Diagnosis and management of acute bronchitis and pneumonia in the ambulatory setting

Acute bronchitis and pneumonia are frequently encountered by primary care providers in an outpatient setting. The primary care nurse practitioner plays an active role in the diagnosis and management of acute bronchitis and pneumonia. Certain elements of the history and physical examination help separate infectious causes of acute cough from non-infectious causes. If an infectious cause is established by etiology, history and physical factors also help to identify whether acute bronchitis or pneumonia is present. Certain diagnostic tests are necessary to aid in making the diagnosis and in establishing the causative agent upon which the appropriate therapy is based. The primary care nurse practitioner must also be attuned to identifying those clients in whom respiratory illness can be a severe syndrome necessitating hospitalization and those for whom vaccination is recommended. This article addresses the practice needs of the clinician.