The Malicious Third-Grade Cougher uring her well-child visit in mid-September, M
ID: 203312 • Letter: T
Question
The Malicious Third-Grade Cougher uring her well-child visit in mid-September, Mary was excited to be in the third grade. "We get to read chapter books and write stories. Plus-we have a pet hamster, and we take turns taking him home. My turn is next Friday!" Mary was weighed and measured and given a physical exam. All findings were normal for an 8-year-old girl. "I sure hope we don't have a repeat of last year," her mother sighed. "I lost all my sick leave staying home with poor Mary's colds. But she's been healthy all summer-and she grew 2 inches, too!" On October 12 Mary caught her first cold. It came and went in three days over the weekend, leaving only a dry, hacking cough. Two weeks later her teacher said to Mary's mother at a parent-teacher meeting, "I think Mary is coughing in school on purpose. She doesn't seem to cough anything up. And from what you just said, she's okay at home. I'd like to make a referral to the school psychologist." "Give me a week," Mary's mom responded. "I want to take her back to our nurse practitioner first." Mary's APRN asked Mary to lean over, take a deep breath, and try to cough up sputum. Mary was unable to cough up anything. The APRN listened to Mary's heart and lungs and then told her mother that she would like Mary to have an evaluation at the spirometry lab.Explanation / Answer
7. probable triggers of mary's cough-
As described in the question Mary was unable to cough up sputum, that means it was a dry cough. the reasons could be common cold/ flu (viral infection), allergies or air pollutants.
8. treatment of Mary's cough-
Home remedies such as honey, ginger, garlic, turmeric, tulsi. herbel remedies such as extracts of spruce or pine shoots.
9. PEFR- Peak Expiratory Flow Rate (PEFR) , Peak expiratory flow rate is the measurement of how much the patient can blow out (exhale) of their lungs in one breath.
it is measured using a handheld instrument with a mouthpiece on one end and a scale on the other. When air is blown into the mouthpiece a small plastic arrow moves. This measures the airflow speed.
it is used to check for lung problems such as asthma, COPD . it helps you discover when you need to adjust your medication. also it can help determine whether environmental factors or pollutants are affecting your breathing.
10. precautions to be taken-
Gargling with hot water or salt-water, No ice cream, cold drinks or cold fruit juices especially in winter, Drink hot water , avoid overeating, avoid fried foods and wshing hands thoroughly with water and soap.
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