Mike is a 69-year-old man who presents to the outpatient office with a hacking, raspy cough.

Subjective Data

PMH: HTN, DM

Cough is productive, bringing up green phlegm

Runny nose, sore throat

Denies fever

Sore throat pain when swallowing

No history of smoking or seasonal allergies

Complains of fatigue

Objective Data

Vital signs: T 37 P 72 R 14 BP 134/64

Lungs: + Rhonchi bilateral upper lobes, wheeze

O2 Sat = 98%

Ears = TM bulging

Nose = + erythema, yellow discharge

Throat = + erythema, – pustules

Medications: Metoprolol 12.5 mg per day, Glucophage 500 mg twice a day

Questions

1. What other questions should the nurse ask about the cough?

2. Develop a problems list from the objective and subjective data.

3. What nursing diagnoses can be derived from the problems list?

4. What should be included in the plan of care?

5. What risk factors are associated with this age group?

6. Based on the readings, what is the most likely cause of this patient’s cough?