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Respondtoat leasttwoof your colleagues ontwodifferent days who were assigned different case studies than you. Analyze the possible conditions from your colleagues' differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.Dale – Case study #3Dale,You have developed good supporting information for the vignette we were given. The conclusions you developed are well supported. I agree with you on the presumptive diagnosis of pneumonia. Here are my thoughts on the differentials you chose.Presumptive diagnosis:Accept/RejectSupportBacterial PneumoniaAcceptThis client is currently experiencing shortness of breath, green (blood-tinged) sputum, fever and chills, elevated pulse. Dains, Baumann, and Scheibel (2016) noted these as common symptoms of a bacterial pneumonia. The diminished, adventitious sounds of crackles (rales) fit those described by Ball, Dains, Flynn,Solomon and Stewart (2015) as common for pneumonia. Is palpation positive for tactile fremitis? The x-ray demonstrates consolidation in the middle lobe which also supports this diagnosis.Differential DiagnosesViral PneumoniaAcceptFalsey and Walsh (2008) reported a pneumonia in older clients is often caused by a virus, with influenza being a common cause. They noted common symptoms include high fever and myalgias (not currently seen in this client). These researchers also warned there is little in a client’s presentation to differentiate between a viral and bacterial caused pneumonia. Laboratory testing can be used to differentiate.BronchitisRejectBall et al. (2015) describe symptoms of bronchitis as dry, hacking cough with no significant dyspnea. However, they did note in a chronic bronchitis, the cough can become productive. It is not clear in this scenario how long the cough has been present, but theclient is clearly in respiratory distress with dyspnea on walking, talking with a SP02 of 89%.Lung abscessRejectThere is not enough information to support this diagnosis. A lung abscess would be a chronic issue. It isuncertain how long this client has had the cough.Chronic obstructive RejectThere is not enough information to fully support or
pulmonary disease (COPD)reject this diagnosis. Dains et al. (2016) noted symptoms would include a more chronic cough, increased exhalation time, decreased chest expansion and clients often have an increase in the AP diameter of the chest (negative in this client). In addition to the history provided, I would like to know more about the cough (duration, timing). Is there a history of asthma? He mentions dyspnea from just talking and his SP02 is only 89% so I do understand the need for prioritizing history. I would add the differential of tuberculosis to the list.