Question

What do you think the patient’s diagnosis is and why?

Gladys Young is a 68 year old female that resides in an Independent Living facility with her husband. She presents to her primary care physicians office with complaints of fever, chills, nausea and vomiting. She also states that she has had some mild hemoptysis occasionally with her persistent coughing. She has recently completed treatment with Chemotherapy for Breast cancer and is concerned that she may have an infection. You are the nurse caring for her.

You complete the following assessment:

Subjective Data:

She is able to complete a sentence in its entirety, but she is persistently coughing during the history. She is a former smoker, she smoked ½ pack of cigarettes per day for 30 years and quit when she was diagnosed with breast cancer 6 months ago. She denies shortness of breath or chest tightness. She has not yet gotten her influenza vaccine, but did receive the Pneumovax vaccine last year. She has had problems with persistent coughing at night which has prevented her from getting a good night’s sleep for the past two weeks. She also states that she has been waking up soaked in sweat in the morning.

Objective Data:

• Temp – 38.6 C; HR – 132 beats/min; RR—28; BP – 168/87; O2 sat – 90% on Room Air
• Auscultation: Lungs with faint crackles at bases bilaterally. No wheezing present.
• Patient is flushed and warm to touch.

Answer 1

Patient diagnosis is Tuberculosis

Because mainly confusion occur between COPD and TUBERCULOSIS. In this case also as smoking can be cause of both the disease condition

But the diagnosis is Tuberculosis because patient present with hemoptysis and persistent cough and also have severe night sweating which make it different from COPD because in copd wheezing is mainly present with shortness of breath . Also night sweating is associated with tuberculosis mainly , hemoptysis and fever and chills major clinical symptoms of tuberculosis which differentiate it from copd

Also on auscultation , in COPD rhonchi is heard mainly and faint crackles are heard in tuberculosis . By this auscultation reports, it confirms that it is Tuberculosis .

Thus the most likely diagnosis is Tuberculosis

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