Posted: April 8th, 2023

CASE: A 52-year-old male presents to the clinic

CASE: A 52-year-old male presents to the clinic with a productive cough for 5 days.

Differential diagnosis:
1. Pneumonia
2. Acute bronchitis
3. Chronic obstructive pulmonary disease
4. Asthmatic acute exacerbation
5. Gastroesophageal reflux disease

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Instructions:
- Describe at least 5 more questions the FNP should ask this patient in the health history.
- Describe how the FNP would clinically manage and follow up this patient based on each differential diagnosis. Explain the differential diagnosis and why it fits.

Requirements:
Minimum 250 words, not including references
APA format with intext citation
References at least two high-level scholarly reference per post within in the last 5 years.
Plagiarism free.
Turnitin receipt.

Questions to ask the patient:

What is the color and consistency of the sputum?
Have you been experiencing any fever or chills?
Have you been experiencing any chest pain or tightness?
Have you recently traveled anywhere?
Have you been in contact with anyone who has been sick recently?
Differential Diagnosis:

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Pneumonia - Pneumonia is a serious infection of the lungs. Symptoms may include cough, fever, chest pain, and shortness of breath. The FNP should order a chest x-ray and blood tests. Treatment usually involves antibiotics. The FNP should follow up with the patient to ensure that their symptoms are improving.
Acute Bronchitis - Acute bronchitis is an inflammation of the bronchial tubes that can cause a cough with mucus. The FNP should ask about the duration of the cough and order a chest x-ray if needed. Treatment may include cough suppressants and bronchodilators. The FNP should follow up with the patient to ensure that their symptoms are improving.
Chronic Obstructive Pulmonary Disease (COPD) - COPD is a chronic lung disease that makes it difficult to breathe. Symptoms may include cough, shortness of breath, and wheezing. The FNP should order pulmonary function tests and chest x-rays. Treatment may include bronchodilators and inhaled corticosteroids. The FNP should follow up with the patient to ensure that their symptoms are improving.
Asthmatic Acute Exacerbation - Asthma is a chronic disease that affects the airways in the lungs. Symptoms may include cough, wheezing, and shortness of breath. The FNP should order pulmonary function tests and chest x-rays. Treatment may include inhaled bronchodilators and inhaled corticosteroids. The FNP should follow up with the patient to ensure that their symptoms are improving.
Gastroesophageal Reflux Disease (GERD) - GERD is a chronic digestive disorder that occurs when stomach acid flows back into the esophagus. Symptoms may include cough, chest pain, and heartburn. The FNP should order an upper endoscopy and pH testing. Treatment may include acid-reducing medications and lifestyle changes. The FNP should follow up with the patient to ensure that their symptoms are improving.
In conclusion, the FNP should ask the patient specific questions related to their health history to help them make an accurate diagnosis. Once a differential diagnosis has been made, the FNP should order appropriate diagnostic tests and prescribe treatment accordingly. The FNP should also follow up with the patient to ensure that their symptoms are improving and to adjust treatment as necessary.

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