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.
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During a respiratory assessment, history taking helps gather more information regarding the patient’s current symptoms. This helps determine the required further assessment tests and narrow down differential diagnosis, thus preventing delayed diagnosis and care. In the case of a 52-year-old presenting to the clinic with a five-day history of a productive cough, further questions that I would ask during respiratory history taking include the presence of associated symptoms such as chest pain, wheezing, congestion, sore throat, and shoes of breath, the location of the pain, the frequency of the cough and whether it’s productive or not. I would also ask about the color of the sputum, the time of the day when the cough is worse, the progression of the cough, the alleviating and aggravating factors, and any medications that the patient has used to manage the cough. It is also essential to ask about the past medical history regarding respiratory illnesses and exposure to risk factors such as smoke.
Differential Diagnoses for a Cough.
The first differential diagnosis for acute cough is common cold, which refers to a viral infection of the upper respiratory tract. Besides cough, common cold also causes sore throat, congestion, sneezing, fever, and fatigue. Treatment entails managing symptoms with over-the-counter pain relievers, cough syrups, decongestants and nasal sprays (Sharma, Hashmi & Alhajjaj, 2018). Follow-up care should be after ten days since common cold symptoms usually resolve after ten days even without medical intervention.
Acute bronchitis is another differential diagnosis for acute cough. The condition refers to a viral infection and inflammation of the bronchial tubes. Symptoms include cough, yellowish-green sputum, fatigue, fever, Shortness of breath, and chest discomfort. Treatment entails symptom management through cough suppressants, anti-inflammatory medication, and inhalers. Follow-up care is usually after two weeks because most acute bronchitis cases typically get better without treatment within two weeks.
The other differential diagnosis for acute cough is Influenza. Influenza is a viral infection of the upper and lower respiratory system. The disease causes dry cough, fever, headache, chills, Shortness of breath, sore throat, fatigue, running nose, diarrhea and vomiting. Treatment interventions include plenty of rest and fluid intake to help manage symptoms. Antiviral drugs are prescribed in severe cases. Follow-up care is usually in 2 weeks because influenza usually resolves on its own after two weeks (Sharma, Hashmi & Alhajjaj, 2018).
Pneumonia is another differential diagnosis for cute cough. It refers to bacterial or viral infection of the air sacs in the lungs. Besides cough, other pneumonia symptoms include chest pain, breathing difficulties, confusion, fever, sweating, fatigue, nausea, vomiting, or diarrhea. Treatment depends on the cause. Antibiotics are used to treat bacterial pneumonia, while antivirals are used to treat viral pneumonia (Gibson, 2019). In addition, cough and fever medication is used to manage symptoms. Follow-up care s usually after two weeks because pneumonia resolves two to three weeks after onset of the medicine.
Another differential diagnosis for acute cough is asthma. It refers to inflammation and narrowing of airways caused by exposure to environmental allergens. Common symptoms are wheezing, Shortness of breath, coughing, chest tightness, or pain. Long-term control medications such as Inhaled corticosteroids are prescribed to reduce airway inflammation. Quick-relief medicines such as Oral and intravenous corticosteroids are administered to open swollen airways quickly (Gibson, 2019). Allergy medicines such as an allergy shot are administered to reduce immune system response to allergens. Follow-up care is usually after two weeks.