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Case Study -Adult

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Case Study -Adult

Q.1

As part of the medical history, the healthcare provider may have asked the patient

questions such as, what is the onset, duration, and severity of the cough? Are there aggravating

factors or triggers for the cough? Do you experience symptoms of chest pain, shortness of breath,

or difficulty breathing? Are any previous episodes of similar symptoms? Do you have a history

of smoking or exposure to environmental irritants?

Q.2

A healthcare provider typically would have conducted a thorough examination of the

head, neck, chest, heart, lungs, abdomen, and extremities during a physical exam. The healthcare

provider would have also checked signs of distress, and cervical nodes for masses, infection,

inflammation, or other abnormalities. In addition, the neurological system would have also been

examined, including reflexes, sensation, muscle strength, and peripheral neuropathy, together

with any other symptoms reported by the patient.

Q.3

Following the medical history and physical exam of the patent, his dry hacking cough is

most likely connected to the side effect of ACE inhibitors, lisinopril which he has been taking for

6 months and regarded as a side effect of ACE inhibitors medication (Yilmaz, 2019). Coughing

is the popular side effect of the ACE inhibitors class, as it is thought to be associated with

inhibiting enzymes that break down the mediators of inflammation, like tachykinins and

bradykinins (Yilmaz, 2019). Nevertheless, it is also possible that his cough could also be caused

by long-term use of over-the-counter allergy medication or other underlying conditions such as

asthma and COPD, or it could be as a result of a complication of his hypertension, diabetes, or

colon polyps.

Q.4

Other possible diagnoses that should be considered for the patient's persistent dry hacking

cough include:

Asthma: it is described chronic lung disease characterized by inflammation and contraction of

the airways, making breathing difficult, which is often accompanied by a persistent cough.

Chronic Obstructive Pulmonary Disease (COPD): it is regarded as a progressive lung disease

that makes breathing difficult and includes conditions such as emphysema and chronic

bronchitis. According to World Health Organization (WHO) (2022), both asthma and COPD

share common symptoms, which include breathing difficulties, wheezing, and chronic coughs.

Pneumonia: An infection in one or both lungs that causes inflammation and fluid build-up,

leading to cough and difficulty breathing.

Gastroesophageal Reflux Disease (GERD): this is a condition that involves stomach acid flowing

back to the esophagus thereby leading to irritations hence presenting symptoms of heartburn and

a chronic cough.

Sarcoidosis: a chronic inflammatory disease that can cause inflammation in many organs,

including the lungs, characterized by consistent dry cough.

Q.5

Yes, other tests should be completed before producing a diagnosis for the patient's

persistent dry hacking cough. Some of these tests include:

Chest X-ray: to evaluate the lungs and detect any signs of infection, inflammation, or structural

abnormalities.
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Spirometry: a test that measures how much air a person can inhale and exhale and how quickly

they can do it. It can help diagnose and assess the severity of asthma and COPD.

Bronchoscopy: a procedure that involves using a small camera to look inside the bronchial tubes

and lungs. It can help diagnose bronchitis, pneumonia, and lung cancer (Thiboutot & Yarmus,

2022).

Chest CT scan: this can give more detailed information on the lung anatomy and may pick up

specific abnormalities that may not be visible on an x-ray.

All of these tests may be necessary for every patient, and the specific tests will depend on

the patient's specific symptoms and medical history. Therefore, the healthcare provider may

decide to order some of these tests or none at all based on the context and clinical judgment.

Q.6

The treatment for the patient's persistent dry hacking cough will depend on the

underlying cause, which may not be clear yet. The healthcare provider may suggest some initial

treatment options while awaiting the results of any diagnostic tests that have been ordered. The

ACE inhibitors-associated cough might be a side effect of the patient's lisinopril medication; the

healthcare provider may suggest switching to a different class of blood pressure medication or

adjusting the dosage (Yilmaz, 2019).

Allergic bronchitis: If allergies cause the patient's cough, the healthcare provider may

recommend an over-the-counter antihistamine or a nasal steroid spray to help control symptoms.

Asthma or COPD: If the patient's cough is caused by asthma or COPD, the healthcare provider

may prescribe inhaled bronchodilators or corticosteroids to help control symptoms and reduce

inflammation in the airways.

GERD: If GERD causes the patient's cough, the healthcare provider may recommend over-the-

counter antacids or prescribe a proton pump inhibitor (PPI) to help control stomach acid.

In addition, the patient should be educated about their specific diagnosis, the treatment

plan, any medications, how to use them correctly, and how to monitor their symptoms. The

healthcare provider is responsible for informing the patient about the importance of follow-up

visits and monitoring symptoms to ensure that the treatment is working as it should (Siegel et al.,

2019).
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References

Siegel, D. A., Jatlaoui, T. C., Koumans, E. H., Kiernan, E. A., Layer, M., Cates, J. E.,

Kimball, A., Weissman, D. N., Petersen, E. E., Reagan-Steiner, S., Godfred-Cato, S.,

Moulia, D., Moritz, E., Lehnert, J. D., Mitchko, J., London, J., Zaki, S. R., King, B. A.,

Jones, C. M., … Koppaka, R. (2019). undefined. American Journal of

Transplantation, 19(12), 3420-3428. https://doi.org/10.1111/ajt.15690

Thiboutot, J., & Yarmus, L. (2022). Interventional bronchoscopy. Encyclopedia of Respiratory

Medicine, 756-764. https://doi.org/10.1016/b978-0-08-102723-3.00147-5

WHO. (2022, May 20). Chronic obstructive pulmonary disease (COPD). World Health

Organization (WHO). https://www.who.int/news-room/fact-sheets/detail/chronic-

obstructive-pulmonary-disease-(copd)

Yilmaz, I. (2019). Angiotensin-converting enzyme inhibitors induce cough. Turkish Thoracic

Journal, 20(1), 36-42. https://doi.org/10.5152/turkthoracj.2018.18014