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Is it acute or chronic? Acute onset of a cough would suggest an acute URI, viral pneumonia, or bronchopneumonia. A chronic cough is more suggestive of pneumoconiosis, chronic bronchitis, emphysema, bronchiectasis, tuberculosis ... DIAGNOSTIC WORKUP
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Are there abnormalities on the ear examination? The ear examination may reveal severe otitis externa, an epithelioma of the pinna, a foreign body, or impacted wax. It may also show inflammation and bulging of the ... DIAGNOSTIC WORKUP
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Are there exudates? This is a key question when evaluating a sore throat. Most cases of sore throat with exudates will be found to have streptococcal pharyngitis. Without exudates, one could still have a ... DIAGNOSTIC WORKUP
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Is there a history of drug ingestion or injection? This will help diagnose drug reactions and serum sickness, which are common and easily discovered in the history. Patients with glucose-6-phosphate dehydrogenase deficiency may develop fever after ... DIAGNOSTIC WORKUP
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Is there a history of drug ingestion or injection? Of course, the history should reveal that the patient has been on a certain drug or has received certain antitoxins, serums, or vaccines.
Is there a rash? If there ... DIAGNOSTIC WORKUP
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Fever is defined as an elevation of normal body temperature (37°C, or 98.6°F). True fever occurs when the body adopts a new thermoregulatory “set point” secondary to the release of pyrogenic cytokines in response to bacteria, viruses, or other exogenous sources (e.g.... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Sore throat is a common symptom. Many patients incorrectly believe that antibiotics improve the clinical course in all sore throats. Although the vast majority of sore throats are of viral origin and should be managed conservatively, an... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Initial history of cough should include an assessment of the production of sputum, and the quantity, quality, and circumstances of the sputum production and coughing episodes. Additionally, associated history and physical findings, with particular attention to... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Initial history of cough should include an assessment of the production of sputum. Additionally, associated history and physical findings, with particular attention to the quantity, quality, and circumstances surrounding coughing episodes and social details (such as history of smoking,... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The etiologies of rash with fever are vast, but a systematic approach will help the clinician quickly narrow the differential. Patients who appear “toxic” with fever and prostration must be rapidly and thoroughly evaluated to rule out life... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Most sore throats and coughs are due to infection. Children may have 5–8 upper respiratory infections per year. The primary differential is between viral and bacterial etiologies, especially group A β-hemolytic streptococcus.
... Workup and Diagnosis ... Treatment
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Cyclic or periodic fever is an unexplained fever that recurs after fever-free periods at almost predictably fixed intervals. True cyclic fever is rather uncommon in childhood; it should be differentiated from recurrent fever, which refers to fever prone to... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Recurrent or relapsing fever is a cluster of febrile episodes that occur over a period of time, with documented fever-free intervals and without an apparent medical cause for each episode. It should be differentiated from cyclic fever, which... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Fever of unknown origin (FUO) is a term that is often misused to describe febrile illness without an obvious etiology or without other symptoms. The definition in different studies is arbitrary, but basically refers to at least 2 weeks of daily... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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A cough occurs by increased intrathoracic pressure against a closed glottis (Valsalva maneuver), followed by the abrupt opening of the glottis and a sudden expulsion of air. Increased intrathoracic pressure leads to dynamic compression of the airways. The effect of air flow at high pressure... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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In adults, “chronic” is often defined as more than 3 months of coughing in 2 years, but chronic cough is not as well defined in children. In general, for children, cough of more than 3–4 weeks’ duration will be brought to the attention of... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Fever is an elevation of body temperature over the normal daily range for a specific individual in response to different insults. It occurs when the thermoregulatory center in the hypothalamus is reset to higher temperature because of exogenous and endogenous pyrogens. It should be... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... The differential diagnosis of cough is best developed with the use of anatomy. Cough may arise from an irritative focus anywhere along the respiratory tract. The irritation may be intrinsic, in which case it is usually inflammatory, neoplastic, or toxic, or it may be
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... The analysis of earache is much like that of dysuria: It is anatomic and inflammation accounts for the vast majority of causes. Thus, otitis externa would be like urethritis and otitis media like cystitis, and so forth.
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... The differential diagnosis of fever is best developed using physiology first and anatomy second.
FEVER, NONINFECTIOUS CAUSES
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... Breaking down the orophraynx, nasopharynx, and larynx into anatomic components is not very valuable in developing a differential diagnosis of sore throat. What is useful is to use the mnemonic VINDICATE to establish the etiologies. Further
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... Resonant, brassy, and harsh, a barking cough is part of a complex of signs and symptoms that characterize croup syndrome, a group of pediatric disorders marked by varying degrees of respiratory distress. It's most prevalent in the fall and may recur in the same... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations
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... Productive coughing is the body's mechanism for clearing airway passages of accumulated secretions that normal mucociliary action doesn't remove. It's a sudden, forceful, noisy expulsion of air from the lungs that contains sputum, blood, or both. The sputum's color... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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Earaches usually result from disorders of the external and middle ear associated with infection, obstruction, or trauma. Their severity ranges from a feeling of fullness or blockage to deep, boring pain. At times, it may be difficult to determine... History and physical examination ... Medical causes ... Special considerations ... Pictures
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...Pyrexia
A fever is a common sign that can arise from many disorders. Because these disorders can affect virtually any body system, a fever in the absence of other signs usually has little diagnostic significance. A persistent high... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... A nonproductive cough is a noisy, forceful expulsion of air from the lungs that doesn't yield sputum or blood. It's one of the most common complaints of patients with respiratory disorders.
Coughing is a necessary protective mechanism that clears airway... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Acute
Viral upper respiratory infection
Pharyngitis
Rhinitis
Tracheobronchitis
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... Infection
Bacterial
Bacterial endocarditis
Sinusitis
Osteomyelitis
Intravascular catheter
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... Infections
Bacterial
Streptococcus pneumoniae
Salmonella spp.
Haemophilus influenzae
Staphylococcus
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... The common cold (also known as acute coryza) is an acute, usually afebrile viral infection that causes inflammation of the upper respiratory tract. It's the most common infectious disease, accounting for more time lost from school or work... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Cold injuries result from overexposure to cold air or water and occur in two major forms: localized injuries such as frostbite and systemic injuries such as hypothermia. Untreated or improperly treated frostbite can lead to gangrene and may require amputation;... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Colorado tick fever is a benign infection caused by the Colorado tick fever arbo-virus and transmitted to humans by a tick. It occurs in the Rocky Mountain region of the United States, mostly in April and May at lower altitudes and in June and July at higher altitudes. Because... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Lassa fever is an epidemic hemorrhagic fever caused by the Lassa virus, an extremely virulent arenavirus. This highly fatal disorder kills 10% to 50% of its victims, but those who survive its early stages usually recover and acquire immunity to... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... An acute infectious disease caused by spirochetes of the genus Borrelia, relapsing fever (also called tick, fowl-nest, cabin, or vagabond fever or bilious typhoid) is transmitted to humans by lice or ticks and is characterized by relapses and remissions... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Acute rheumatic fever is a systemic inflammatory disease of childhood, in many cases recurrent, that follows a group A beta-hemolytic streptococcal infection. Rheumatic heart disease refers to the cardiac manifestations of rheumatic fever and... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Rocky Mountain spotted fever (RMSF) is a febrile, rash-producing illness caused by Rickettsia rickettsii. The disease is transmitted to humans by a tick bite.
RMSF is fatal in about 5% of patients. Mortality rises when treatment is... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Whooping cough, also known as pertussis, is a highly contagious respiratory infection usually caused by the nonmotile, gram-negative coccobacillus Bordetella pertussis and, occasionally, by the related similar bacteria B. parapertussis and B. bronchiseptica.... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Resonant, brassy, and harsh, a barking cough is part of a complex of signs and symptoms that characterize croup syndrome, a group of pediatric disorders marked by varying degrees of respiratory distress. Croup syndrome is most common in boys and... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations
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... Productive coughing is the body’s mechanism for clearing airway passages of accumulated secretions that normal mucociliary action doesn’t remove. It’s a sudden, forceful, noisy expulsion of air (from the lungs) that contains sputum or blood (or both).... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Usually developing gradually, this increased sensitivity to cold temperatures reflects damage to the body’s temperature-regulating mechanism, based on interactions between the hypothalamus and the thyroid gland. Typically, the symptom results from a tumor or a hormonal... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling
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... A nonproductive cough is a noisy, forceful expulsion of air from the lungs that doesn’t yield sputum or blood. It’s one of the most common complaints of patients with respiratory disorders.
Coughing is a necessary protective mechanism that clears airway passages... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Earaches usually result from disorders of the external and middle ear associated with infection, obstruction, or trauma. Their severity ranges from a feeling of fullness or blockage to deep, boring pain. At times, it may be difficult to determine the precise location of... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... Fever is a common sign that can arise from numerous disorders. Because these disorders can affect virtually any body system, fever in the absence of other signs usually has little diagnostic significance. A persistent high fever, though, represents an emergency.
Fever can be... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Désirée A. Lie
Cough is among the top 10 reasons for visits to family physicians in the United States. It accounts for 200 to 400 million episodes of illness per year. Three causal conditions increasing in frequency over the past two decades are asthma,... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Lyle J. Fagnan
Fever is a physiologic state in which the body temperature is elevated above the individual’s normal temperature. Patients and clinicians consider fever an important sign of illness.
Approach to the febrile patient. ... History ... Physical examination ... Testing. ... Diagnostic assessment. ... Pictures
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... Michael L. O’Dell
Fever with an accompanying rash represents a diagnostic challenge for even the most experienced of clinicians, as this combination of signs can represent trivial or life-threatening illnesses.
Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Differential Overview
❑ Rhinovirus
❑ Group A streptococci
❑ Ebstein-Barr virus
❑ Adenovirus
❑ ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Infection
❑ HIV
❑ Tuberculosis
❑ Endocarditis
❑ Osteomyelitis ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Viral upper respiratory infection
❑ Asthma
❑ Sinusitis
❑ Mycoplasma bronchitis
❑... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Upper respiratory infection
❑ Allergy
❑ Asthma
❑ Chronic bronchitis
❑ Chronic sinusitis
... Diagnostic Approach ... Clinical Findings ... Pictures
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... The common cold — an acute, usually afebrile viral infection — causes inflammation of the upper respiratory tract. It accounts for more time lost from school or work than any other cause and is the most common infectious disease.... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Overexposure to cold air or water causes cold injuries. They occur in two major forms: localized injuries (such as frostbite) and systemic injuries (such as hypothermia). Untreated or improperly treated frostbite can lead to gangrene and may necessitate amputation; severe... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Often recurrent, acute rheumatic fever is a systemic inflammatory disease of childhood that follows a group A beta-hemolytic streptococcal infection. Rheumatic heart disease refers to the cardiac manifestations of rheumatic fever, including pancarditis ... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Resonant, brassy, and harsh, a barking cough is part of a complex of signs and symptoms that characterize croup syndrome, a group of pediatric disorders marked by varying degrees of respiratory distress. Croup syndrome is most common in boys. It’s most... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Nursing considerations ... Patient teaching
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... Productive coughing is the body’s mechanism for clearing airway passages of accumulated secretions that normal mucociliary action doesn’t remove. It’s a sudden, forceful, noisy expulsion of air (from the lungs) that contains... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Fever is a common sign that can arise from any one of several disorders. Because these disorders can affect virtually any body system, fever in the absence of other signs usually has little diagnostic significance. A persistent high fever, though, represents an emergency. ... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Resonant, brassy, and harsh, a barking cough is part of a complex of signs and symptoms that characterize croup syndrome, a group of pediatric disorders marked by varying degrees of respiratory distress. Croup syndrome is most common in boys... History ... Physical assessment ... Medical causes ... Special considerations ... Patient counseling ... Pictures
... READ EXCERPTS »
... Productive coughing is the body’s mechanism for clearing airway passages of accumulated secretions that normal mucociliary action doesn’t remove. It’s a sudden, forceful, noisy expulsion of air (from the lungs) that contains sputum or blood (or both). The sputum&rsquo... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Also known as otalgia, earaches usually result from disorders of the external and middle ear that are associated with infection, obstruction, or trauma. Their severity ranges from a feeling of fullness or blockage to deep, boring pain. It... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Fever, or pyrexia, is a common sign that can arise from any one of several disorders. Because these disorders can affect virtually any body system, fever in the absence of other signs usually has little diagnostic significance. A persistent high fever, though, represents an... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A nonproductive cough is a noisy, forceful expulsion of air from the lungs that doesn’t yield sputum. It’s one of the most common complaints of patients with respiratory disorders.
Coughing is a necessary protective mechanism that clears airway... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Definedas sound that occurs on sudden release of air under high pressure,which is generated by forceful contraction of expiratory musclesagainst a closed glottis. Clinical dilemma is to determine whethercoughing is associated with mild illness or more serious... Principal Causes of Cough ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Can be causedby external or middle ear pathology or by referred pain from another source. According to Potsic (1997), 85% ofchildren with ear pain have infection; 7%, referred pain; 5%,middle ear effusion; and 3%, miscellaneous causes. ... Principal Causes of Earache ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Occurs whenpathologic process causes body temperature to exceed normal range. DuBois suggested that usual range ofnormal body temperature is 97–100.4°F (36.2–38.0°C)rectal or 96.8–99.3°F (36.0–37.4°C)oral. Rectal temperature tends to... Principal Causes of Acute Fever ... Clinical Features and Diagnosis: Acute Fever ... Diagnostic Approach: Acute Fever ... Principal Causes of Fever of Unknown Origin ... Clinical Features and Diagnosis: Fever of Unknown Origin ... Diagnostic Approach: Fever of Unknown Origin ... References
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...Sore throat refers to any painful sensationof the pharynx or surrounding tissues and is a common complaintin childhood and adolescence. Principal Causes of Sore Throat Infection Pharyngitis/tonsillitis Viral Bacterial Group A ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Resonant, brassy, and harsh, a barking cough is part of a complex of signs and symptoms that characterize croup syndrome, a group of pediatric disorders marked by varying degrees of respiratory distress. It's most prevalent in the fall and may recur in the same... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Productive coughing is the body's mechanism for clearing airway passages of accumulated secretions that normal mucociliary action doesn't remove. It's a sudden, forceful, noisy expulsion of air from the lungs that contains sputum, blood, or both. The sputum's color,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... A nonproductive cough is a noisy, forceful expulsion of air from the lungs that doesn't yield sputum or blood. It's one of the most common complaints of patients with respiratory disorders.
Coughing is a necessary protective mechanism that clears airway... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Earaches usually result from disorders of the external and middle ear associated with infection, obstruction, or trauma. Their severity ranges from a feeling of fullness or blockage to deep, boring pain. At times, it may be difficult to determine... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A fever is a common sign that can arise from many disorders. Because these disorders can affect virtually any body system, a fever in the absence of other signs usually has little diagnostic significance. A persistent high fever, though, represents... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
...
The differential diagnosis of cough is best developed with the use of
anatomy. Cough may arise from an irritative focus anywhere along the
respiratory tract. The irritation may be intrinsic, in which case it
is usually inflammatory,... Pictures
... READ EXCERPTS »
...
The analysis of earache is much like that of dysuria: It is anatomic, and
inflammation accounts for the vast majority of causes.
Thus, otitis externa would be like urethritis and otitis media like
cystitis, and so forth.
... Pictures
... READ EXCERPTS »
...
The differential diagnosis of fever is best developed using
physiology first and anatomy second.
Physiology. Increased heat in the body is caused by increased
production or decreased elimination or dysfunction... Pictures
... READ EXCERPTS »
...
Breaking down the oropharynx, nasopharynx, and larynx into anatomic
components is not very valuable in developing a differential diagnosis of
sore throat. What is useful is to use the mnemonic VINDICATE to
establish the etiologies. Further... Pictures
... READ EXCERPTS »
When you have watery eyes, a runny nose, congestion and sneezing, how can you tell if it's a cold or an allergy? Find out the difference and the...
Adults may already know the new ways to avoid catching and spreading the flu. But you may need to teach these behaviors to kids. Listen to an...
Allergies can leave children feeling sniffly, teary and itchy and take their toll at play and at school. Previously, allergy remedies left children...
Our parents told us to cover our mouths when we cough. But that might not be the best strategy for flu prevention. Listen to an infection control...