Case Study

35-year-old Asian male presents to your clinic complaining of productive cough for two weeks. Stated he has had mild intermittent fever with myalgia, malaise and occasional nausea.

· SH: works as a law clerk

· PE: NP noted low grade fever (99 degrees), with very mild wheezing and scattered rhonchi.

Discussion: Examining Chest X-Rays

Chest x-rays are an invaluable diagnostic tool as they can help identify common respiratory disorders such as pneumonia, pleural effusion, and tumors, as well as cardiovascular disorders such as an enlarged heart and heart failure. As an advanced practice nurse, it is important that you are able to differentiate a normal x-ray from an abnormal x-ray in order to identify these disorders. The ability to articulate the results of a chest x-ray with the physician, radiologist, and patient is an essential skill when facilitating care in a clinical setting. In this Discussion, you practice your interprofessional collaboration skills as you interpret chest x-rays and exchange feedback with your colleagues.

Case Study 1

35-year-old Asian male presents to your clinic complaining of productive cough for two weeks. Stated he has had mild intermittent fever with myalgia, malaise and occasional nausea.

· SH: works as a law clerk

· PE: NP noted low grade fever (99 degrees), with very mild wheezing and scattered rhonchi.

This week

you analyzed patient x-rays for normal and abnormal results and the implementation of COPD strategies in clinical settings, including treatment options. In addition, you assessed patient diagnoses using x-ray results and pulmonary function test results.

Required Readings

Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2017). Primary care: A collaborative practice (5th ed.). St. Louis, MO: Elsevier.

· Part 4, “Office Emergencies”

· Chapter 24, “Acute Bronchospasm” (pp. 192-194)

This chapter explores the epidemiology, pathophysiology, and clinical presentation of acute bronchospasm. It also describes the roles of physical examinations, diagnostics, and differential diagnoses in management of acute bronchospasm.

· Part 10, “Evaluation and Management of Pulmonary Disorders” (pp. 417-503)

This part outlines examination and treatment components of pulmonary disorders, such as acute bronchitis, asthma, chest pain, chronic cough, COPD, dyspnea, lung cancer, pleural effusions, and pneumonia. Lifespan considerations, complications, and health promotion strategies are also examined.

· Part 20, “Evaluation and Management of Infectious Disease”

· Chapter 235, “Tuberculosis” (pp. 1262-1271)

This chapter differentiates between active and latent tuberculosis and examines components that aid in diagnosing and managing tuberculosis, including pathophysiology, clinical presentation, and diagnostics.

Global Initiative for Chronic Obstructive Lung Disease. (2017). At-a-glance outpatient management reference for chronic obstructive pulmonary disease (COPD).Retrieved from http://goldcopd.org/wp-content/uploads/2016/11/wms-At-A-Glance-2017-FINAL

This article outlines the COPD guidelines and includes guidance for diagnosis, assessment, and management of patients with COPD.