Important parts of her history:

 Coughing fits for the past 6 days

 5 upper respiratory infections and associated coughing in the 18 months
 Cough as “dry” and says during times of infection, she wakes up coughing more than once a
night

Explanation of Symptoms:
 Cystic Fibrosis—frequent infections and coughing

Recommendations for Melissa

There is no cure for CF so I’d give her and her parents a list of specialists to go to, to start medications
and treatments. She will need to see a pulmonologist of course but also a gastroenterologist, as people
with cystic fibrosis can develop complication in the pancreas, liver and intestines, which can lead to
malnutrition, constipation, liver disease, and CF-related diabetes, other digestive issues as well such as
abdominal pain and a poor appetite which brings me to recommending them a nutritionist, they will
need to better their diet for less risk of developing infections. Melissa will also need to see a respiratory
therapist.

Pulse Ox.:
 Non-invasive test to measure your oxygen saturation
 Can rapidly detect slight changes in oxygen efficiency to extremities furthest from the heart