Discussion 1 A 52-year-old man goes to the clinic with a cough that has lasted f

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Discussion 1 A 52-year-old man goes to the clinic with a cough that has lasted five days. Describe at least five more health history questions the FNP should ask this patient. Please include at least five alternative diagnoses for a cough. Describe how the FNP would manage this patient clinically and conduct follow-ups based on each differential diagnosis.
Clarifying questions:
What is the sputum’s color? Bloody, green, or transparent?
What is your smoking history?
When is the coughing at its worst or most persistent?
Do you have a fever?
Do you have shortness of breath or trouble breathing?
Any chest discomfort or heart palpitations?
What, if anything, makes the cough better or worse?
Is cough linked to eating or acid reflux (Hall & Glass, 2021)?
What treatments is the patient taking?
Included in the differential diagnosis of acute productive cough are:
Lab tests for heart failure include a CBC, CMP, and BNP. Diagnostics include a chest x-ray and echocardiography. Treatment focuses on enhancing the quality of life and reducing hospitalizations (Malik, Daniel, Vaqar, & Chhabra, 2021). Included among the medications are hydralazine and ACE inhibitors. F/U: Education on healthy lifestyles, weight loss, quitting smoking or drinking, if necessary, and regular exercise. If symptoms intensify, chest discomfort, or dyspnea occurs, immediate medical care is required (Malik, Daniel, Vaqar, & Chhabra, 2021).
Diagnostics for pneumonia include a chest x-ray. Antibiotics such as Amoxicillin or Doxycycline for 5-7 days in low-risk patients. If the patient begins to develop chest pain or worsening dyspnea, he or she should seek medical attention. In the clinic, if there is no improvement in symptoms within one week, treatment is initiated (Arnold, 2020). The patient should utilize an incentive spirometer, rest with intermittent short walks, and increase water consumption.
The diagnosis of acute bronchitis is based on clinical symptoms and current sickness history. Bronchitis can be viral or bacterial, but the treatment requirements remain the same. Antibiotics are not advised for the treatment of acute bronchitis because the sickness is usually self-limiting and follows an upper respiratory infection or an allergic reaction (Singh, Akshay, & Zahn, 2022). A cough that produces mucus might last up to four weeks. The purpose of treatment is to alleviate symptoms. Patients should be instructed to seek medical assistance if their cough worsens, their fever persists, they have dyspnea, or they experience chest pain.
Pertussis- Diagnosis is done from a nasal swab. Following coughing spasms, the predominant diagnostic symptom is a “whooping” sound. Other symptoms include upper respiratory infections and an absence of vaccines or booster shots. Antibacterial therapy using azithromycin as the major medicine constitutes the treatment. Due to the high danger of exposing newborns to pertussis, which can be fatal, care should be exercised and treatment should begin while lab results are awaited. (2017) Pertussis (whooping cough)
Depending on the season, influenza is the most likely cause of a productive cough (Hall & Glass, 2021). The best treatment is the influenza vaccine, which is preventative medicine. The duration of symptomatic treatment for influenza is up to three weeks. Seek medical care if dyspnea develops or if symptoms linger without improvement beyond the first week.
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Post discussion 2
HEENT & Respiratory
The cough is the body’s natural protective mechanism for clearing the airway of secretions and irritants that may affect a person’s health. A cough can be acute or chronic. It can be caused by a myriad mechanism that is related to a person’s diseases and comorbidities. Cough with or without sputum, and dyspnea are the most common respiratory symptoms experienced by patients with respiratory diseases. These symptoms can reduce their quality of life. Yi, et al., (2018). For the 52-year-old who presented to the clinic with a cough, I would first ask the patient When was the onset of the cough, when does the cough normally occur, is it during the day or night, or during exercise, What triggers the cough and what relieves the patient of the cough? What home treatment has the patient used and, does the patient has any airway disease. what alleviates the cough? And what measures have been taken to alleviate the cough? What is the quality of the cough? Does it have sputum? And what is the color of the sputum if any? The NP would like to ask if the patient is a current and former smoker?
5 differential diagnoses for a cough.
Allergic Rhinitis and postnasal drip: The NP will prescribe Decongestant and antihistamine, alone and in combination which can be used in this diagnosis. Intranasal corticosteroid spray may be used like Flonase and Nasonex may be used on a consistent basis for this patient. The patient will be educated to drink 2-3 L of water daily and, will be asked to come back to the clinic in 2 weeks if symptoms do not improve. Additionally, Pt will be educated to go to the ER if symptoms persist or if the patient is having shortness of breath or chest pain.
Acute bronchitis
It is defined as a sudden inflammation of the bronchial tubes in the lung mainly caused by a viral infection. It is characterized by a persistent cough that can be productive or dry. It is the most common disease in industrialized countries. Kruttschnitt, et al., (2020). Evidence-based recommendations from the CDC and other national societies suggest antibiotics are not prescribed for acute bronchitis in healthy individuals. Antibiotic stewardship for treatment of acute bronchitis in retail health. (2020).
COVID-19 Coughing is considered a major clinical manifestation in COVID-19 patients. The viscous exudates block the airway, which seriously affects the ventilation function of the lung. It reduces the efficacy of oxygen therapy and mechanical ventilation and even causes asphyxia death. Zhang et al., (2022). The treatment supportive oxygen therapy, administration of antivirals, cough medications and other symptom management. Zhang et al., (2022). Patients should continue taking ICSs, long-acting bronchodilators, roflumilast, chronic macrolides, systemic steroids, and antibiotics as prescribed. Harris, et al., (2022).
COPD
a long- or short-acting bronchodilator. Patients will be prescribed a long-acting muscarinic antagonist (LAMA) or a long-acting â agonist (LABA); there is no evidence to recommend one drug over the other, and the choice should be dependent upon the patient’s perception of symptom relief. If the patient is experiencing persistent breathlessness or is exercise-intolerant, combination treatment should be used. If there is no improvement with dual therapy, treatment should be changed to triple therapy with LAMA, LABA, and ICS. If patients on triple therapy still have exacerbations, treatment options are to add roflumilast, add a macrolide, or stop ICSs if the patient reports a lack of efficacy or adverse effects (eg, pneumonia). For Nonpharmacologic Management of COPD, smoking cessation and physical activity are recommended for all patients with COPD. For patients in groups, Additionally, pulmonary rehabilitation is should be recommended. Harris, et al., (2022)
Tuberculosis
If a patient has an active TB disease the NP will probably be treating the patient with a combination of antibacterial medications for a period of six to 12 months. The most common treatment for active TB is isoniazid INH in combination with three other drugs rifampin, pyrazinamide, and ethambutol. The patient may begin to feel better only a few weeks after starting to take the drugs. However, treating TB takes much longer than other bacterial infections. Patients must be educated to continue taking their medication as prescribed for the entire time their doctor indicates or they could get sick again, have a harder time fighting the disease in the future, and spread the disease to others. Not completing your entire course of medication could also contribute to drug-resistant TB. For all the Diagnoses above, the patient will be advised to drink 2-3 L of water daily and will be asked to come back to the clinic in 2-3 weeks if symptoms do not improve. Additionally, Pt will be educated to go to the ER if symptoms persist or if she is having shortness of breath or chest pain. For patients who smoke, Pt should be educated on the dangers of smoking and being a secondhand smoker
respond to each post with about 175 words. Thank you references need 2 per discussion means 4 in total

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