Final answer:
A patient with a productive cough, runny nose, fever, and coarse rhonchi likely has acute bronchitis. The next step is a chest radiograph to rule out pneumonia and possibly sputum cultures. Treatment may include symptomatic relief and antibiotics.
Step-by-step explanation:
The case presents a patient with a productive cough of yellow-green sputum, runny nose, and a temperature of 100.8°F, along with coarse rhonchi on lung examination. The clinical picture is suggestive of a lower respiratory tract infection, such as bronchitis or pneumonia. Given the symptoms and the physical findings, the preliminary diagnosis could be acute bronchitis. This condition often follows a cold or viral infection and is characterized by increased mucus production and inflammation in the bronchial tubes.
The best next step in management would be to perform a chest radiograph to rule out pneumonia, especially if the patient has risk factors such as smoking, and to conduct further tests like sputum cultures to identify any specific pathogens. Symptomatic treatment for cough and fever, and possibly an antibiotic if a bacterial infection is suspected or confirmed, would also be recommended.