Response to below DQ 100 words APA with 1 citation and reference
Response to below DQ 100 words APA with 1 citation and reference
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A runny nose is a common problem seen in the primary care setting. Sometimes it can be difficult to determine what is causing the runny nose. Through questioning, examination, and diagnostic testing, a cause can be found. Questions that need to be asked are; when did the runny nose start? What does the color of the drainage look like? Is it clear? Bloody? Yellow? Are you experiencing any sneezing? Is there a time when you notice your runny nose is worse? Is there anything that makes your runny nose better? Do you have any other symptoms? Have you had a fever? Do you have a cough? Do you have a sore throat? Have you taken any over the counter medications? Has any medication helped? Do you have any allergies? Is there a high pollen concentration in your area? Have you been outside often lately? Have you been around any new animals? Are you pregnant? Depending on those questions, further questioning can be done to narrow down what may be going on. Body parts to be examined include the nares, mouth, throat, ears, eyes, lymph nodes in neck, and sinus palpitation of the face.
With a runny nose, various types of illness can be present. The patient could be experiencing a viral cold, a bacterial sinus infection, allergies due to weather or another cause, influenza, pregnancy, or a more serious problem where cerebral spinal fluid is leaking from the nose. Pregnancy can induce rhinitis in 20-30% of women possibly due to hormonal changes, but the cause is not well understood (Odedra, 2014). Diagnostic testing that should be done is a respiratory filmarray which identifies 17 viruses and 3 bacterial pathogens, including influenza a and b (Azadeh, Sakata, Brighton, Vikram, & Grys, 2015). This will rule out a viral cause if negative. Depending on the patient’s symptoms and nasal drainage color, a sinus infection could also be ruled out. Questions about patient’s allergies and environmental allergies could rule out an allergic cause. If all other diagnostic testing and questioning are negative, a CT scan can be performed to determine if cerebral spinal fluid could be leaking from the nose. Cerebral spinal fluid leaking from the nose can be caused by trauma, surgery, or a tumor (Daneshbod, Mahdavi, & Mirfazaelian, 2014).
Depending on what testing is positive will determine what steps will be taken to help the patient. If the patient is pregnant the runny nose symptoms will resolve after giving birth. If the patient is positive for a virus, cold medicine will be recommended for comfort such as DayQuil. If the patient is experiencing allergies, over the counter loratadine (Claritin) would be recommended. If the patient has symptoms of a sinus infection an antibiotic of amoxicillin would be prescribed. All prescription medications would depend on patient’s medication allergies and be altered from there. If the patient is positive for influenza, Tamiflu would be prescribed if symptoms started within 48 hours. If the patient has cerebral spinal fluid leaking from nose, the patient should be advised bedrest and to see a neurologist.
References
Azadeh, N., Sakata, K. K., Brighton, A. M., Vikram, H. R., & Grys, T. E. (2015). Filmarray
respiratory panel assay: Comparison of nasopharyngeal swabs and bronchoalveolar
lavage samples. Journal of Clinical Microbiology, 53(12), 3784-3787.
Daneshbod, Y., Mahdavi, A., & Mirfazaelian, H. (2014). The runny nose. Internal & Emergency
Medicine, 9(6), 689-690. doi:10.1007/s11739-014-1057-8
Odedra, K. M. (2014). Treatment of rhinitis in pregnancy. Nursing Standard, 29(8), 37-41.
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