Sore throat pain when swallowing

Full Answer Section

Problem List:

• Hacking, raspy cough with green phlegm production
• Runny nose with yellow discharge
• Sore throat with pain on swallowing
• Bulging eardrums (possible otitis media)
• Fatigue

Nursing Diagnoses:

• Ineffective airway clearance related to cough and mucus production
• Acute pain related to sore throat
• Risk for infection related to upper respiratory symptoms and possible otitis media
• Fatigue related to underlying medical conditions (HTN, DM) or possible infection

Plan of Care:

• Assessment: Continue monitoring vital signs, temperature, oxygen saturation, and respiratory effort. Monitor for worsening of symptoms or complications (e.g., pneumonia, sinusitis).
• Diagnostics: Obtain culture swabs from the nose and throat to identify the causative organism and guide antibiotic therapy. Consider chest X-ray if pneumonia is suspected.
• Interventions:
  • Administer prescribed medications and nebulizer treatments (if indicated) to improve airway clearance and relieve symptoms.
  • Encourage adequate hydration and throat lozenges to soothe the sore throat.
  • Encourage rest and proper sleep hygiene to manage fatigue.
  • Provide patient education on proper cough hygiene, symptom management, and importance of completing antibiotic therapy (if prescribed).
• Collaboration: Communicate with the physician regarding diagnostic results and treatment plan. Monitor for potential medication interactions or complications.

Risk Factors in this Age Group:

• Underlying medical conditions: Hypertension and diabetes can increase the risk for severe complications from respiratory infections.
• Weakened immune system: Older adults are more susceptible to infections due to declining immune function.
• Decreased respiratory reserve: Reduced lung capacity and muscle strength can limit the ability to effectively clear secretions.

Sample Answer

M.C.'s Case: Further Assessment and Nursing Care

Additional Questions about the Cough:

• Onset and duration: When did the cough begin? Has it been worsening, improving, or staying the same?
• Character of the cough: Is it dry or productive? If productive, what color and amount of phlegm is produced?
• Exacerbating and relieving factors: What makes the cough worse or better (e.g., lying down, cold air, certain activities)?
• Other respiratory symptoms: Any chest pain, shortness of breath, difficulty breathing, or wheezing?
• Any recent upper respiratory illnesses or contact with sick individuals?