Signs and Symptoms of Sinusitis

Case scenario:
Sandy is a 64-year-old patient with a 10-year history of recurrent sinusitis. She presents to your primary care clinic today complaining of"head congestion." She also reports that she had a "cold" last week with symptoms of cough and "runny nose." Two days ago, she developed a headache which was "worse" when bending over but improved with Tylenol. She describes the headache as a "3 out of 10" and says it is primarily a "frontal headache." She also reports that her nasal congestion has become worse; she has been blowing her nose even more; and the discharge from her nose has become thicker, with a yellow-green color. She has been taking pseudo-ephedrine for the past 48 hours with little relief of her nasal congestion. She denies tooth pain or pain on chewing. She has no past history of seasonal allergies, although she was treated for sinusitis 6 mo ago in your clinic as well as approx. 1 yr ago.
The remainder of her medical history is essentially negative.
Her vital signs are: blood pressure: 128/88; Pulse: 78 and regular; Respiratory rate: 20 p/min, non-labored.Her temp taken at the clinic is 99.6°F.
On physical examination, she has tenderness to palpation in the frontal area, no maxillary tenderness, nasal mucosa is erythematous as is her pharynx. Her submaxillary nodes are enlarged bilaterally, but there is no cervical lymphadenopathy. Her canals are clear bilat, with mild retraction noted, no redness, landmarks identified, TM's intact pearly gray. Her lungs are clear to auscultation. Her heart has a regular rate and rhythm and is negative for murmurs, gallops, and rubs.
Readings required:
1.Hollier, A. (2021). Clinical Guidelines in Primary Care 4th edition. Advanced Practice Education Associates (APEA): Lafayette, LA. ISBN: 978-1-892418-27-2
2. Dunphy, L. M., Winland-Brown, J., Porter, B., & Thomas, D. (2015). Primary care: Art and science of advanced practice nursing. FA Davis.
Questions: (just answers the questions based on given readings)
Q1. What symptoms and signs are most indicative of a diagnosis for sinusitis? Which are not? How many of these symptoms/signs does Sandy have?
Q2. What are some other things you might do to better assess Sandy? Are there assessments missing you would want to complete?
Q3. What are your therapeutic options?
Q4. What plan of care as a group do you decide on today & how?
At this point you should have started to make your Clinical Decision tree document.
Q5. What follow-up do you need to do on Sandy based on your plan of care today? What patient education should be completed?
Q6. If you choose a medication, either OTC or prescription, how did you decide which medication to order? What factors were considered? Is there any information specific to this patient that was important to educate on?