Understanding Cough Symptoms: A Patient Consultation Guide

Hi Danny. My name is Amanda, APRN and I will be taking care of you today. Greet 02/04/24 10:14 PM CST Hi. What brings you here today? Question 02/04/24 10:14 PM CST My Abuela brought me here because I've been feeling sick. I have been coughing a lot. . . and I feel kinda tired. Oh no. That does not sound like fun. Let's see what we can do to get you feeling better. Empathize 02/04/24 10:15 PM CST Thank you. When did you start coughing? Question 02/04/24 10:18 PM CST I think the cough started four. . . No, it started five days ago. How often are you coughing? Question 02/04/24 10:18 PM CST I just keep feeling like I have to cough every couple minutes or so. I think it gets worse at night. Is your cough dry? Question 02/04/24 10:18 PM CST No . . . my cough seems kind of gurgly and watery. Are you coughing anything up? Question 02/04/24 10:18 PM CST

No . . . my cough seems kind of gurgly and watery. Do you have any sputum? Question 02/04/24 10:19 PM CST Is that the gross, slimy stuff? Yeah, I've been coughing some of that up. It's not any strange color, though. It's just clear. Is your cough worse at night? Question 02/04/24 10:19 PM CST Yeah, my cough's worse at night. Are you around anyone that smokes? Question 02/04/24 10:19 PM CST Well . . . sometimes Papi smokes cigars in the house and my mom has to tell him to go outside. I breathe it a little bit then, but it's not all the time or anything. I don't like how it smells. Does anything make your cough worse? Question 02/04/24 10:20 PM CST My cough mostly stays the same no matter what I do. It seems to get worse at night though. Have you taken any medicine for your cough? Question 02/04/24 10:20 PM CST I had some cough medicine this morning. [AUDIO COMING SOON] What makes your cough better? Question 02/04/24 10:20 PM CST

I had some cough medicine this morning. [AUDIO COMING SOON] It must be hard to sleep. Empathize 02/04/24 10:21 PM CST Thank you. What makes your cough better? Question 02/04/24 10:21 PM CST I had some cough medicine this morning. [AUDIO COMING SOON] What are you doing for your cough? Question 02/04/24 10:21 PM CST My mom gave me some medicine and it helped my cough a little bit, but it started again. Are you drinking a lot of water? Question 02/04/24 10:21 PM CST I don't usually get really thirsty unless it's after gym class or if I'm playing outside. That sounds miserable coughing so much. Empathize 02/04/24 10:22 PM CST Thank you. Does resting help your cough? Question 02/04/24 10:22 PM CST My cough has just stayed the same. I've taken some naps, but it doesn't seem to help.

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Does water help your cough? Question 02/04/24 10:22 PM CST Drinking water doesn't do anything to my cough. Have you been sneezing? Question 02/04/24 10:22 PM CST I don't usually have to sneeze. My nose gets runny a lot of times though, like I have a cold. Has your nose been runny lately? Question 02/04/24 10:23 PM CST My nose is always a little bit runny... but ever since I started coughing it's been worse, I think. Do you have any drainage from your nose? Question 02/04/24 10:23 PM CST My nose is always a little bit runny... but ever since I started coughing it's been worse, I think. Let's see what we can do to make you feel better. Empathize 02/04/24 10:23 PM CST Thank you. Have your ears been hurting? Question 02/04/24 10:23 PM CST My right ear is starting to hurt a little bit . . . my left one is OK though. Are you having any problems hearing from your right ear? Question 02/04/24 10:24 PM CST

A lady came to my school to give all the kids a hearing test. It was kind of cool! I was hoping I would have super hearing, but I think I was just normal . . . Do you have any drainage from your right ear? Question 02/04/24 10:24 PM CST No, nothing comes out of my ears, but my right ear kind of hurts. Does anything make your ear hurt worse? (Clarified to Is there something that makes your ear better?.) Question 02/04/24 10:24 PM CST It just started yesterday, so nobody has done anything yet. (Clarified to if anything makes my ear feels better.) How bad does your ear hurt? Question 02/04/24 10:25 PM CST Well, I have a little pain . . . in my right ear. Maybe almost a 3. Yeah. It's not too bad. Does your throat hurt? Question 02/04/24 10:25 PM CST It feels a little bit sore, yeah. Does anything make your throat hurt more? (Clarified to What makes your throat hurt more?.) Question 02/04/24 10:26 PM CST It hurts a little when I swallow, but I can drink okay if I make myself. [AUDIO COMING SOON] (Clarified to what makes my throat hurt more.) That must be awful. Empathize 02/04/24 10:26 PM CST

Thank you. Are you allergic to any food? Question 02/04/24 10:26 PM CST I'm not allergic to any foods I don't think. Are you allergic to any medications? Question 02/04/24 10:26 PM CST I don't think I'm allergic to medicine. Do you take any medicine? Question 02/04/24 10:27 PM CST Just when I'm sick and my mom or the doctor says I should take some medicine. My mom gave me some cough medicine this morning. Have you been around anyone sick? Question 02/04/24 10:27 PM CST No, I'm the only one. [AUDIO COMING SOON] Do you take a daily vitamin? Question 02/04/24 10:27 PM CST Oh yeah, I take vitamins every day! The gummy dinosaur kind. I don't think I'm supposed to, but sometimes I sneak extra ones to be super healthy! Taking more than you are supposed to could actually make you sick. Educate 02/04/24 10:28 PM CST

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Oh, OK. Have you ever been told that you have asthma? Question 02/04/24 10:28 PM CST Is that when you have to use a, uh, an inhaler? My friend Tony does that sometimes, but I don't have to. Have you had all of your immunizations? Question 02/04/24 10:28 PM CST Like getting shots? It seems like I get shots whenever I go to the doctor. Mom says I need them for school, but I hate it. Do you have a lot of colds? Question 02/04/24 10:28 PM CST I get colds a lot. My nose is always runny. Have you ever had pneumonia? Question 02/04/24 10:29 PM CST I think I had that last year, when I was seven. My mom was really worried. Have you ever been in the hospital? Question 02/04/24 10:29 PM CST I have never been to the hospital. My mom likes to watch doctor shows on TV, so I kind of know what it's like. Who do you live with? Question 02/04/24 10:29 PM CST I live in a house with my mom and Papi. . . and my Abuelo and Abuela. [AUDIO COMING SOON]

That sounds fun. Empathize 02/04/24 10:30 PM CST Thank you. Do you feel safe at home? Question 02/04/24 10:30 PM CST I always feel safe at home. I have a good family! What do you do for fun? Question 02/04/24 10:30 PM CST Usually I play video games or read or try to write stories. If Tony is here, we do that stuff together. Have you had a fever? Question 02/04/24 10:30 PM CST My mom said I didn't have a fever this morning before Abuela took me here. Do you have a headache? Question 02/04/24 10:31 PM CST No, my head doesn't hurt. Are you tired? Question 02/04/24 10:31 PM CST Yeah, I feel kind of tired. I think it's because I couldn't sleep much at night. My cough kept me from falling asleep. I'm sorry you are so sick. Empathize 02/04/24 10:31 PM CST

Thank you. Are you able to eat like normal? Question 02/04/24 10:31 PM CST I can still play OK, but I don't feel like it while I'm coughing. [AUDIO COMING SOON] Do you have a lot of ear infections? Question 02/04/24 10:32 PM CST I don't know if it is infected, but my right ear kind of hurts. Does your nose bleed? Question 02/04/24 10:32 PM CST Just one time. Tony and I were kicking a ball at recess and I got hit in the nose. Do your eyes hurt? Question 02/04/24 10:32 PM CST No, my eyes don't hurt, but they kind of feel like they do when I'm tired. Are you dizzy? Question 02/04/24 10:32 PM CST I only get dizzy if I'm spinning around a lot at recess. Is your nasal discharge thick? Question 02/04/24 10:33 PM CST It's kind of clear and, like, watery.

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Do you have any problems breathing? Question 02/04/24 10:33 PM CST I breathe OK. Is your chest tight? Question 02/04/24 10:34 PM CST My chest feels okay. Checked vitals Exam Action 02/04/24 10:47 PM CST Blow into the spirometer. Question 02/04/24 10:47 PM CST Tested lung capacity with spirometer: FVC: 1.78L, FEV1 1.549L (FEV1/FVC: 87%) Exam Action 02/04/24 10:47 PM CST Inspected upper conjunctiva Exam Action 02/04/24 10:48 PM CST Inspected lower conjunctiva Exam Action 02/04/24 10:48 PM CST Inspected left orbital area and sclera Exam Action 02/04/24 10:48 PM CST Inspected right orbital area and sclera Exam Action 02/04/24 10:48 PM CST Performed otoscopic examination of right naris Exam Action 02/04/24 10:50 PM CST

Performed otoscopic examination of left naris Exam Action 02/04/24 10:50 PM CST Performed otoscopic examination of right ear Exam Action 02/04/24 10:51 PM CST Performed otoscopic examination of left ear Exam Action 02/04/24 10:52 PM CST Inspected mouth Exam Action 02/04/24 10:52 PM CST Inspected front of neck Exam Action 02/04/24 10:53 PM CST Inspected right side of neck Exam Action 02/04/24 10:53 PM CST Inspected back of neck Exam Action 02/04/24 10:53 PM CST Inspected left side of neck Exam Action 02/04/24 10:53 PM CST Inspected anterior chest wall Exam Action 02/04/24 10:54 PM CST Inspected posterior chest wall Exam Action 02/04/24 10:54 PM CST Inspected anterior chest wall Exam Action 02/04/24 10:54 PM CST Palpated frontal sinuses: No tenderness reported Exam Action 02/04/24 10:54 PM CST

Palpated maxillary sinuses: No tenderness reported Exam Action 02/04/24 10:54 PM CST Palpated cervical lymph nodes: Enlarged and reported tenderness on the right side Exam Action 02/04/24 10:55 PM CST Palpated supraclavicular lymph nodes: Not palpable Exam Action 02/04/24 10:55 PM CST Palpated axillary lymph nodes: Not palpable Exam Action 02/04/24 10:55 PM CST Palpated fremitus in anterior upper chest wall: Expected fremitus, equal bilaterally Exam Action 02/04/24 10:56 PM CST Ninety-nine. Palpated fremitus in anterior lower chest wall: Expected fremitus, equal bilaterally Exam Action 02/04/24 10:56 PM CST Ninety-nine. Auscultated breath sounds in anterior right upper lobe Exam Action 02/04/24 10:56 PM CST Auscultated breath sounds in anterior left upper lobe Exam Action 02/04/24 10:56 PM CST Auscultated breath sounds in anterior right middle lobe Exam Action 02/04/24 10:56 PM CST Auscultated breath sounds in anterior left mid-chest (upper lobe) Exam Action 02/04/24 10:56 PM CST

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Auscultated breath sounds in anterior right middle lobe Exam Action 02/04/24 10:56 PM CST Auscultated breath sounds in anterior left mid-chest (upper lobe) Exam Action 02/04/24 10:56 PM CST Auscultated breath sounds in anterior right lower lobe Exam Action 02/04/24 10:56 PM CST Auscultated breath sounds in anterior left lower lobe Exam Action 02/04/24 10:57 PM CST Auscultated breath sounds in posterior left upper lobe Exam Action 02/04/24 10:57 PM CST Auscultated breath sounds in posterior right upper lobe Exam Action 02/04/24 10:57 PM CST Auscultated breath sounds in posterior left mid-back (lower lobe) Exam Action 02/04/24 10:57 PM CST Auscultated breath sounds in posterior right mid-back (lower lobe) Exam Action 02/04/24 10:57 PM CST Auscultated breath sounds in posterior left lower lobe near spine Exam Action 02/04/24 10:57 PM CST Auscultated breath sounds in posterior right lower lobe near spine Exam Action 02/04/24 10:57 PM CST Auscultated breath sounds in posterior left lower lobe on side Exam Action 02/04/24 10:57 PM CST Auscultated breath sounds in posterior right lower lobe on side Exam Action 02/04/24 10:57 PM CST

Auscultated breath sounds in posterior right lower lobe Exam Action 02/04/24 10:57 PM CST Auscultated breath sounds in posterior left lower lobe Exam Action 02/04/24 10:57 PM CST Auscultated voice sounds in anterior right upper lobe Exam Action 02/04/24 10:58 PM CST Ninety-nine. Ninety-nine. Auscultated voice sounds in anterior left upper lobe Exam Action 02/04/24 10:58 PM CST Ninety-nine. Ninety-nine. Auscultated voice sounds in anterior right middle lobe Exam Action 02/04/24 10:58 PM CST Auscultated voice sounds in anterior left mid-chest (upper lobe) Exam Action 02/04/24 10:58 PM CST Auscultated voice sounds in anterior right middle lobe Exam Action 02/04/24 10:58 PM CST Ninety-nine. Auscultated voice sounds in anterior left mid-chest (upper lobe) Exam Action 02/04/24

10:58 PM CST Ninety-nine. Auscultated voice sounds in anterior right lower lobe Exam Action 02/04/24 10:58 PM CST Ninety-nine. Auscultated voice sounds in anterior left lower lobe Exam Action 02/04/24 10:58 PM CST Ninety-nine. Auscultated voice sounds in posterior left upper lobe Exam Action 02/04/24 10:58 PM CST Ninety-nine. Auscultated voice sounds in posterior right upper lobe Exam Action 02/04/24 10:58 PM CST Ninety-nine. Auscultated voice sounds in posterior left mid-back (lower lobe) Exam Action 02/04/24 10:58 PM CST Ninety-nine. Ninety-nine.

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Auscultated voice sounds in posterior right mid-back (lower lobe) Exam Action 02/04/24 10:58 PM CST Ninety-nine. Ninety-nine. Ninety-nine. Auscultated voice sounds in posterior left lower lobe near spine Exam Action 02/04/24 10:58 PM CST Ninety-nine. Ninety-nine. Ninety-nine. Auscultated voice sounds in posterior right lower lobe near spine Exam Action 02/04/24 10:58 PM CST Ninety-nine. Auscultated voice sounds in posterior left lower lobe on side Exam Action 02/04/24 10:58 PM CST Ninety-nine. Auscultated voice sounds in posterior right lower lobe on side Exam Action 02/04/24 10:58 PM CST

Ninety-nine. Auscultated voice sounds in posterior right lower lobe Exam Action 02/04/24 10:59 PM CST Ninety-nine. Auscultated voice sounds in posterior left lower lobe Exam Action 02/04/24 10:59 PM CST Ninety-nine. Auscultated voice sounds in posterior right lower lobe on side Exam Action 02/04/24 10:59 PM CST Ninety-nine. Auscultated voice sounds in posterior left lower lobe on side Exam Action 02/04/24 10:59 PM CST Ninety-nine. Ninety-nine. Auscultated aortic area with the bell Exam Action 02/04/24 10:59 PM CST Auscultated pulmonic area with the bell Exam Action 02/04/24 10:59 PM CST Auscultated pulmonic area with the diaphragm Exam Action 02/04/24 10:59 PM CST

Auscultated pulmonic area with the bell Exam Action 02/04/24 10:59 PM CST Auscultated Erb's point with the bell Exam Action 02/04/24 10:59 PM CST Auscultated Erb's point with the diaphragm Exam Action 02/04/24 10:59 PM CST Auscultated aortic area with the diaphragm Exam Action 02/04/24 10:59 PM CST Auscultated aortic area with the bell Exam Action 02/04/24 10:59 PM CST Auscultated tricuspid area with the bell Exam Action 02/04/24 10:59 PM CST Auscultated tricuspid area with the diaphragm Exam Action 02/04/24 10:59 PM CST Auscultated mitral area with the diaphragm Exam Action 02/04/24 11:00 PM CST Auscultated mitral area with the bell Exam Action 02/04/24 11:00 PM CST Percussed anterior right upper lobe Exam Action 02/04/24 11:00 PM CST Percussed anterior left upper lobe Exam Action 02/04/24 11:00 PM CST Percussed anterior right middle lobe Exam Action 02/04/24 11:00 PM CST

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Percussed anterior left mid-chest (upper lobe) Exam Action 02/04/24 11:00 PM CST Percussed anterior right lower lobe Exam Action 02/04/24 11:00 PM CST Percussed anterior left lower lobe Exam Action 02/04/24 11:00 PM CST Percussed posterior left upper lobe Exam Action 02/04/24 11:00 PM CST Percussed posterior right upper lobe Exam Action 02/04/24 11:00 PM CST Percussed posterior right mid-back (lower lobe) Exam Action 02/04/24 11:00 PM CST Percussed posterior left mid-back (lower lobe) Exam Action 02/04/24 11:00 PM CST Percussed posterior left lower lobe Exam Action 02/04/24 11:00 PM CST Percussed posterior right lower lobe Exam Action 02/04/24 11:01 PM CST Percussed posterior left lower lobe on side Exam Action 02/04/24 11:01 PM CST Percussed posterior left right lobe on side Exam Action 02/04/24 11:01 PM CST Percussed posterior left lower lobe near spine Exam Action 02/04/24 11:01 PM CST

Percussed posterior right lower lobe near spine Exam Action 02/04/24 11:01 PM CST Checked vitals Exam Action 02/04/24 11:11 PM CST

Shadow Health Cough 1

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