Wait a second!
More handpicked essays just for you.
More handpicked essays just for you.
Don’t take our word for it - see why 10 million students trust us with their essay needs.
Recommended: Case study
“A 60 year old man that enters your community pharmacy and asks to speak to you about his cough which he has had for more than three weeks” A cough is a troublesome symptom that is frequently presented to clinicians in both primary and secondary care. A cough is caused by a reflex that occurs by an irritation of the respiratory mucosa in the lungs, bronchi and pharynx. It allows for the removal of foreign particles and secretions from the respiratory system (Irwin & Madison, 2000). A cough can be classified according to it’s duration, a cough of threes weeks is acute, and a cough that lasts longer than 8 weeks is classified as chronic. If it is in between the period of 3-8 weeks is known to be subacute (Pratter, Brightling, Boulet, & Irwin, 2006). This essay will look at the case of a 60 year old man who presents to us a symptom of a persistent cough lasting longer than 3 weeks. An attempt to diagnose the patients will be made by assessing the cough through different guidelines available. The first question a clinician shall ask when diagnosing a patient with a cough is about the duration. This patient is an elderly man, with a cough of three weeks, thus classified as a subacute cough. The main diagnostic distinction to make for a patient presenting with a subacute cough, is to identify whether the cough has been caused by an infection. However, due to this man being an elderly man, one must immediately find out the patient’s drug history, as to see if any ACE inhibitors have been prescribed. This is due to the reason that ACE inhibitors are known to cause a dry persistent cough to around 10% of patients treated with it. (Longmore, Wilkinson, & Rajagopalan, 2004). If the patient is not on any medications that can cause the co... ... middle of paper ... ...0). The diagnosis and treatment of cough. New England Journal of Medicine, 343, 1715–1721. • Jevon, P. (2011). Clinical diagnosis. Chichester, West Sussex: Wiley-Blackwell. • Kumar, P. J. (2012). Kumar & Clark's clinical medicine (8th ed.). Edinburgh: Elsevier/Saunders. • Longmore, J. M., Wilkinson, I., & Rajagopalan, S. R. (2004). Oxford handbook of clinical medicine (6th ed.). Oxford: Oxford University Press. • National Institute for Health and Care Excellence (2008). Respiratory tract infections – Antibiotic Prescribing. CG069. London: National Institute for Health and Care Excellence. • Pratter, M. R., Brightling, C. E., Boulet, L. P., & Irwin, R. S. (2006). An Empiric Integrative Approach to the Management of Cough: ACCP Evidence-Based Clinical Practice Guidelines. Chest Journal, 129(1), 222-231. Retrieved October 24, 2013, from http://tinyurl.com/mthq2gk
Hospital-acquired infections (HAI) are preventable and pose a threat to hospitals and patients; increasing the cost, nominally and physically, for both. Pneumonia makes up approximately 15% of all HAI and is the leading cause of nosocomial deaths. Pneumonia is most frequently caused by bacterial microorganisms reaching the lungs by way of aspiration, inhalation or the hematogenous spread of a primary infection. There are two categories of Hospital-Acquired Pneumonia (HAP); Health-Care Associated Pneumonia (HCAP) and Ventilator-associated pneumonia (VAP).
Duerden, M. & Price, D. (2001). Training issues in the use of inhalers. Practical Disease
Sequeiros, IM, Jarad, NA. 2009. Home intravenous antibiotic treatment for acute pulmonary exacerbations in cystic fibrosis-Is it good for the patient?. Annals of Thoracic Medicine 4(3), pp. 111-114.
...spiratory infections. The patient must always be under continuous scrutiny since they can undergo aspiration or lack the ability to change from the passageway to their lungs versus their stomach and their spit travels to the lungs which, in turn, causes bronchopneumonia. The patient also does not have the facility to cough and so must undertake a treatment to shake up their body to eliminate the mucus from the lining of their lungs.
Haas, D. F. (1990). The Chronic Bronchitis And EMPHYSEMA. New York,NY: John Wiley and Sons, Inc.
later brings up green and yellow mucus. The cough may persist to 4 to 6
Friedman JF, Lee GM, Kleinman KP, Finkelstein JA. "Acute Care and Antibiotic Seeking for Upper Respiratory Tract Infections for Children in Day Care: Parental Knowledge and Day Care Center Policies." JAMA Pediatrics 157.4 (2003): 369-374. .
U.S. National Library of Medicine, 26 Sept. 2011. Web. The Web. The Web. 19 Nov. 2013.
Chronic obstructive pulmonary disease (COPD) is preventable disease that has a detrimental effects on both the airway and lung parenchyma (Nazir & Erbland, 2009). COPD categorises emphysema and chronic bronchitis, both of which are characterised by a reduced maximum expiratory flow and slow but forced emptying of the lungs (Jeffery 1998). The disease has the one of the highest number of fatalities in the developed world due to the ever increasing amount of tobacco smokers and is associated with significant morbidity and mortality (Marx, Hockberger & Walls, 2014). Signs and symptoms that indicate the presence of the disease include a productive cough, wheezing, dyspnoea and predisposing risk factors (Edelman et al., 1992). The diagnosis of COPD is predominantly based on the results of a lung function assessment (Larsson, 2007). Chronic bronchitis is differentiated from emphysema by it's presentation of a productive cough present for a minimum of three months in two consecutive years that cannot be attributed to other pulmonary or cardiac causes (Marx, Hockberger & Walls, 2014) (Viegi et al., 2007). Whereas emphysema is defined pathologically as as the irreversible destruction without obvious fibrosis of the lung alveoli (Marx, Hockberger & Walls, 2014) (Veigi et al., 2007).It is common for emphysema and chronic bronchitis to be diagnosed concurrently owing to the similarities between the diseases (Marx, Hockberger & Walls, 2014).
JAMA: Journal of the American Medical Association. 14 Nov. 2001: 2322. Academic Search Complete. Web.
Turner, B. J., Newschaffer, C. J., Zhang, D., Fanning, T., & Hauck, W. W. (1999). Translating clinical trial results into practice. Annals of Internal Medicine, 130(12), 979-986.
The clinical manifestation one may see in patients with chronic bronchitis are chronic cough, weight loss, excessive sputum, and dyspnea. Chronic cough is from the body trying to expel the excessive mucus build up to return breathing back to normal. Dyspnea is from the thickening of the bronchial walls causing constriction, thereby altering the breathing pattern. This causes the body to use other surrounding muscles to help with breathing which can be exhausting. These patients ca...
The symptoms include chest discomfort, wheezing, shortness of breath and coughing up mucus. There are two types of Bronchitis, acute and chronic. Acute bronchitis is also known as a chest cold and lasts around three weeks. Chronic bronchitis is a productive cough that last for three months or more per year for at least two years. (2011)
Ed. David Zieve. U.S. National Library of Medicine, 26 Feb. 2014. Web. The Web.
WHO, W. H. (2008). Tradtional Medicine. available at http://www.who.int/mediacentre/factsheets/fs134/en/ retrieved on 9-11-11 at 10:30 pm.