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Case Study Of Patient Complaining Of Shortness Of Breath And Cough

Case Study Of Patient Complaining Of Shortness Of Breath And Cough

For the case you have chosen, post to the discussion:

Discuss what questions you would ask the patient, what physical exam elements you would include, and what further testing you would want to have performed.
In SOAP format, list:
Pertinent positive findings that validate your main diagnosis
Pertinent negative findings that make you think of other differential diagnoses
Treatment plan, including: pharmacotherapy with complementary and OTC therapy, diagnostics (labs and testing), health education and lifestyle changes, age-appropriate preventive care, and follow-up to this visit.
Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.
Initial post must have a minimum of 300 words, excluding references Case Study Of Patient Complaining Of Shortness Of Breath And Cough.

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NURS 681 Discussion Board
NURS 681 Discussion Board
Criteria Ratings Pts
This criterion is linked to a Learning Outcome Initial Response Timing
4 pts
Proficient
On time (posted by Wednesday, 11:59 p.m. of the week in which assigned)
0 pts
Unsatisfactory
Late (did not submit by Wednesday, 11:59 p.m. of the week in which assigned)
4 pts
This criterion is linked to a Learning Outcome Evidence of Critical Thinking: Initial Responses to Discussion Prompt(s) Case Study Of Patient Complaining Of Shortness Of Breath And Cough
10 to >9.2 pts
Proficient
Applies course content sufficiently by expanding on the main points of the prompt. Responses exhibit critical thinking and analysis. There is a significant correlation to course materials, national guidelines, and evidence-based research.
9.2 to >8.2 pts
Acceptable
Content knowledge is exhibited by identification of the main topics. There is some evidence of critical thinking and analysis. Responses may be insufficient or lacking in detail.
8.2 to >7.5 pts
Needs Improvement
An understanding of content knowledge is poorly exhibited and insufficient in critical thinking, analysis, and detail. Some main discussion topics are not covered, or they significantly digress from the topic at hand.
7.5 to >0 pts
Unsatisfactory
An initial response is missing or provides no indication of understanding. Main topics are not covered.
10 pts
This criterion is linked to a Learning Outcome Word Count Initial Post
2 to >1.0 pts Case Study Of Patient Complaining Of Shortness Of Breath And Cough
Proficient
The initial post is 300 words or more.
1 to >0.0 pts
Acceptable
n/a You will either receive 100 or 0.
0 pts
Needs Improvement
n/a You will either receive 100 or 0.
0 pts
Unsatisfactory
The initial post has fewer than 300 words.
2 pts
This criterion is linked to a Learning OutcomeFrequency of Participation and Minimum Posting Requirements
4 to >3.0 pts
Proficient
Responses to peers’ initial posts occur throughout the week with replies to peers and/or instructors present on two or more days. A minimum of 2 replies on 2 separate days per weekly prompt is evident.
3 to >1.0 pts
Acceptable
n/a You will either receive 100 or 0.
1 to >0.0 pts
Needs Improvement
n/a You will either receive 100 or 0.
0 pts
Unsatisfactory
Responses to peers’ initial posts do not occur throughout the week with replies to peers and/or instructors present on two or more days. Less than a minimum of 2 replies on 2 separate days per weekly prompt is evident Case Study Of Patient Complaining Of Shortness Of Breath And Cough.
4 pts
This criterion is linked to a Learning Outcome Evidence of Critical Thinking:<br>Responses to Peers and/or Instructors
11 to >10.12 pts
Proficient
Well-developed and insightful replies provide an opportunity for response. Responses promote discussion either by sharing prior knowledge and experiences, making meaningful connections with course content, asking meaningful questions, or challenging viewpoints. There is a significant correlation of student ideas to course materials, national guidelines, and evidence-based research.
10.12 to >9.02 pts
Acceptable
Somewhat developed replies provide some opportunity for response. Responses contribute to the discussion either by sharing prior knowledge and experiences, making connections with course content, or asking questions.
9.02 to >8.25 pts
Needs Improvement
Poorly developed replies provide little or no opportunity for response. Responses do little to contribute to the discussion Case Study Of Patient Complaining Of Shortness Of Breath And Cough.
8.25 to >0 pts
Unsatisfactory
Responses are severely limited; no critical thought is present.
11 pts
This criterion is linked to a Learning OutcomeWriting Mechanics
9 to >8.28 pts
Proficient
The writing is clear, concise, formal, and organized. Responses contain a maximum of 2 errors in spelling and grammar. Sources are paraphrased, referenced, and cited correctly in current APA style in all but 1 or 2 instances.
8.28 to >7.38 pts
Acceptable
The writing is generally clear and organized but is not concise or formal in language. Responses contain 3- to 5 errors in spelling and grammar with minor interference with readability or comprehension. Sources are paraphrased, referenced, and cited correctly in current APA in all but 3 or 4 instances.
7.38 to >6.75 pts
Needs Improvement
The writing is unclear and unorganized. Responses contain more than 5 errors in spelling and grammar that detract from the readability of the paper. Sources are missing or they are improperly cited; APA style is barely evident.
6.75 to >0 pts
Unsatisfactory
Extensive errors in spelling and grammar detract from readability and comprehension, and/or the writing includes slang or is inappropriate for academic discourse. APA style is not evident Case Study Of Patient Complaining Of Shortness Of Breath And Cough.
9 pts
Total Points: 40

NURS 681 Discussion

Case 2: A 29-year-old newly immigrated woman complains of weakness, shortness of breath, cough, and night sweats for the past month.

 Relevant Questions

  • Do you frequently have chills or fever?
  • Do you cough up sputum or blood?
  • When do you cough during or after activities?
  • Have you suffered from chest pain?
  • Do you feel tightness in your lungs or throat?
  • Where did you come from, and for how long you have been in the country?
  • Do you have a history of TB? Case Study Of Patient Complaining Of Shortness Of Breath And Cough

Physical Exam Elements

  • General Appearance
  • HEENT
  • Skin
  • Cardiac
  • Respiratory
  • Extremities
  • Neurological
  • Psychiatric

Further Testing

  • Chest X-ray
  • Blood tests
  • Lung function tests
  • Echocardiogram

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A.

Pertinent Positive Findings

– The patient can be suffering from pulmonary tuberculosis, which is associated with chronic cough, weakness, and night sweats for the identified period (one month) (CDC, 2022)Case Study Of Patient Complaining Of Shortness Of Breath And Cough.

– Patient could have lung cancer characterized by weakness and chronic coughing for one month. Also, this can be ascertained by the differential diagnosis if it finds cervical lymph and supraclavicular nodes are swollen (         NIH, 2021).

Pertinent Negative Findings

– Pulmonary can be ruled out because there is no medical history and record of weight loss.

– Lung cancer cannot be ascertained at the moment because the family and medical history related to cancer are lacking, and no information about exposure to smoking.

– Fungal infections can be ruled out because there is no information on the patient’s exposure to plants, soil, or decaying vegetation. Also, no history of neutropenia or respiratory infections (CDC, 2020)Case Study Of Patient Complaining Of Shortness Of Breath And Cough.

P.

Treatment Plan

According to CDC (2022), the patient is treated with a 4-month TB treatment regimen consisting of daily high-dose of rifapentine with isoniazid, moxifloxacin, and pyrazinamide. This medication is suitable for the patient because she is above twelve years and hopefully above 40 kg. The medication is recommended for patients with pulmonary TB suspected to be caused by unknown organisms or to be drug resistant.

Diagnostics

  • Chest X-ray
  • Sputum culture
  • T-SPOT TB test
  • HIV

Health Education and Lifestyle

The patient’s health education will be tailored to make sure she has the right knowledge about taking the prescribed medications. The health education will inform the patient of the significance of completing the treatment regimen. The patient will be educated on avoiding contact with other people to minimize the infection. The patient will be directed on increasing the quality sleeping. The health education will emphasize the importance of taking on prescribed medications, especially OTC medications. The education will inform the patient when to seek immediate assistance from health care providers.

Preventive Care

  • Practicing to cover the nose and mouth with a handkerchief or tissue paper.
  • Maintaining hand hygiene with water and soap.
  • Throwing away used tissue paper and thoroughly washing used handkerchiefs.
  • The immediate family members will be advised to support the patient.

Follow-up Visit

A follow-up visit will be after one week to allow monitoring of the patient’s progress. Also, medication refills will be administered and monitored every month Case Study Of Patient Complaining Of Shortness Of Breath And Cough.

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References

CDC (Ed.). (2022). Treatment for TB disease. Centers for Disease Control and

Prevention. Retrieved from https://www.cdc.gov/tb/topic/treatment/tbdisease.html

CDC (Ed.). (2020). Symptoms of aspergillosis. Centers for Disease Control and

Prevention. Retrieved from

https://www.cdc.gov/fungal/diseases/aspergillosis/symptoms.html

NIH (Ed.). (2021). Lung cancer-patient version. National Cancer Institute. Retrieved

from https://www.cancer.gov/types/lung/patient/lung-screening-pdq Case Study Of Patient Complaining Of Shortness Of Breath And Cough