Which of the following would be an expected outcome for a client recovering from an upper respiratory tract infection? The client will:
A. Maintain a fluid intake of 800 ml every 24 hours.
B. Experience chills only once a day.
C. Cough productively without chest discomfort.
D. Experience less nasal obstruction and discharge.
Correct Answer: D. Experience less nasal obstruction and discharge.
A client recovering from an URI should report decreasing or no nasal discharge and obstruction. Decongestants and combination antihistamine/decongestant medications can limit cough, congestion, and other symptoms in adults. Avoid cough preparations in children. H1-receptor antagonists may offer a modest reduction of rhinorrhea and sneezing during the first 2 days of a cold in adults.
Option A: Daily fluid intake should be increased to more than 1 L every 24 hours to liquefy secretions. Topical and oral nasal decongestants (i.e., topical oxymetazoline, oral pseudoephedrine) have moderate benefit in adults and adolescents in reducing nasal airway resistance. Evidence-based data does not support the use of antibiotics in the treatment of the common cold because they do not improve symptoms or shorten the course of illness.
Option B: The temperature should be below 100*F (37.8*C) with no chills or diaphoresis. According to a Cochrane Review, vitamin C used as daily prophylaxis at doses of =0.2 grams or more had a “modest but consistent effect” on the duration and severity of common cold symptoms (8% and 13% decreases in duration for adults and children, respectively).
Option C: A productive cough with chest pain indicated pulmonary infection, not an URI. The presence of classical features for rhinovirus infection, coupled with the absence of signs of bacterial infection or serious respiratory illness, is sufficient to make the diagnosis of the common cold. The common cold is a clinical diagnosis, and diagnostic testing is not necessary.
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