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Respond on two different days ;who selected a different scenario than you, in one or more of the following ways:
Share insights on how the factor you selected impacts the disorder your colleague identified.
Ask a probing question regarding the disorder that your colleague identified.
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Suggest an alternative disorder for the scenario your colleague selected.
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Scenario 3:
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Maria is a 36-year-old who presents for evaluation of a cough. She is normally a healthy young lady with no significant medical history. She takes no medications and does not smoke. She reports that she was in her usual state of good health until approximately 3 weeks ago when she developed a “really bad cold.” The cold is characterized by a profound, deep, mucus-producing cough. She denies any 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. Maria 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.
Acute Cough
; ; ; ; Coughs are the body’s way of clearing airways via forceful expiration. ; Inflammation, inhaled particles, accumulated mucus, or foreign bodies stimulate a cough reflex by irritant receptor stimulation in the airway. ; An acute cough is classified as lasting 2-3 weeks, and chronic cough is greater than three weeks in a non-smoker. Frequent cough causes are allergic rhinitis, upper respiratory infections, pneumonia, aspiration, pulmonary embolus, and congestive heart failure. ; Due to the above-listed scenario, this cough would be diagnosed as acute cough due to timeframe, cough characteristics, and patient history (Huether & McCance, 2019).
Green Sputum
; ; ; ; Sputum contains immune cells and white blood cells from the lower respiratory tract that protect the airway from infections. ; Sputum can be clear or colored. ; Color sputum may be yellow, white, green, red or blood-tinged, or pink. ; Neutrophils are white blood cells that can take on a green color. ; This color sputum can be indicative of bacterial infections of the lower respiratory tract. ; Pneumonia and cystic fibrosis can produce this color sputum. ; To indeed rule out something benign, a sputum culture would need to be obtained and tested (Verywell Health, 2019). ; At three weeks in, it would likely be premature to order cultures with limited symptoms. ;
Treatment
; ; ; ; Due to the timeframe of cough and only accompanying symptom being green sputum, as a practitioner, I would prescribe an expectorant and schedule a follow up if symptoms persist or worsen. ; Teaching should include that adverse effects of expectorants might be GI upset, headache, drowsiness, and dizziness. ; Advise patient that expectorants are designed to be short-term (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Additional home treat to loosen secretions would be a humidifier, staying adequately hydrated and warm salt water gargles if sore throat should appear (Barkley, 2018).
Patient Factors- Behavior and Age
; ; ; ; ; ; ; ; ; Maria is an otherwise, healthy 36-year-old female. ; Due to her age and symptom status, Maria would be treated conservatively. ; Maria is a non-smoker and takes no prescribed medications. ; Further investigation would be required if she was a smoker, currently on prescriptions medications, had current disease processes that may factor into the treatment plan.
References
Arcangelo, ; V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). ; (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams ; & Wilkins.
Barkley, T. ; (2018). ; Adult-gerontology primary care nurse practitioner. ; West Hollywood, CA: ; Barkley & Associates.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Verywell Health. ; (2019). What causes the amount of sputum to increase? ; Retrieved from https://www.verywellhealth.com/what-is-sputum-2249192