Question

A 35 year old females patient comes to the clinic with severe hacking cough of greater than 2 weeks. She states that she has had a low-grade fever and rhinorrhea. What labs should the nurse practitioner order for this patient?

a. Nasopharyngeal swab for culture and PCR with ELISA
b. CBC with CXR and BMP
c. Nasopharyngeal swab for culture and BMP
d. ELISA and BMP

Answer 1

For a patient with a severe cough, fever, and rhinorrhea, the nurse practitioner should order a nasopharyngeal swab for culture and PCR with ELISA to accurately diagnose the infection, potentially avoiding the need for a basic metabolic panel (BMP) unless indicated by underlying conditions.

Step-by-step explanation:

The patient presenting with severe hacking cough for more than two weeks, low-grade fever, and rhinorrhea suggests a possible respiratory infection, which could be bacterial, viral, or due to other causes. Suitable laboratory tests to appropriately diagnose the condition include a nasopharyngeal swab for culture to identify any bacterial pathogens and PCR to detect viral pathogens such as influenza or RSV. In addition, ELISA as part of the workup could help confirm or rule out specific viral infections or immunological responses to pathogens. A complete blood count (CBC) is advisable to check for signs of infection or systemic response in terms of white blood cell counts, and a CXR (chest X-ray) can be useful in identifying any lung pathology such as pneumonia.

A basic metabolic panel (BMP) may not be necessary in the initial workup of an acute cough unless there are other underlying health concerns that warrant this test. Hence, the most appropriate lab tests the nurse practitioner should order are Option A: a nasopharyngeal swab for culture and PCR with ELISA.