This paper discusses the case of a 52-year-old male who presents to the clinic with a productive cough.

52-Year-Old Male Case Study- Cough

Introduction

A cough can be a symptom of an underlying condition in the respiratory tract. It can be disruptive and may require medical attention to resolve. This paper discusses the case of a 52-year-old male who presents to the clinic with a productive cough.

Health History

Proper evaluation is necessary in order to come up with an appropriate treatment plan. The FNP will, therefore, need to collect the patient’s history in order to fully evaluate the patient. Some of the questions the FNP can ask include whether the positioning of the patient increases or decreases the intensity of the cough. Since the cough is productive, the FNP can ask for the color of the product and whether it is bloody. The FNP can ask for any relieving or exacerbating factors. The FNP can also ask for any associated symptoms such as fever, dyspnea, wheezing, chest pain, and hematemesis. Timing of the cough is also important. What is the duration and course of the cough? The severity should also be assessed, i.e., how frequent is the cough? Finally, a past medical history should be checked to determine the availability of any underlying chest condition. A medication history, such as the use of ACE inhibitors, should be assessed (Glynn & Drake, 2018).

Differential Diagnosis

The differential diagnoses for cough could either be due to infectious causes or non-infectious causes (Weinberger & Hurvitz, 2020). The differential diagnosis includes the common cold. The FNP can encourage the patient to maintain adequate fluid intake, maintain personal hygiene, get enough rest, and take the medication prescribed for relief of symptoms. A common cold is self-limiting and doesn’t require medical treatment.

Acute bronchitis is the second differential diagnosis. The management is the same as that for a common cold. In addition, medications can be prescribed to clear the infection and relieve the inflammation. Monitoring should be done to avoid the progression of pneumonia. The third differential diagnosis is acute sinusitis. Management can be done at home using fluids, NSAIDs, and antibiotic therapy. Regular monitoring is necessary to avoid spreading.

Asthma and infection exacerbated COPD can also be considered as differential diagnoses. In addition to conservative management, medication can be used to relieve symptoms. Bronchodilators and inhaled corticosteroids are recommended (Jansen et al., 2021). The patient also needs to be educated on the importance of avoiding environmental triggers.

References

Glynn, M., & Drake, W. M. (2018). Hutchison’s clinical methods are an integrated approach to clinical practice. Elsevier.

Jansen, E. M., van de Hei, S. J., Dierick, B., Kerstjens, H., Kocks, J., & van Boven, J. (2021). Global burden of medication non-adherence in chronic obstructive pulmonary disease (COPD) and asthma: a narrative review of the clinical and economic case for smart inhalers. Journal of Thoracic Disease, 13(6), 3846–3864. https://doi.org/10.21037/jtd-20-2360

Weinberger, M., & Hurvitz, M. (2020). Diagnosis and management of chronic cough: similarities and differences between children and adults. F1000Research, 9, F1000 Faculty Rev-757. https://doi.org/10.12688/f1000research.25468.1