Question Based on the following case study please address each of t

Question Based on the following case study please address each of the following: Construct a problem list in order of priority for AJ. Provide a list of differential diagnoses for your top five problems with rationale.  List from most likely to least likely.What additional data would you need with rationale (subjective and objective)?   Case Study cc:       A.J. is a 42 year old single Caucasian female who presents today stating that “I can’t get rid of this darned cough” which she has had for the past five weeks. HPI:    The patient says that her cough began five weeks ago when she developed a “cold” with accompanying symptoms of stuffy nose, cough, and sore throat: all of those symptoms resolved except for a persistent cough.  The cough occurs daily and is productive of green sputum.  She gets short of breath with minimal exertion and needs to sit down frequently to catch her breath.  She thinks she has bronchitis because she had frequent bronchitis as a child.  She is requesting antibiotics today because she says her primary care provider always gives her antibiotics for these symptoms.  She denies smoking or chest pain.  Cold weather seems to be making her symptoms worse and she is no longer able to participate in her weekly exercise regime due to the shortness of breath.  She is also now experiencing episodes of being awakened at night by coughing.   PMH: Denies any serious illness, no hospitalizations, no surgeries, no transfusions, denies any allergies including allergies to medications, takes no routine medications.   FH:       Minimal knowledge of family health history but thinks mother had asthma: mother died before age 40 – cause unknown.  One brother with allergies.  Father unknown.  SH:      Works as a CNA in a local nursing home; formerly worked as a prison guard for two years.  Lives in an apartment which she shares with her male partner whom she met while working at the prison and where he is still employed.  No children but she and her partner have three cats, one dog, a tank of fish, and a newly adopted parrot.  Works four days a week for 10 hours each.  Awakens at 5 A.M. and gets to bed no later than 10 P.M. most nights.  Dietary intake is coffee and breakfast sandwich from Dunkin Donuts on way to work, snack from vending machine of honey bun, lunch of soup and sandwich which she packs the night before, snack of peanuts when she gets home and meat with vegetable and salad if her partner is home for dinner; otherwise, she says she just heats a frozen dinner.  Exercise is walking the dog a mile or two each day before and after work. ROS:   Positives noted in history given above.  Otherwise, negative. PE:      Appears stated age in no acute distress when sitting.  No obvious deformities or difficulty communicating. Vitals: BP 110.70    RR 16     HR 80    T 98.2     Ht. 67″     Wt. 160 HEENT:  All WNL CV:  HR RRR; no murmurs or abnormal sounds Lungs: Expiratory wheezing heard bilaterally in lower lobes Abd:    All WNL                     Health Science Science Nursing NURSING 508 Share QuestionEmailCopy link Comments (0)

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