Question

A Your Patient: D.D. is a 37 year old male who comes to the health care provider's office with complaints of a "cough that will not go away." Subjective Data: Has had a Is not taking any medications dry, hacking cough intermittently for past 2-3 months Objective Data: Height 5'11", Weight 185 lbs Oxygen saturation on room air is 97% BP 132/78, Pulse 86, Temp 98.5 F, RR 24 Questions: Describe questions that you would ask D.D. to specifically evaluate his cough. What information should you obtain as part of a smoking history? What additional health history information would you obtain from D.D. ? What are 2 common causes of chronic cough, and what are 4 specific questions you would ask D.D., for each cause? Describe what D.D. physical assessment would include. III

Answer 1

Some of the questions to be asked specifically are

• Environmental triggers are exposure :can ask about the place of residence, work place exposure, pollution
• Medication :Use of certain medications link ACE inhibitor induces a long term cough
• Smoking habits:this can damage the lung tissues and cause a continuous cough
• Infectious disease:A chronic cough lasts in case of mycobacterium tuberculosis infection.

In regards to the smoking history the following has to be asked yo a patient

• Since when he is smoking,longer the duration ,greater the damage to lung tissues
• How many or quantity he takes a day
• What type of tobacco he uses (smoking type or a chewing type )

The additional health information to be collected are

• History of any past medical or surgical history
• Any treatment for pulmonary tuberculosis and any history in family
• assess patients immune status

The two common causes of chronic cough are

• Post nasal drip
  • Is the cough aggregates in night
  • Is there any production of phlegm or mucus
  • Do you have sore throat
  • Can you adapt to change in weather
• Tuberculosis
  • Do you wheeze or have difficulty in breathing
  • Is there any secretion and do you do you spit it out
  • Did you have any weight loss
  • Do you have fever ,night sweats, fatigue

The following basic physical assessment to be done

• Inspection :chest movements,dyspnea ,clubbed nails or changes in nail
• Percussion :to assess for any fluid or air in the lung field
• Ascultation :to assess breath sounds,fluid trap or accumulation etc.,crackles,wheeze, rhonchi ,etc.,
• Anthropometric measurement to rule out any underlying cause like obesity
• others:chest x Ray,PFT,CT scan aide in diagnostic purposes