Discussion Question On Respiratory

Week 2: Discussion Question – Respiratory

A 52-year-old male presents to the clinic with a productive cough for 5 days.

Describe at least 5 more questions the FNP should ask this patient in the health history.

Please generate at least 5 differential diagnoses for a cough. Describe how the FNP would

clinically manage and follow up this patient based on each differential diagnosis.

When performing an initial intake of this patient and his symptom of productive cough. I

would go through the acronym OLD CARTS to assess his cough further. Onset: When did the

cough start? What factors may have prompted the cough? Location; I could ask if he notices if

the cough seems to be coming from the upper or lower respiratory tracts. Duration: How

persistent is the cough? Do you cough constantly or intermittently? Character: I could ask about

the quality, consistency, amount, and color of the sputum and if there is ever any blood present.

Aggravating factors: Is there anything that makes the cough worse? Relieving factors: Is there

anything that makes the cough better? Have you used any cough drops or other over-the-counter

medications that have helped? Timing: Might be questions about if the cough seems worse at

night or during the day. And Severity: How bad is the cough, how is the cough affecting your

normal daily life, quality of life (Dunphy et al., 2019).

Differential diagnoses and recommendations for follow up for cough could include;

(1) Bronchiectasis: Supportive interventions such as; assessing adequate oxygenation,

rest, increasing fluid intake, and using a cool-mist humidifier. Acetaminophen (Tylenol), 500 to

1000 mg Q6H for fever or malaise (adults). Expectorants such as guaifenesin with

dextromethorphan for minor cough, throat irritation, 10mL by mouth every 4 hours. Antibiotics

are not recommended if an acute episode is viral, however they should be considered if

symptoms persist for longer than two weeks. Erythromycin, 250 to 500 mg by mouth four times

This study source was downloaded by 100000783599662 from CourseHero.com on 10-31-2021 05:53:30 GMT -05:00

https://www.coursehero.com/file/110441058/Week2DiscussionQuestionHEENTdocx/

Th is

stu dy

re so

ur ce

w as

sh ar

ed v

ia C

ou rs

eH er

o. co

m

https://www.coursehero.com/file/110441058/Week2DiscussionQuestionHEENTdocx/
2

per day. Albuterol for patients with wheezes or rhonchi, 2 puffs every 4 to 6 hours. Instruct

patient to follow up if symptoms do not improve or worsen within 48 hours, high fever, chills,

chest tightness or pain, and shortness of breath. Recommend annual flu and pertussis

vaccinations. Refer the patient to a physician if symptoms persist, if in respiratory distress or if

you suspect pneumonia. (Cash et al., 2020).

(2) Common Cold/Upper Respiratory Infection: Consider a rapid strep test if the

patient has had a recent exposure or a throat culture if strep is negative and the patient is

symptomatic. Treatment recommendations for the common cold are supportive, such as rest and

fluids. Saline nose drops for moisture. For rhinorrhea and nasal congestion decongestant, nasal

spray such as pseudoephedrine (Afrin) 0.05% 2-3sprays per nostril twice daily. Warn the patient

that using nasal sprays longer than 2-3 days can cause rebound congestion and drug abuse. Oral

decongestants such as; pseudoephedrine (Sudafed) 60 mg every 4-6 hours or 120 mg every 12

hours for adults. For headache relief Acetaminophen (Tylenol), 500 to 1000 mg every 6 hours or

ibuprofen (Advil) 200-400 mg every 4-6 hours. Cough suppressants if needed; dextromethorphan

10 to 20 mg every 6-8 hours. No, follow up recommended unless symptoms persist longer than 7

days or if the patient is experiencing pain that is worsening in the ears, sinuses, nose, throat,

neck, or chest, has green or yellow nasal drainage, or has a temperature higher than 100.4. Talk

to the patient about reducing transmission by covering mouth and nose when coughing and

sneezing and good hand hygiene. Consult MD if the patient has been reevaluated and given a

new treatment plan and symptoms are not improving. (Cash et al., 2020).

(3) Gastroesophageal Reflux Disease: Management depends on the cause and severity

of the symptoms. Prevention includes; avoiding smoking, avoiding wearing tight clothing and

belts that may increase abdominal pressure, do not lying down for 3 hours after a meal, avoid

This study source was downloaded by 100000783599662 from CourseHero.com on 10-31-2021 05:53:30 GMT -05:00

https://www.coursehero.com/file/110441058/Week2DiscussionQuestionHEENTdocx/

Th is

stu dy

re so

ur ce

w as

sh ar

ed v

ia C

ou rs

eH er

o. co

m

https://www.coursehero.com/file/110441058/Week2DiscussionQuestionHEENTdocx/
3

large, heavy meals and alcohol. Lose weight if indicated, stop smoking, elevate the head of the

bed on 6 blocks. Some medications can promote relaxation of the lower esophageal sphincter

(LES) and may need to be eliminated for symptom improvement, such as; NSAIDs, benzos,

calcium-channel blockers, and nitrates, to name a few. Medications to reduce GERD symptoms

may include a proton pump inhibitor (PPI) such as Omeprazole (Prilosec) 20 mg tablet daily.

PPIs can increase the risk of community-acquired pneumonia and GI infections. Histamine 2-

receptors agonists (H2 blockers) such as famotidine (Pepcid) can help treat mild and less

frequent symptoms on an as-needed basis. Schule follows up for 1-2 weeks to reevaluate for

relief of symptoms. Refer if patients do not improve after trying two different medications (Cash

et al., 2020).

(4) Medication-induced cough from ACE-inhibitors: A repeat trial should be

attempted if the patient’s cough ceases after ACE inhibitors are stopped or if it is decided that the

patient needs to continue treatment with these drugs. ACE inhibitors should be considered

entirely or partially causative in a patient with a persistent cough, regardless of the time interval

between commencement of ACE inhibitor therapy and the onset of cough. Discontinuation of

therapy is the only consistently successful treatment for ACE inhibitor-induced cough (Cash et

al., 2020)

(5) Coronavirus Disease (COVID-19): General therapies for mild symptoms (without a

positive test result) are generally supportive in nature and might include increasing fluid intake,

rest, and follow-up with a primary care physician to evaluate outcome. Patients should cancel or

reschedule travel, adhere to any local limitations, avoid big gatherings, and stay at home if they

feel unwell, even if the symptoms are mild. If a patient’s screen is positive, they should be

followed up according to the severity. Patients with minor symptoms should be called every two

This study source was downloaded by 100000783599662 from CourseHero.com on 10-31-2021 05:53:30 GMT -05:00

https://www.coursehero.com/file/110441058/Week2DiscussionQuestionHEENTdocx/

Th is

stu dy

re so

ur ce

w as

sh ar

ed v

ia C

ou rs

eH er

o. co

m

https://www.coursehero.com/file/110441058/Week2DiscussionQuestionHEENTdocx/
4

days for up to 14 days, or until symptoms improve. Patients experiencing more severe symptoms

should be seen every 24 hours. The WHO does not recommend self-medication with any drug,

including antibiotics, as a means of preventing or treating COVID-19. Anypyretics such as

Acetaminophen (Tylenol), 500 to 1000 mg every 4-6 hours. Avoid the use of NSAIDs as they

may have a negative outcome for the patient. Expectorants such as guaifenesin with

dextromethorphan can be used to treat minor cough from bronchial/throat irritation. Consult with

a physician if the pateint has acute respiratory decompensation. Consider sending pateint to the

hospital if they are exhibiting RED FLAG symptoms such as; severe shortness of breath,

hemoptosis, chest pain, cool clammy skin, or cyanosis (Cash et al., 2020).

References

Cash, J. C., Glass, C. A., & Mullen, J. (2020). Family practice guidelines. Springer Publishing

Company. https://doi.org/10.1891/9780826153425.0018b

Dunphy, L. M., E, J., Porter, B. O., & Thomas, D. J. (2019). Primary care: Art and science of

advanced practice nursing – an interprofessional approach (5th ed.). F.A. Davis

Company.

This study source was downloaded by 100000783599662 from CourseHero.com on 10-31-2021 05:53:30 GMT -05:00

https://www.coursehero.com/file/110441058/Week2DiscussionQuestionHEENTdocx/

Th is

stu dy

re so

ur ce

w as

sh ar

ed v

ia C

ou rs

eH er

o. co

m

Powered by TCPDF (www.tcpdf.org)

https://www.coursehero.com/file/110441058/Week2DiscussionQuestionHEENTdocx/
http://www.tcpdf.org

---

Get Professional Assignment Help Cheaply

Are you busy and do not have time to handle your assignment? Are you scared that your paper will not make the grade? Do you have responsibilities that may hinder you from turning in your assignment on time? Are you tired and can barely handle your assignment? Are your grades inconsistent?

Whichever your reason is, it is valid! You can get professional academic help from our service at affordable rates. We have a team of professional academic writers who can handle all your assignments.

Why Choose Our Academic Writing Service?

• Plagiarism free papers
• Timely delivery
• Any deadline
• Skilled, Experienced Native English Writers
• Subject-relevant academic writer
• Adherence to paper instructions
• Ability to tackle bulk assignments
• Reasonable prices
• 24/7 Customer Support
• Get superb grades consistently

 

Online Academic Help With Different Subjects

Literature

Students barely have time to read. We got you! Have your literature essay or book review written without having the hassle of reading the book. You can get your literature paper custom-written for you by our literature specialists.

Finance

Do you struggle with finance? No need to torture yourself if finance is not your cup of tea. You can order your finance paper from our academic writing service and get 100% original work from competent finance experts.

Computer science

Computer science is a tough subject. Fortunately, our computer science experts are up to the match. No need to stress and have sleepless nights. Our academic writers will tackle all your computer science assignments and deliver them on time. Let us handle all your python, java, ruby, JavaScript, php , C+ assignments!

Psychology

While psychology may be an interesting subject, you may lack sufficient time to handle your assignments. Don’t despair; by using our academic writing service, you can be assured of perfect grades. Moreover, your grades will be consistent.

Engineering

Engineering is quite a demanding subject. Students face a lot of pressure and barely have enough time to do what they love to do. Our academic writing service got you covered! Our engineering specialists follow the paper instructions and ensure timely delivery of the paper.

Nursing

In the nursing course, you may have difficulties with literature reviews, annotated bibliographies, critical essays, and other assignments. Our nursing assignment writers will offer you professional nursing paper help at low prices.

Sociology

Truth be told, sociology papers can be quite exhausting. Our academic writing service relieves you of fatigue, pressure, and stress. You can relax and have peace of mind as our academic writers handle your sociology assignment.

Business

We take pride in having some of the best business writers in the industry. Our business writers have a lot of experience in the field. They are reliable, and you can be assured of a high-grade paper. They are able to handle business papers of any subject, length, deadline, and difficulty!

Statistics

We boast of having some of the most experienced statistics experts in the industry. Our statistics experts have diverse skills, expertise, and knowledge to handle any kind of assignment. They have access to all kinds of software to get your assignment done.

Law

Writing a law essay may prove to be an insurmountable obstacle, especially when you need to know the peculiarities of the legislative framework. Take advantage of our top-notch law specialists and get superb grades and 100% satisfaction.

What discipline/subjects do you deal in?

We have highlighted some of the most popular subjects we handle above. Those are just a tip of the iceberg. We deal in all academic disciplines since our writers are as diverse. They have been drawn from across all disciplines, and orders are assigned to those writers believed to be the best in the field. In a nutshell, there is no task we cannot handle; all you need to do is place your order with us. As long as your instructions are clear, just trust we shall deliver irrespective of the discipline.

Are your writers competent enough to handle my paper?

Our essay writers are graduates with bachelor’s, masters, Ph.D., and doctorate degrees in various subjects. The minimum requirement to be an essay writer with our essay writing service is to have a college degree. All our academic writers have a minimum of two years of academic writing. We have a stringent recruitment process to ensure that we get only the most competent essay writers in the industry. We also ensure that the writers are handsomely compensated for their value. The majority of our writers are native English speakers. As such, the fluency of language and grammar is impeccable.

What if I don’t like the paper?

There is a very low likelihood that you won’t like the paper.

Reasons being:

• When assigning your order, we match the paper’s discipline with the writer’s field/specialization. Since all our writers are graduates, we match the paper’s subject with the field the writer studied. For instance, if it’s a nursing paper, only a nursing graduate and writer will handle it. Furthermore, all our writers have academic writing experience and top-notch research skills.
• We have a quality assurance that reviews the paper before it gets to you. As such, we ensure that you get a paper that meets the required standard and will most definitely make the grade.

In the event that you don’t like your paper:

• The writer will revise the paper up to your pleasing. You have unlimited revisions. You simply need to highlight what specifically you don’t like about the paper, and the writer will make the amendments. The paper will be revised until you are satisfied. Revisions are free of charge
• We will have a different writer write the paper from scratch.
• Last resort, if the above does not work, we will refund your money.

Will the professor find out I didn’t write the paper myself?

Not at all. All papers are written from scratch. There is no way your tutor or instructor will realize that you did not write the paper yourself. In fact, we recommend using our assignment help services for consistent results.

What if the paper is plagiarized?

We check all papers for plagiarism before we submit them. We use powerful plagiarism checking software such as SafeAssign, LopesWrite, and Turnitin. We also upload the plagiarism report so that you can review it. We understand that plagiarism is academic suicide. We would not take the risk of submitting plagiarized work and jeopardize your academic journey. Furthermore, we do not sell or use prewritten papers, and each paper is written from scratch.

When will I get my paper?

You determine when you get the paper by setting the deadline when placing the order. All papers are delivered within the deadline. We are well aware that we operate in a time-sensitive industry. As such, we have laid out strategies to ensure that the client receives the paper on time and they never miss the deadline. We understand that papers that are submitted late have some points deducted. We do not want you to miss any points due to late submission. We work on beating deadlines by huge margins in order to ensure that you have ample time to review the paper before you submit it.

Will anyone find out that I used your services?

We have a privacy and confidentiality policy that guides our work. We NEVER share any customer information with third parties. Noone will ever know that you used our assignment help services. It’s only between you and us. We are bound by our policies to protect the customer’s identity and information. All your information, such as your names, phone number, email, order information, and so on, are protected. We have robust security systems that ensure that your data is protected. Hacking our systems is close to impossible, and it has never happened.

How our Assignment  Help Service Works

1.      Place an order

You fill all the paper instructions in the order form. Make sure you include all the helpful materials so that our academic writers can deliver the perfect paper. It will also help to eliminate unnecessary revisions.

2.      Pay for the order

Proceed to pay for the paper so that it can be assigned to one of our expert academic writers. The paper subject is matched with the writer’s area of specialization.

3.      Track the progress

You communicate with the writer and know about the progress of the paper. The client can ask the writer for drafts of the paper. The client can upload extra material and include additional instructions from the lecturer. Receive a paper.

4.      Download the paper

The paper is sent to your email and uploaded to your personal account. You also get a plagiarism report attached to your paper.

PLACE THIS ORDER OR A SIMILAR ORDER WITH US TODAY AND GET A PERFECT SCORE!!!

---

The post Discussion Question On Respiratory appeared first on Nursing Area.