Reference no: EM133663475

Problem

Mrs. S is a 56- year old woman is a frequent hospital admit due to episodes of upper respiratory infections.

The woman works as a file clerk at a local health department and is known for her strong work ethic. Despite what she describes as her "chronic cold" she rarely misses work, although she often requests permission to leave work early due to doctor's appointments.

The hospital chart shows that her respiratory problems began when she was in her early teens. During that period, frequent upper respiratory tract infections and an annoying cough were her only symptoms. The chart also states that she was a smoker of about one pack of cigarettes per day during her teen years. Over the years she has quit and restarted smoking many times. For the past several years she has treated herself with aerosolized bronchodilators and kept a humidifier running in her room most of the time. She frequently has been given antibiotics in alternating cycles.

She has stated she has not smoked for the last 3 months. However, her cough has become almost continuous, with production of copious amounts of foul-smelling, purulent sputum. She denies hemoptysis but has lost weight and generally feels poorly.

Answer the following questions:

i. What further information would be important to obtain from this patient?
ii. What diagnostic tests would you order and why?
iii. What vital signs would you collect?