The patient is most likely to say that she cannot concentrate on her household duties due to the cold and the lack of energy. This factor might influence her feeling of insecurity towards family life. She might also be willing to know whether her state would last long since she does not want to be a burden for her husband.
The first thing that should be identified in this case is the length of symptoms. A nurse should ask about any similar cases in the past to exclude a chronic illness. Also, it would be helpful to identify whether the patient had respiratory issues before.
The patient mentioned several symptoms that are typical for a cold or other viral respiratory infection. However, a nurse discovered some other symptoms that did not fall in line with this diagnosis. If it appears that they are regular, then the VA/DoD clinical practice guideline for the management of chronic multisymptom illness must be considered (National Guideline Clearinghouse, 2014).
Since the first symptom is associated with a painful cough, the patient should undergo a photofluorography to exclude such illnesses as tuberculosis or lung cancer. A blood test should be done as a standard procedure. Finally, heart functions should be evaluated by using a cardiograph.
Since the mentioned symptoms can serve as evidence for different illnesses, various specialists should be included in the process. A nurse should consult a cardiologist and an infection specialist. A doctor specializing in diabetes should provide consultation about any special conditions for treatment. Besides, consulting other doctors is recommended by the National Guidelines.
The nursing diagnosis would be a severe cough and chronic fatigue associated with it due to the lack of sleep. The medical diagnosis could be anything depending on the test results. While respiratory issues give an idea about pneumonia, other symptoms show that the problem is more serious than that. It is possible that a long treatment would be required to cure the illness.
Legal and Ethical Considerations
It is important for a nurse to discuss whether the patient has any ethical objections towards different kinds of treatment. In a case, if she refuses to be treated in a certain way, a nurse will not have to discuss it with her husband. However, if it becomes clear that the patient is harming herself, a nurse will have a responsibility of addressing a court for it to insist on treatment.
If the pneumonia diagnosis is proven, a doctor should prescribe antibiotics. A nurse should offer medication preventing a cough along with sleeping drugs. Complementary therapy actions would include walks in the fresh air and drinking a lot of warm beverages.
Healthy People 2020
The primary objective should be Immunization and Infectious Diseases (Healthy People 2020, n. d.). However, the case includes evidence of several medical issues. Thus, objectives like Diabetes or Sleep Health could also be useful.
Circle of Caring
The Circle of Caring identifies patience as one of the important processes in health care (Dunphy, Winland-Brown, Porter, & Thomas, 2015, p. 13). A nurse should take time to investigate the case and offer some additional treatment if required. Another factor lies in issuing supplementary therapy. Specialists from other fields could be included to help the patient recover over time.
Dunphy, L., Winland-Brown, J., Porter, B., & Thomas, D. (2015). Primary care: Art and science of advanced practice nursing (4th ed.). Philadelphia, PA: F. A. Davis Company.
Healthy People 2020. (n. d.) Immunization and infectious diseases. Web.
National Guideline Clearinghouse. (2014). VA/DoD clinical practice guideline for the management of chronic multisymptom illness. Web.