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Chapter 84: Acute Bronchitis Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. A patient develops a dry, nonproductive cough and is diagnosed with bronchitis. Several days later, the cough becomes productive with mucoid sputum. What may be prescribed to help with symptoms?

a. Antibiotic therapy b. Antitussive medication c. Bronchodilator treatment d. Mucokinetic agents

ANS: B a. A prescription for a macrolides b. Isolation if paroxysmal cough develops c. Pertussis vaccine booster d. Symptomatic care only

Antitussive medications are occasionally useful for short-term relief of coughing. Antibiotic therapy is generally not needed and should be avoided unless a bacterial cause is likely. Bronchodilator medications show no demonstrated reduction in symptoms and are not recommended. Mucokinetic agents have no evidence to support their use.

2. An adult patient who had pertussis immunizations as a child is exposed to pertussis and develops a runny nose, low-grade fever, and upper respiratory illness symptoms without a paroxysmal cough. What is recommended for this patient?

ANS: A

NURSINGTB.COM a. Trimethoprim-sulfamethoxazole therapy b. Antibiotic therapy c. Supportive care d. Antitussive therapy

Adults previously immunized against pertussis may still get the disease without the classic whooping cough sign seen in children and are contagious from the beginning of the catarrhal stage of runny nose and common cold symptoms. Macrolide antibiotics are useful for reducing symptoms and for decreasing shedding of bacteria to limit spread of the disease. Patients should be isolated for 5 days from the start of treatment. Pertussis vaccine booster will not alter the course of the disease once exposed. Symptomatic care only will not reduce symptoms or decrease disease spread.

3. A 35-year old patient develops acute viral bronchitis. Which is the focus for the management of symptoms in this patient?

ANS: C

The mainstay of treatment in acute bronchitis is directed toward symptom reduction and supportive care. Data suggest that 85% of patients diagnosed with acute bronchitis will improve without specific treatment. Trimethoprim-sulfamethoxazole is prescribed for pertussis when macrolides are not an option. Antibiotic therapy is not effective in treating viral acute bronchitis.

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