alone in a small, one-story home she and her husband purchased several years ago before he died. She lives on Social Security income and her deceased husband's corporate pension and is financially secure. Though she is in relatively good health, she has been having increasing difficulty walking for the past several years, which has been attributed to peripheral vascular disease. She complains of weakness and pain in her legs and a loss of feeling in her fingers and feet. She also suffers from occasional constipation. She is happiest just doing her activities of daily living, such as preparing breakfast, lunch, and a late afternoon snack, then relaxing in her living room until it is time for bed. She has a good relationship with her adult children, who have been discussing with her the possibility of hiring a visiting nurse as her mobility declines. Her children take turns visiting on Sundays. When they come, they help with her…

Sylvia Gaylord works as a legal aide on the 12th floor of a tall glass-and-steel monument to modern architectural technology. On clear days, the views are spectacular. From her cubicle, Sylvia’s eye catches the edge of the beautiful blue-and-white skyscraper as she reaches for her inhaler. This is the third attack since she returned from lunch 4 hours ago—her asthma is really bad today. But if she leaves work early again, her boss will write her up for it. Sylvia concentrates on breathing normally. Her roommate, Kelly, is a respiratory therapist at the county hospital. Kelly says Sylvia’s asthma attacks are probably triggered by the city’s high level of air pollution. That can’t be true. They both run in the park every morning before work, and Sylvia rarely needs to use her inhaler. The problems start when she gets to work. The wheezing and coughing were so bad today that by the time she got up the elevator and into her cubicle, she could hardly breathe. Last night, the cable news ran…