PRIMARY-CARE FOR WOMEN - MANAGEMENT OF COMMON RESPIRATORY-PROBLEMS

This article reviews the clinical management of common respiratory ill nesses that primary care providers encounter in an out-patient setting . The latest recommendations from the American Thoracic Society, the N ational Heart, Lung, and Blood Institute, and the Centers for Disease Control and Prevention are summarized. The article discusses the causa tive organisms and antibiotics of choice for community-acquired pneumo nia, and how to determine which patients require hospitalization. The appropriate use of asthma medications is described in detail, along wi th strategies for reducing aeroallergen exposure and for educating pat ients. An extensive section covers the interpretation of tuberculin sk in tests and use of prophylactic isoniazid for preventive therapy of l atent tuberculous infection, as well as the treatment of active tuberc ulosis. Controversies regarding antibiotics for both acute and chronic bronchitis are discussed, along with other treatment options includin g over-the-counter medications, bronchodilators, and non-pharmacologic interventions. Finally, a strategy for dealing with the complaint of chronic cough is outlined. Although many of these conditions require a ctive comanagement by collaborating physicians, the nurse-midwife will be better able to communicate with and advocate for her clients if sh e possesses expanded and current knowledge of treatment strategies.