THE CASE OF an Egyptian- British Boy A boy aged 12 years presented to the tuberculosis clinic (TB) with a several year h

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THE CASE OF an Egyptian- British Boy A boy aged 12 years
presented to the tuberculosis clinic (TB) with a several year
history of a chronically productive cough with associated shortness
of breath and wheeze. He also reported of lethargy, night sweats
and weight loss. He had been screened for TB, with a negative
Mantoux test, 5 years previously. Initially, the patient had been
managed by his GP who had referred him on to secondary care with
suspected asthma. At this point, he was started on a budesonide
with formoterol preventer inhaler (Symbicort) and terbutaline
sulfate turbohaler (Bricanyl) to variable effect. Owing to his
ongoing symptoms, a chest X-ray was performed which revealed
bilateral hilar lymphadenopathy, resulting in a referral to the TB
clinic. On initial examination at the TB clinic, his chest was
clear on auscultation and he had several small submandibular lymph
nodes. His height and weight were on the 9th centile for his age.
Repeat TB investigations, including Mantoux, T-spot and sputum AFB,
were negative. His sputum culture grew Staphylococcus aureus and he
was treated for a lower respiratory tract infection with 2 weeks of
coamoxiclav (amoxicillin with clavulanic acid). On admission, he
was still symptomatic with a chronically productive cough and poor
appetite. Further questioning revealed abdominal pain and
steatorrhoea. Examination at this point revealed finger clubbing
prompting further investigations into an underlying chronic
respiratory condition.
TASKS: Complete the following activities to provide high
quality, individualized care for the patient. Accomplish the
worksheet below (Prehospital Care Record)
1. Discharge instructions (METHOD) M- Medication E- Environment
T- treatment H- Health teaching O- Output patient referal D-
Diet