NURS 6541: Primary Care of Adolescents and Children INITIAL POST Evaluation and Management of Respiratory, Cardiovascular, and Genetic Disorders – Case Study #3 A father presents his 9-year-old with a 3-day history of cough. Dad states that his son is coughing up yellow mucus. The boy is afebrile and is sleeping through the night, but the father’s sleep is disturbed listening to his son coughing. Dad says he thinks his son has bronchitis and is requesting treatment. Physical examination reveals the following: respiratory rate is 18, lungs are clear to auscultation, patient is able to take deep breaths without coughing, there is no cervical adenopathy, nasal turbinates are slightly enlarged, and there is moderate clear rhinorrhea. LOCATES Mnemonic L – locations of symptoms were present in the case study 1. Productive cough with yellow mucus O – other symptoms were described as the following but further questions are needed 1. No nocturnal awakening from the cough 2. Does it hurt when you swallow? 3. Do you have a runny nose? 4. Do you have a frontal headache? 5. Did you ever develop a fever or chills? 6. Have you noticed any skin changes such as rashes? C – further information on the characteristics of the symptoms are indicated besides the color of the mucus (yellow) 1. Is the mucus thick or thin? 2. Did the mucus change colors? A – the case study does not reveal any alleviating or aggravating factors requiring further questioning 1. Did you take any medications for relief and did they work? 2. Are your symptoms worse when you outdoors? 3. Are there any aggravating factors around you that make you cough? T – the case study reveals that the onset of symptoms is 3 days
E – the environment where the symptoms occurred were not revealed 1. Where did the symptoms start (i.e. at school, after school activities)? 2. Does anyone smoke around the child? S – there is no information on the severity of the symptoms 1. Does it hurt when you cough? 2. Do you have any chest pain? Additional questions: 1. Is anybody else sick besides your son? 2. Is he currently taking any prescription medications?
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- Summer '17
- Common cold, productive cough