Summary NR 661 Know presentation, DX and Management

NR 661 Know presentation, DX and ManagementNR 661 Know presentation, DX and Management Diagnoses List 1. Acute bronchitisDESCRIPTION Acute cough due to inflammation of the bronchioles, bronchi, and trachea; usually follows an upper respiratory infection or exposure to a chemical irritant. ETIOLOGY • Adenovirus • Rhinovirus • Influenza A and B • Parainfluenza RISK FACTORS • Upper respiratory infection • Air pollutants • Smoking and/or secondary exposure • Reflux esophagitis • Allergy • Chronic obstructive pulmonary disease • Acute and chronic sinusitis • Infants • Older adults • Immunosuppression ASSESSMENT FINDINGS • Cough: dry and nonproductive, then productive; may be purulent • URI symptoms • Fatigue • Fever due to bacterial infection; more common in smokers and patients with COPD • Fever due to viral cause (unusual after first few days) • Burning sensation in chest • Crackles, wheezes • Chest wall pain DIFFERENTIAL DIAGNOSIS • Pneumonia • Tuberculosis • Asthma DIAGNOSTIC STUDIES • Decision criteria for chest radiographs: tachypnea, hypoxia, fever, abnormal lung exam • Only consider chest X-ray if high index of suspicion for pneumonia or superimposed heart failure • Consider PPD: expect negative results • PREVENTION • Smoking cessation • Avoid known respiratory irritants • Treat underlying conditions that contribute to risk (asthma, gastroesophageal reflux disease, etc.) • Influenza immunization for high-risk populations NONPHARMACOLOGIC MANAGEMENT • Increase fluid inta