Syd discussion answer Post
A patient presents with a history of a cough and rust-colored sputum for one week. Based on only these two signs and symptoms, there are a couple different differential diagnoses that the patient could have. A more thorough history, physical, and work up will be necessary to further diagnose and effectively treat the patient. In children, the most common causes of hemoptysis are lower respiratory tract infections and foreign body aspiration. In adults, the most common causes of hemoptysis are bronchitis, bronchogenic carcinoma, and pneumonia (Bidwell and Pachner, 2005). As I mentioned, a more in-depth history, physical, and work up is necessary as the two pieces of information given to us are not enough to confirm a diagnosis. Because the signs and symptoms are pulmonary in nature, a focused pulmonary exam would be appropriate. The patient should be asked about the characteristics of his hemoptysis, his smoking status, his pulmonary history, etc. When performing a physical assessment on the patient, the provider should assess the work of breathing, listen to lung sounds, assess for cyanosis, etc. As part of the work up, the provider should perform a chest x-ray on the patient. The images will give the provider a better idea of what is going on inside the patient’s lungs. According to Haouimi et al. (2021), “Bacterial pneumonia characteristically produces focal segmental (i.e. bronchopneumonia) or lobar pulmonary opacities (i.e. lobar pneumonia).” According to Weerakkody et al. (2021), a patient with bronchitis may have bronchial wall thickening, which is nonspecific, on a chest x-ray, but usually the chest x-ray is normal. Although the different subtypes of bronchogenic cancer have different radiographic appearances, demographics, and prognoses from one another, they will appear differently on an x-ray than pneumonia or bronchitis (Rasuli et al., 2021).
Based on the known signs and symptoms and the differential diagnoses, some possible pertinent positive findings include:
1. Fever
2. Chills
3. Fatigue
4. Cough
5. Rust-colored sputum
Some possible pertinent negatives include:
1. Normal vital signs
2. WBCs WNL
3. No use of accessory muscles
4. Lung sounds clear
5. No adenopathy
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