course material

1. cough case study – 550 words
Attached.Location: ABC Matter PracticeLisa Milan (60 year old, Spanish female) who works
at Life Insurance Company. During hervisit, she starts to cough continually. She states that
this coughing started a week ago but hadbecome constant in the last 3 days. Her chart also
indicates she has been in and out of the facilityin the last 6 years, and has received
treatment for similar condition severally.Social HistoryMarried – 2 adult children.Non-
SmokerNo alcohol or drug useBaptist, attends church regularly and is a member of the
choirFamily HistoryMother – Deceased at age 39 from traumatic accidentFather – Deceased
age 84Siblings – one brother age 61 A & WMedical/Surgical/Health Maintenance
HxMeasles, mumps and chicken pox as a child.Tetanus/Diptheria/Pertussis – Last dose 1
year agoInfluenza – Last dose 6 months agoPneumococcal vaccine at age 44LISA
MILANZostivax at age 60Chronic diagnoses – HTN x 4 yearsTakes HCTZ 25 mg
dailyROSGeneralHas maintained normal weightFever for 6 days up to 101SkinDry
skin.HEENTWears reading glassesDentition fair.Partial upper dentureNeckNo swelling or
stiffnessChestSubsternal pain on cough2LISA MILANRespiratoryBegan coughing 6 days ago.
Started as mild, intermittent and non-productive. The cough hasbecome constant for the
last 3 days with frothy. She is frequently awake due to the condition.Did not respond
effectively to OTC drugs.CVNo CP at restPVSwelling of feet and anklesDecreased appetite for
the last one weekEndocrineNo change in weight, heat and thirst intolerance.The physical
exam reveals:Temp 101.3, Respiratory 30 labored, no retractions,BP 135/92, HR 110, Pulse
Ox 90 Wt 130 lbsGeneral appearanceAlert in all spheresMild respiratory distressAble to
answer questions using short answersTripod breathing3LISA MILANHEENT –Eyes, nose,
ear and head wnlMouth -mucosa dryPharynx – tonsils present but not enlarged with normal
pink colorLymph – no enlargementHeart- regular rhythm at 110 bpmNo murmursLungs –
normal breathing, bronchophony or egophonyAbdomen – no mass rigidityExtremities –
Hands – no swelling,Feet/legs – +1 edema feet to ankle levelPedal pulses – wnlDifferential
diagnoses:•CAP•Acute bronchitis•Congestive heart failure•Influenza4LISA MILAN5Lisa
Milan Case AnalysisNameInstitutionLISA MILAN6This is the referral case for Lisa Milan’s
consultation. At 60 years, she reported at ABCMatter facility with reports of coughing
persistently. She reports the cough has lasted for the lastone week, having started
intermitted one in the past 5 days, but grew quickly and persisten…