NR507 Week 2 Case Study Discussion - Part Two - Latest Guide - Top Best peers posts. Verified Answers.

Discussion Part Two (graded) Tammy is a 33-year-old who presents for evaluation of a cough. She reports that about 3 weeks ago she developed a “really bad cold” with rhinorrhea. The cold seemed to go away but then she developed a profound, deep, mucus-producing cough. Now, there is no rhinorrhea or rhinitis—the primary problem is the cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Tammy has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves. Write a differential of at least five (5) possible diagnosis’s and explain how each may be a possible answer to the clinical presentation above. Remember, to list the differential in the order of most likely to less likely. Based upon what you have at the top of the differential how would you treat this patient? Suppose now, the patient has a fever of 100.4 and complains of foul smelling mucous and breath. Indeed, she complains of producing cups of mucous some days. She has some trouble breathing on moderate exertion but this is only a minor complaint to her. How does this change your differential and why? Topic responses  Discussion  Expand All More Sort By:        Sarah Drum 9/5/2016 6:11:48 PM Week 2 DB 2 Bronchitis Bronchitis is an inflammation of the lower respiratory track of the bronchial tubes “Acute bronchitis is usually caused by a respiratory virus and occasionally by bacterial infection, although this occurs in less than 10 percent of cases” (Acute Bronchitis, 2016). The symptoms of bronchitis include coughing up mucus that is yellow or green, a runny or congested nose that started a few days before the chest congestion, fatigue, wheezing, shortness of breath with activities, and “coughing fits.” The patient reports having a runny nose about three weeks ago when this started. A runny nose was her only complaint when the illness started. Once the runny nose went away, the cough and chest congestion started. She currently does not have a fever, but her throat is scratchy. Her throat could be scratchy from all of the coughing she has done. Her symptoms seem to fit all of the symptoms associated with bronchitis, especially since she is not running a fever and the fact bronchitis can last several weeks. The patient is not having any fever or chills, so this could indicate that it is viral, and there is no infection. Pneumonia Pneumonia is a lung infection that can have mild to severe symptoms. They symptoms range from a cough which can produce yellow, green, or bloody mucus, fever, shortness of breath, chills, headache, fatigue, loss of appetite, and sweating. Bronchitis and Pneumonia are very similar, that is why sometimes a person is diagnosed with one when they really have the other. An x-ray can rule out or confirm pneumonia. It can begin with a sore throat, dry cough, muscle aches, and then it will progress to having a productive cough with discolored sputum. It can be from bacteria, viral, or even fungal. The patient is at more of a risk for pneumonia because she did have a cold, it could have possibly turned into a pneumonia due to the congestion (Pneumonia, 2016). Acute Sinusitis “Sinuses are hollow spaces in the bones around the nose that connect to the nose through small, narrow channels” (Sinusitis, 2016). Acute sinusitis is an infection of the sinuses. It affects one in eight adults every year. What happens is the sinus cavities become inflamed and then are unable to empty mucus. The inflammation could have come from the cold, and now that the sinus cavities are blocked from inflammation, she has developed a sinus infection. Symptoms include congestion (chest or nose), pain, pressure, or fullness in the face, and yellow or green mucus. Bacterial sinusitis is suspected if it has been longer than 10 days, and the patient is not better. The patient has had symptoms for at least three weeks, and so acute bacterial sinusitis should be suspected (Sinusitis, 2016). Asthma Even though asthma does not explain all of her symptoms, it is a possibility. The patient may have asthma and an irritant is exacerbating it, which is causing the sputum. These irritants could be pollen, smoke, or house hold chemicals. It also could explain the coughing fits she has