Advanced Practice Care of Adults Across the Life Span
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Advanced Practice Care of Adults Across the Life Span
Upon reviewing the x-ray image and the symptoms of the patient, there is high possibility for the patient to suffer from bacterial pneumonia. A patient with gram positive bacterial pneumonia presents fever, productive cough, chills, rhonchi sound in the lungs and an increased fremitus (Buttaro, Trybulski, Polgar-Bailey, & Sandberg-Cook, 2017). This matches the symptoms presented by the patient and the x-ray picture.
Cough with sputum is one of the consistent symptoms of pneumonia pathogen and it can be identified by the color of sputum which is usually green for the Haemophilus, pseudomonas and pneumonia species (Gamache, 2018). Therefore, the cause of pneumonia in this patient is likely to be one of these species. Differential diagnosis for the patient in this case is influenza. The symptoms of influenza include cough, chills, fever, running nose, body aches, and fatigue (Centers for disease control and prevention, 2018).
The patient in the case study presents cough, chills and fever, and was also expose to those who have been ill in the recent past. This makes her to have high risks of developing flu since those people who are above 65 years and have chronic conditions such as heart disease, diabetes and asthma are at a higher risk of developing flu than the rest of the population (CDC 2018). The patient in the case study was diagnosed of diabetes seven years ago and this makes her to be at a higher risk of developing flu.
The second possible differential diagnosis for this condition is acute sinusitis since those suffering from this condition may present green discharge from the nose, nasal congestion, cough that worsens at night, sore throat, fever, drainage of mucus at the back of the throat, fatigue and fever. The patient works at a daycare and this makes her to be at a risk of acute sinusitis.
The third possible differential diagnosis is bronchitis since it can also cause a patient to cough with clear, green, white or yellow-green sputum, or have a chest discomfort, chills and slight fever. The patient in the case study has a fever of 101.5 and this disqualifies bronchitis.
The patient reports of working in a daycare with children who are sometimes ill, has history of diabetes, and has been coughing for 2 weeks and all this point out the possibility of bacterial pneumonia. In the case study scenario, the physical examination which was done using x-ray is also very useful and shows increased fremitus which is associated with bacterial pneumonia.
After recognizing that the bacteria pneumonia is the condition that the patient suffers, then the bacteria should be identified for a definite diagnosis. The antibiotics are used for treatment of bacterial pneumonia. The drugs that are used to treat bacterial pneumonia are amoxicillin and penicillin G. The oxygen supplement can be taken if needed as well as an increased intake of fluid. There is a need for the patient to use supportive therapies such as antipyretic and analgesic medications. Thus the patient is to be administered with tessalon Perles, which is a non-narcotic drug that numbs the lungs and throat, thus decreasing the cough reflex. The patient can also be provided with guaifenesin to bring up the mucus and loosen her secretions. The analgesic medications such as motrin, ibuprofen, and Tylenol can be used for fever. The patient should also get plenty of rest and hydration for the body immune system to fight the infection better.
Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2017). Primary care: A collaborative practice (5th ed.). St. Louis, MO: Elsevier.\
Centers for disease control and prevention, (CDC). (2018). Flu symptoms and complications. Retrieved from https://www.cdc.gov/flu/consumer/symptoms.htm
Gamache, J. (2018). Bacterial pneumonia. Retrieved from https://emedicine.medscape.com/article/300157-overview