NSG6440 week 2 discussion latest 2018 july
Week 2
discussion
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A fifteen-year-old female presents to your clinic
complaining of shortness of breath and a nonproductive nocturnal cough. She
states she used to feel this way only with extreme exercise, but lately, she
has felt this way continuously. She denies any other upper respiratory
symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her
past medical history is significant only for seasonal allergies, for which she
takes a nasal steroid spray but is otherwise on no other medications. She has
had no surgeries. Her mother has allergies and eczema, and her father has high
blood pressure. She is the only child. She denies smoking and illegal drug use.
On examination, she is in no acute distress and her vital signs are: T 98.6, BP
120/80, pulse 80, and respirations 20. Her head, eyes, ears, nose, and throat
examinations are essentially normal. Inspection of her anterior and posterior
chest shows no abnormalities. On auscultation of her chest, there is decreased air
movement and high-pitched whistling on expiration in all lobes. Percussion
reveals resonant lungs.
What is the chief complaint?
Based on the subjective and objective information provided
what are your 3 top differential diagnosis listing the presumptive final
diagnosis first?
What treatment plan would you consider utilizing current
evidence based practice guidelines?
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