Case study – part one Adnan Kassab is a young

Mr. Coy, a 72-year-old male, presents to the clinic with 4 weeks of productive coughing. He has a 10-year history of chronic obstructive pulmonary disease (COPD). He has a 45-year history of smoking two packs a day of cigarettes. He states he quit smoking due to financial needs about 6 years ago. He complains of pain in his chest from coughing, saying it is sore. He has noticed some dark-colored blood on his tissue. Vital signs: blood pressure 137/90, heart rate 82, respirations 22, body mass index (BMI) 23. Chief complaint: My persistent cough won’t go away with my normal cough medicine. I noticed blood on tissue from coughing. DISCUSSION: As the FNP cares for Mr. Coy today, answer the following: 1. What additional subjective information will you be asking the patient? 2. Identify three (3) differential diagnoses in order of priority. Include pathophysiology and pertinent positive and negative findings for each diagnosis. 3. What labs, radiological examinations, or additional diagnostic studies would you order? Include the EBP rationale. 4. Document the discussion you will have with your patient at the end of this visit. You will summarize your impressions and thoughts regarding today’s visit and your plan of care, including follow-up and any referrals. Document in first-person. State what you are saying to the patient.

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