Health Assessment: Health Promotion, Term Paper Example

Introduction

When a chief complaint is identified, it is important to identify strategies that will enable clinicians to identify important data that will be collected to determine a diagnosis and a potential treatment plan. There are many different types of chief complaints; therefore, each complaint must be addressed individually because the data collection process is highly specific. For example, a common chief complaint is the following: “I have a deep and painful cough that will not go away.” In order to examine this complaint further, a list of subjective and objective data must be collected by the clinician team in order to identify the appropriate diagnosis and treatment plan associated with this cough. The following discussion will address a deep chest cough in greater detail and will identify they key objective and subjective data that is required to ensure that the patient experiences the desired improvements. Furthermore, the discussion will also consider the health promotion strategies that are associated with a deep chest cough that are likely to be beneficial in promoting a greater quality of life.

Analysis

Patients who experience a cough that runs deep into the chest require a detailed physical examination that includes objective and subjective data to determine the nature and source of the cough. This process supports the need for extensive knowledge regarding the possible causes of cough and how to best treat this symptom effectively. For example, a patient with a deep cough is likely be observed by the nurse comprehensively and the following objective data will be recorded: 1) the patient’s cough is deep and well into the chest cavity; 2) it occurs in spells and without warning; 3) the cough signifies additional mucus or phlegm that is not cleared, even with the cough; 4) the cough was observed approximately six separate times during the physical examination, thereby indicating that it is a productive cough. Each of these criteria demonstrate that it is important for nurses to collect objective data regarding the nature and frequency of the cough as a means of evaluating the different clinical perspectives that are probable in this example and to administer a treatment plan.

In order to collect subjective data regarding the cough, it is important to identify the sources of data that are most relevant to the nurse and other clinical staff in forming a diagnosis. Therefore, a patient should be asked a series of questions that will be effective in obtaining information regarding the cough and its possible relationship to other symptoms. To be specific, the nurse should ask questions such as the following: 1) How frequent do the coughing spells take place? 2) Does it hurt when you cough? 3) Do you have excess phlegm in your throat when you cough? 4) Does the cough make you short of breath? 5) How long have you had the cough? Each of these questions will be helpful to the nurse in making a determination regarding the nature of the cough and the types of diagnoses and/or treatments that are available.

A cough may represent a number of different diagnoses; therefore, the specificity of the questions and tests that are conducted to determine the nature and source of the cough are critical (Irwin, 2006). It is important to identify the specific nature of the cough so that the diagnosis is correct and timely (Irwin, 2006). Furthermore, there are a number of predefining characteristics of cough that have been proven in clinical studies and from historical data that should be considered when addressing patients with cough (Irwin, 2006). Coughs may result from a variety of conditions, including colds, respiratory infections, allergies, and other types of complications; therefore, subjective and objective data are of critical importance in addressing these concerns during the diagnostic phase (Irwin, 2006). One alternative to consider is the following: “a health-related quality-of-life instrument canassess how cough severity impacts a patient’s health-related quality of life in multiple domains” (Irwin, 2006, p. 235S). Therefore, it is necessary for clinicians to utilize the resources that are available to obtain much-needed data and information that will contribute to an effective diagnosis of the cough that is present (Irwin, 2006).

For patients with different types of cough, it is essential to establish a greater understanding of the type and nature of the cough so that additional testing might be considered on an as needed basis. Coughing is a common yet complex phenomenon and requires an effective understanding of its nature and origin as early as possible, particularly when it is suspected that the cause may be of a more serious nature (Decalmer et.al, 2007). There are a number of considerations to make in regards to cough that may have an impact on patient care outcomes and quality of life, particularly with chronic coughs (Decalmer et.al, 2007). To be specific, “Chronic cough has a major effect on the quality of life, and patients consume substantial healthcare resources, often seeing several specialists over many years” (Decalmer et.al, 2007, p. 329). Therefore, it is important to recognize the value of different forms of testing and data that are valuable in determining the nature of chronic cough and whether or not a definitive diagnosis and treatment plan might be considered (Decalmer et.al, 2007). Most importantly, the utilization of existing tools and resources are necessary in order to determine how to treat a chronic cough effectively (Decalmer et.al, 2007).

From a health promotion perspective, it is important to identify resources that are available to ensure that coughs are prevented in as many cases as possible. Although this is sometimes impossible, all efforts must be made to enable clinicians to have the resources available to make definitive diagnoses when a cough is evident. Nonetheless, cough prevention is of primary importance, in particular for children who face the risk of Pertussis, or Whooping Cough, a more severe bacterial infection that causes a severe cough and is highly contagious (Centers for Disease Control, 2014). For this particular condition, vaccinations are available that are designed to prevent this disease (Centers for Disease Control, 2014). The pertussis vaccine improves prevention in many patients who otherwise might be at risk of this disease, thereby creating a level of health promotion that is important in reducing this risk throughout the population (Centers for Disease Control, 2014).

The prevention of cough is not always an easy task because the origin of cough may be very complex and diverse. A cough often accompanies a cold, thereby creating a challenging situation for individuals until the symptoms pass. These types of coughs often disappear rather quickly and do not cause any significant complications. However, in other cases where symptoms are more severe and are a contributing factor to a more serious condition, a cough may linger for a longer period of time. Chronic coughs are particularly difficult to diagnose and treat and may lead to a host of other complications. As a result, prevention is critical in order to reduce long-term complications and other factors that may contribute to more serious health concerns. The ability to prevent coughs may also be attributed to the reduction of one or more negative behaviors that may occur throughout the life span, such as smoking, which has a serious impact on lung function and often leads to chronic cough in many patients.

Health promotion activities that are designed to prevent coughs must represent an opportunity to convey the importance of a healthy lifestyle and positive health behaviors so that individuals do not develop diseases or other conditions that may lead to cough or other symptoms. One of the first areas that clinicians consider as the possible cause of a cough is the common cold, whereby there is a disruption to the airway that must be cleared for one or more reasons. Therefore, it is the responsibility of individuals to take the necessary precautions when they are exposed to situations where they could develop coughs that could lead to more serious or chronic complications. There are considerable health promotion efforts that are available to educate individuals regarding coughing, its causes, associated risks, and other factors that may contribute to cough in some patients.

Since coughing is common yet it is often difficult to identify its cause, it is important for clinicians to focus on different methods of health promotion in order to prevent further complications. It is evident that additional measures must be considered that will be effective in preventing long-term complications and in demonstrating the value of health promotion in order to understand cough and its impact on wellbeing. It is important to emphasize diagnostic and treatment tools that will be effective in promoting the treatment of cough in order to minimize symptoms and improve outcomes. Alternatives such as protussive therapies are often used to promote the expulsion of phlegm and mucus and to prevent further development of these agents; however, they are not always effective in deeper coughs that linger for longer periods of time (Morice et.al, 2002). For example, a cough that is associated with a respiratory tract infection is somewhat challenging to treat and may require a twofold treatment process that includes protussive and antitussive therapies (Morice et.al, 2002). These elements are critical to the development of new strategies that will improve the symptoms associated with deeper coughs, while also contributing to the removal of secretions from the throat and chest more effectively (Morice et.al, 2002). These efforts must be considered in the development of effective approaches to treat coughs that are more difficult to diagnose and/or treat as a result of their chronic nature and level of severity (Morice et.al, 2002). Regardless of the condition, it is important to educate patients regarding the risks associated with coughing and to provide them with strategies that will aid in the prevention or limitation of coughs as best as possible (Morice et.al, 2002).

The efforts made by clinicians and healthcare providers in community-based settings must consider these alternatives as a means of improving outcomes and reflecting upon the challenges that coughing may bring to the immune system and in the form of other complications that may be difficult to treat. Clinicians must consider the utilization of objective and subjective data as learning exercises in order to treat larger groups of patients by learning about the nature of different types of coughs and how they impact health and wellbeing. These actions are likely to be effective in demonstrating the importance of new perspectives that will encourage positive outcomes for patients and that will alleviate coughs and related symptoms as best as possible without serious and lasting complications.

Conclusion

Coughing is a complex physical phenomenon that may be a result of any number of underlying causes. Coughs are challenging to treat because they have a significant impact on human health, particularly when they are deep into the chest cavity and cause pain and other related symptoms. Therefore, it is important for clinicians to consider their alternatives when addressing coughing in the healthcare setting through the use of objective and subjective data in different forms. Nurses and other clinicians must consider these forms of data in order to identify the nature and origin of the cough, identify any related symptoms, determine a diagnosis, and establish a treatment plan. These elements will provide a greater understanding of the cough and its impact on different patients. Health promotion activities associated with coughing must consider its impact on short and long-term health and wellbeing and the methods of prevention that are available to reduce the risks associated with colds and respiratory infections, amongst other conditions. These factors are essential to the discovery of new methods to improve outcomes and address patient wellbeing more effectively.

References

Centers for Disease Control (2014). Pertussis (whooping cough): prevention. Retrieved from http://www.cdc.gov/pertussis/about/prevention.html

Decalmer, S.C., Webster, D., Kelsall, A.A., McGuiness, K., Woodcock, A.A., and Smith, J.A. (2007). Chronic cough: how to cough reflex sensitivity and subjective assessments correlate with objective cough counts during ambulatory monitoring? Thorax, 62, 329-334.

Irwin, R.S (2006). Assessing cough severity and efficacy of therapy in clinical research. Chest, 129, 232S-237S.

Morice, A.H., Widdicombe, J., Dicpinigaitis, P., and Groenke, L. (2002). Understanding  cough. European Respiratory Journal, 19, 6-7.