Instructions: The response is a substantive interaction that builds on the ideas of others, delving deeper into the discussion question and course content in response to a colleague. The response includes one reference from a professional peer-reviewed scholarly journal.
Lou is a 35-year-old who presents for evaluation of a cough. She is normally a healthy young lady with no significant medical history. She takes no medications and does not smoke. She reports that she was in her usual state of good health until approximately three weeks ago when she developed a “really bad cold.” The cold is characterized by a profound, deep, mucus-producing cough. She denies any rhinorrhea or rhinitis—the primary problem is a cough. She develops these coughing fits that are prolonged, very deep, and productive of a lot of green sputum. She hasn’t had any fever but does have a scratchy throat. Lou has tried over-the-counter cough medicines but has not had much relief. The cough keeps her awake at night and sometimes gets so bad that she gags and dry heaves.
· Identify the most likely condition that best explains the patient’s cough. Provide a description of the disorder and underlying respiratory alteration associated with the type of cough selected in the scenario.
· Describe and explain the pathophysiologic process of the disease and underlying respiratory alteration associated with the cough.
· Describe common clinical manifestations associated with the disorder.
· Identify the causes and risk factors for the condition depicted in the chosen case.
· Consider the following patient factors genetics, gender, ethnicity, age, or behavior. Select two patient factors and discuss the influence of the factors chosen on the disorder.
Reply to Lina
The patient is experiencing prolonged deep coughs, and these are signs that she is suffering from acute bronchitis. Acute bronchitis is a common illness that is encountered in healthcare settings. The condition is a viral infection that makes the bronchial tubes inflamed. The tubes are responsible for carrying air into the lungs, and when they go through inflammation, it is rather complicated for the process to go through effectively, consequently leading to the mucus-producing cough that the patient is experiencing. The pathophysiology process of this condition involves the cells of the bronchial lining getting some form of irritation.
After the irritation, the mucus membrane becomes edematous and hyperemic (Bush & Floto, 2019). The bronchial mucociliary function then diminishes after this, leading to the secretion of excess mucus. Because of this excess mucus, the cough associated with the disease produces much sputum.Some of the clinical manifestations associated with the disease are similar to those that Lou is experiencing. For example, it is common for a person facing the condition to have prolonged coughs. Most of these coughs are associated with sputum and can make a person lack sleep (Smith et al., 2020).
It is common to have some form of irritation along the throat when a person is coughing. Some of the causes and risk factors associated with the condition include exposure to irritants while on the job. If a person is working in an environment where they are exposed to numerous chemicals, they will get the disease. Another risk factor is gastric reflux. When a person’s body does not respond well to some foreign digestible products, they are highly likely to contract the disease, mostly in children (Strelkova Senatorova, 2018). Behavior as a factor comes in where if a person goes into work and operates for numerous hours exposed to chemicals, there are chances of getting the disease.
Bush, A., & Floto, R. A. (2019). Pathophysiology, causes and genetics of paediatric and adult bronchiectasis. Respirology, 24(11), 1053-1062. https://doi.org/10.1111/resp.13509 (Links to an external site.)
Smith, M. P., Lown, M., Singh, S., Ireland, B., Hill, A. T., Linder, J. A., & Weinberger, M. (2020). Acute cough due to acute bronchitis in immunocompetent adult outpatients: Chest Expert Panel Report. Chest, 157(5), 1256-1265. https://doi.org/10.1016/j.chest.2020.01.044 (Links to an external site.)
Strelkova, M., & Senatorova, G. (2018). Clinical and anamnestic features of the course of acute bronchitis in children. Inter Collegas, 5(3), 143-147. https://doi.org/10.35339/ic.5.3.143-147
Reply to Maka
According to patient’s presentation (three weeks mucus producing deep cough, green sputum, scratchy throat, no fever, rhinorrhea) and health history (healthy 35 years old female), acute bronchitis is most likely diagnosis. However, in patients with suspected acute bronchitis, the important step is to rule out more serious causes of cough, such as asthma, chronic obstructive pulmonary disease exacerbation, heart failure, or pneumonia (Kinkade & Long, 2016)
Acute bronchitis is a self-limited inflammation of the lung’s large airways or bronchi that is characterized by cough without pneumonia (Kinkade & Long, 2016). Pneumonia should be suspected if patient presents with tachypnea, tachycardia, dyspnea, and signs of lung consolidation, such as decreased breath sounds, bronchial breath sounds, crackles, egophony, and increased tactile fremitus (Kinkade & Long, 2016). Acute bronchitis is a condition in which the bronchi become inflamed as a result of a variety of factors, including viral/bacterial infection, allergens, pollution, and so on. Inflammation of the bronchial wall leads to mucosal thickening, epithelial-cell desquamation, and denudation of the basement membrane in association with the presence of body’s immune response to fight the cause (Khudhair et al., 2017). The inflammation can cause airway restriction, which makes air movement difficult through the bronchi. Therefore, patients with acute bronchitis can present with wheezing, chest tightness and shortness of breath. In some cases, a viral upper respiratory infection can progress to infection of the lower respiratory tract resulting in acute bronchitis (Khudhair et al., 2017).
The cough is the most common symptoms of acute bronchitis, and it typically lasts about two to three weeks. It can be aggravated by cold, dry, or dusty air. Although localized symptoms (such as nasal congestion, runny nose, and sore throat) associated with non-specific respiratory infections (colds) might occur with acute bronchitis, systemic symptoms such as fever, myalgia, nausea, malaise, and dyspnea are usually absent (Khudhair et al., 2017). The reason most of the time patients seek treatment is the bothersome cough associated with bronchitis that is slow to resolve. Therefore, it is very important patients receive adequate information about the disease process and emphasize it (Kinkade & Long, 2016).
In this scenario the cause of patient’s bronchitis can be the viral infection since her initial symptoms resembled the cold. Patient stated she developed a “really bad cold.” However, prolonged cough with the production of green sputum could indicate the presence of a bacterial infection. Healthy young individuals are at risk of contracting bronchitis if they come into close contact with someone who has a cold or upper respiratory infection, have been exposed to lung irritants such as tobacco smoke, fumes, dust and air pollution, or have not been vaccinated for flu (American Lung Association, 2021).
Although the cough and mucus production might last several weeks, the course of disease is short, about 3-10 days. In healthy people acute bronchitis usually does not cause complications. However, older adults, young children, people with chronic conditions and weak immune systems, can develop major complications such as pneumonia and respiratory failure (Gifford, 2020).
American Lung Association. (2021). Learn about acute bronchitis. https://www.lung.org/lung-health-diseases/lung-disease-lookup/bronchitis/learn-about-bronchitis (Links to an external site.) .
Gifford, A. (2020). Acute bronchitis. Chest Foundation. https://foundation.chestnet.org/lung-health-a-z/acute-bronchitis/ (Links to an external site.) .
Khudhair, M. E., Hameed, I. H., & Mekhlef, A. K. (2017). A prospective and retrospective study of acute bronchitis in Hillah City-Iraq. Research Journal of Pharmacy and Technology, 10(11), 3839–3844. https://doi.org/10.5958/0974-360x.2017.00696.5 (Links to an external site.)
Kinkade, S., & Long, N. A. (2016). Acute bronchitis. American Family Physician, 94(7), 560–565.
Reply to Kawaisha
The most likely condition that best explains the patient’s cough would be Acute Bronchitis. According to John Hopkins, 2021 stated that acute Bronchitis is the inflammation of the breathing tubes. The inflammation causes mucus production. Acute Bronchitis refers to a chest cold at times. It can last for about 2 to 3 weeks, and the cough can last longer, sometimes up to 8 weeks. A viral infection causes acute Bronchitis when physical or chemical agents. Causes may come by way of dust, allergens, fumes, cleaning compounds, or tobacco smoke. Acute Bronchitis affects the upper respiratory tract. People suffer sinusitis, allergies, and enlarged tonsils and adenoids. The scenario stated that the patient had a profound, deep, mucus-producing cough. She developed a cough that was prolonged, intense, and productive of green sputum, scratchy throat. The patient experienced night sweats and dry heaves at times, all indications of acute Bronchitis.
The common symptoms that occur with Acute Bronchitis are as follows:
Coughing with or without mucus
Soreness in the chest
Feeling tired, mild headache
Mild body aches
Risk factors play an essential part in causing acute Bronchitis, such as being exposed to cigarette smoke; a person does not have to smoke, but just being around someone who smokes can cause the lungs to diminish. Low resistance causes a person to develop acute Bronchitis because the immune-compromised person is vulnerable to infection. Exposure to irritants on the job places a person at risk because the lungs become irritants exposed to chemical fumes. Then lastly, gastric reflux occurs because severe heartburn irrigates the throat and enhances the chances of a person getting Bronchitis.
This scenario gave an example of a woman that did not smoke, and that was a significant risk that deafferented what type of respiratory infection occurred. Age also plays a part in how the lungs function during an illness and how fast or slow.
John Hopkins Medicine (2021). Acute Bronchitis. https://www.hopkinsmedicine.org/health/conditions-and-diseases/acute-bronchitis