FSU Pharyngeal Infection Management and Health Promotion Discussion Reply

Please respond to discussion below using current APA edition and 2 scholarly references.

For my fourth week of clinical rotations, I felt more at ease in managing patient care with my preceptor. I was able to conduct more physical examinations with more confidence, and I feel more adjusted in using the charting system that is used at the office where I am precepting. One of the patients I seen included a 28-year-old African American woman with a history of bronchitis presents in the office today for follow up on hyperlipidemia, vitamin d deficiency with complaints of sore throat with difficulty eating, headaches, and cough. Patient reports being a flight attendant and experienced one episode of wheezing two months ago, was revealed after facial and chest Xray that she has a deviated septum.

Assessment

Patient observed AAOx3, appears ill, able to follow commands. Erythema observed to pharynx with white exudate and patches. Patient’s oral mucous membrane appears dry and pink, indicating dehydration. No wheezing auscultated; breath sounds are normal. Patient observed with deviated septum, no difficulty breathing observed. Mild Cervical lymphadenopathy observed and palpated. Vital signs BP 108/90, Pulse 100, Temperature 99.8F, R 19, O2 Sat 96% on RA.

Plan

• Prescribe amoxicillin 500mg daily for 5-7 days (Luo et al., 2019).
• Lidocaine viscous solutions every 8 hours as needed for sore throat.
• Refer to ENT specialist.
• Vitamin d 5000units daily, vitamin c 500mg daily.
• Go to ER if symptoms get worse or if they do not improve within 7 days. Follow up in office at next visit.
• Use strict hand hygiene.
• Tylenol 650mg liquid form q 6 hours PRN for fever and pain.
• Gargle with salt water as needed to help soothe throat.
• Isolate from other members from household for at least 24 hours after antimicrobial use.
• Encourage intake of fluids and stay hydrated (eat popsicles to help soothe throat).
• Avoid drinking alcohol (Luo et al., 2019).

Differential Diagnosis for Sore Throat

Infectious mononucleosis: Patient is sexually active, is married and monogamous, denies past sexual transmitted diseases. Patient presents with sore throat and cervical lymphadenopathy that is seen in mononucleosis.

Viral Pharyngitis: Patient denies wearing masks when in contact with other people, patient has sore throat, cough, and headaches. The onset of viral pharyngitis is fast, those who are infected with viral pharyngitis present with cough, runny nose, conjunctivitis, however, they do not have exudate in their throat (Rhoads & Petersen, 2021). The patient also has a positive rapid strep test, so this may be unlikely.

Bacterial Streptococcal: with bacterial streptococcal infection, an infected individual presents with systemic symptoms of weakness, body aches, and fever greater than 101.2 F (Rhoads & Petersen, 2021). The patient denies past history of strep throat, but the patient has cough, headache, fever and sore throat. The patient also has exudative on their tonsils with a rapid antigen test for GABHS that is positive.

Health Promotion Interventions for Sore Throat

Include encouraging fluid intake 2-3L a day, adhere to antimicrobial regimen as prescribed, use of lidocaine viscous liquid as prescribed, vitamin c and vitamin d supplements. Eat a soft diet with liquids (popsicles, soup, mashed potatoes, etc.) until you are able to tolerate foods with more consistency. Avoid citrus juices or foods that can irritate the throat. Use strict hand hygiene to prevent reinfecting self or other people. Isolate from other members from household for at least 24 hours after antimicrobial use. Recommend travel restrictions until symptoms resolve to avoid infecting others. Avoid drinking alcohol to further irritate throat.

Learning Points

As the weeks are continuing to progress and my time spent at my clinical site, I am learning more about not jumping to the most invasive or expensive treatment option and the importance of encouraging non pharmacologic treatments first in managing patient care. This week I incorporated plenty of health promotion interventions into the plan of care of the patients I have seen with my preceptor, and I did not feel doubtful of myself, which felt good.