Reference no: EM131398883
Upper Respiratory Infection Case
M. R., a 28-year-old Asian-American, presents with complaints of a cold. He states he has been sick for 6 days and is feeling worse. He complains of a thick, green nasal discharge, congestion, and inability to breathe through his nose. He also says he has had a thick, yellow-green expectoration for 4 days, and has chills off and on. He complains of a pounding headache all over his head with sudden movement. He has pain in his neck over the submaxillary and submental nodes when touched, but he is able to swallow. He has tried "flu medicine," but it is not effective. Nothing makes it better or worse.
Objective data include the following:
Vital signs: temperature, 100.4°F; pulse rate 88; respiratory rate 18; blood pressure 120/70
Ears: tympanic membrane intact bilaterally, landmarks visible
Eyes: conjunctivae pale and moist
Nose: anterior nasal turbinates erythematous and boggy
Throat: pharynx injected without exudates
Neck: (+) tenderness and lymphadenopathy submaxillary and submental cervical nodes, (2) thyroid
Sinuses: frontal and maxillary sinuses tender on palpation; minimal transillumination
Lungs: anterior upper lobes bilaterally with scattered rhonchi-clears with coughing
Other lobes clear to auscultation; (+) thoracic expansion and thorax symmetric; resonance on percussion; no shortness of breath
Neurologic: cranial nerves 2 to 12 intact
DIAGNOSIS: ACUTE SINUSITIS
1. List specific goals for treatment for M. R.
2. What drug therapy would you prescribe? Why?
3. What are the parameters for monitoring the success of the therapy?
4. Discuss specific patient education based on the prescribed therapy.
5. List one or two adverse reactions for the selected agent that would cause you to change therapy.
6. What would be the choice for the second-line therapy?
7. What OTC or alternative medications would be appropriate for this patient?
8. What dietary and lifestyle changes should be recommended for this patient?
9. Describe one or two drug-drug or drug-food interactions for the selected agent.
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: List specific goals for treatment for M. R. What drug therapy would you prescribe? Why? What are the parameters for monitoring the success of the therapy
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