Anamnesis and examination
For assessing cough in adult patients, I would follow the PQRSTU mnemonic. I would ask when the cough started, whether the cough is productive, and what seems to aggravate it (Jang et al., 2017). I would also look for any of the following symptoms: chest pain or tightness, chills or sweating, swallowing difficulties, fatigue, fever, headaches, hoarse voice, changes in appetite, muscle aches, runny nose, shortness of breath, sneezing, sore throat, watery or itchy eyes, and wheezing (Irwin et al. 2018). I would also examine the patient’s head, eyes, ears, nose, neck, chest, and respiratory system (D’Amico, & Barbarito, 2016). Vital signs would also be taken and recorded to support future assessment.
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As for the diagnostic test, I would order a blood test to exclude any virus infections. Additionally, depending on the history of the present illness and family history, I would order allergy tests, peak flow, and spirometry to exclude asthma, and laryngoscopy to test for laryngitis. All the abnormal findings will be documented and systematized to assist with future diagnosis. The list of differentials would include cold, flu, asthma, laryngitis, and bronchitis (D’Amico, & Barbarito, 2016). I would also consider allergies if the patient has a family history of the condition. Moreover, in the case of fatigue, chest pains, nausea, vomiting, or diarrhea, I would also suspect pneumonia.
D’Amico, D., & Barbarito, C. (2016). Health & physical assessment in nursing (3rd ed.). Hoboken, NJ: Pearson.
Irwin, R. S., French, C. L., Chang, A. B., Altman, K. W., Adams, T. M., Altman, K. W., … Blackhall, F. (2018). Classification of cough as a symptom in adults and management algorithms. Chest, 153(1), 196–209. Web.
Jang, S., Kim, J., Koo, H., Jeong, I., Park, S., & Kim, D., … Kim, H. (2017). Development and first validation of the COugh Assessment Test (COAT). General Practice and Primary Care. Web.