Cough productive of purulent sputum

A 45- year-old man presents to the clinic with a cough productive of purulent sputum of 3-week duration.  He says that he had just gotten over a cold a few weeks prior to this episode.  He occasionally has fevers and he coughs so much that he has chest pain.  He reports that he also has a mild sore throat and runny nose.

 

He has no history of asthma and no history of any type of lung disease.

 

He denied N/V/D and any recent travel.  He denies any smoking history.

 

PE: Temp 98.6, AP 96, BP 124/80, resp 18 and oxygen sats 99% on RA.  Lung sounds have expiratory wheezing in the upper lobes, no crackles.

 

  1. Would you order a chest x ray on this patient?  Why or why not- support your decisions with how this patient fits or does not fit criteria according to the guidelines.

2. What medication regimen would you order for this patient (include dose) and why?  Provide supporting evidence for your pharmacological interventions.

 

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