Discussion board for Mn566: Diagnostic reasoning and rationale of acute
Cough can be caused by a variety of factors. In order to properly diagnose and treat a cough, a healthcare professional must conduct a comprehensive assessment. We will address the following issues related to cough in this article:
What are the questions to ask and which body part should be checked?
In evaluating the patient who has a cough, you should ask them:
- How long and how often does the cough last?
- What is the cause of your cough?
- Do you have any other symptoms such as a fever, wheezing, chest pain or shortness of breathe?
- Do you have a history that includes smoking, or environmental irritation?
- Do you know if the patient is suffering from any other medical conditions such as allergies, COPD (chronic obstructive pulmonary disease), or asthma?
It is important to perform a respiratory examination in conjunction with a complete history. Healthcare providers should check the patient for signs of abnormality in these areas:
- Nasal and sinus problems
- The throat
- Chest and lungs
Why is it necessary to obtain diagnostic tests?
Diagnostic tests are needed based on the findings of the physical exam and history. The following tests can be useful:
- Chest Xray: The chest Xray is used to identify abnormalities of the lungs and chest cavity.
- Tests of pulmonary function: These can be used to determine the lung’s function, and any respiratory problems such as COPD or asthma.
- Sputum Culture: This can be used to identify the infectious organisms responsible for coughing.
- Allergy tests: An allergy test can identify allergens which may trigger the cough.
What is your response to abnormal findings?
Management of abnormal results will be determined by the root cause of cough. A chest X-ray may reveal a lung infection. The patient will need antibiotics. Inhalers and other medication may be required if pulmonary function testing indicates asthma. Any abnormalities should be addressed immediately to avoid complications and to improve outcomes.
What are your plans for differentials?
There are many different diagnoses for cough.
- Infections of the respiratory tract, including bronchitis and pneumonia
- COPD (chronic obstructive pulmonary disease) or asthma
- Allergies
- Gastroesophageal Reflux Disease (GERD).
- Lung cancer
- Air pollution and cigarette smoke are examples of environmental irritants
Summary: The evaluation of patients with cough involves a complete history and physical exam as well as appropriate diagnostic testing. Management of cough is dependent on the cause. Prompt attention should be given to abnormal findings to avoid further complications.