Discussion: iHuman Case Study – HEENT and Respiratory Infections

NSG 6435 Week 4 Discussion
Discussion: iHuman Case Study – HEENT and Respiratory Infections
iHuman Case Study – HEENT and Respiratory Infections
This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.For this assignment, make sure you post your initial response to the Discussion Area.
Start reviewing and responding to the postings of your classmates as early in the week as possible.Respond to at least two of your classmates’ initial postings.Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion.Cite sources in your responses to other classmates.Complete your participation for this assignment.
To support your work, use your course textbook readings and the South University Online Library.As in all assignments, cite your sources in your work and provide references for the citations in APA format.
For this iHuman Case Study – HEENT and Respiratory Infections assignment, you will complete an iHuman case study based on the course objectives and weekly content.iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum.Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.
The iHuman assignments are highly interactive and a dynamic way to enhance your learning.Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.
Here you can view information on how to access and navigate iHuman.
This week, complete the iHuman case titled “Katherine Harris.”
Apply information from the iHuman Case Study to answer the following questions:
Do you recommend a limited or an involved use of antibiotics in treatment of these diseases and other unconfirmed bacterial illnesses and why? What are the standards regarding the use of antibiotics in pediatric population, and what assessment findings would warrant prescribing an antibiotic for Asthma symptoms?
Using national guidelines and evidence-based literature, develop an Asthma Action Plan for this patient.
Do the etiology, diagnosis, and management of a child who is wheezing vary according to the child’s age? Why or why not? Which objective of the clinical findings will guide your diagnosis? Why? When is a chest x-ray indicated in this case?
NSG 6435 Week 4 Assignment 4
Assignment 4: SOAP Note
Each week, you are required to enter your patient encounters into eMedley.Your faculty will be checking to ensure you are seeing the right number and mix of patients for a good learning experience.You will also need to include a minimum of one complete SOAP note using the Pediatric SOAP Note template.The SOAP note should be related to the content covered in this week, and the completed note should be submitted to the Dropbox.When submitting your note, be sure to include the reference number from eMedley.
Submission Details:
enter your patient encounters into eMedley and complete at least one SOAP note in the template provided.
Name your SOAP note document SU_NSG6435_W4_A4_LastName_FirstInitial.doc.
Include the reference number from eMedley in your document.
Do you recommend a limited or an involved use of antibiotics in treatment of these diseases and other unconfirmed bacterial illnesses and why? What are the standards regarding the use of antibiotics in pediatric population, and what assessment findings would warrant prescribing an antibiotic for Asthma symptoms?
Antibiotics such as penicillin are commonly used in the treatment of bacterial infections since they help prevent the further spread of diseases, in addition to reducing the serious complications of a disease. Antibiotics can either be bactericidal or bacteriostatic, depending on whether they suppress the growth of bacteria or kill them. However, some antibiotics that used to be standard treatments for bacterial infection have become less effective due to the development of resistance through bacterial mutation (Toich, 2017). As a result, the use of antibiotics should be limited to only when it is necessary, a precaution aimed at reducing the threatening trend of bacterial resistance to drugs. Sometimes patients overuse or tend to take the medication even when it is not appropriate. Most antibiotics, above 70%, have been prescribed by the ambulatory pediatrics in managing respiratory conditions; of this, 23% are prescribed for conditions that do not necessitate antibiotic treatment (Bush & Fleming, 2015). The commonly treated infections using antibiotics include asthma, cold, flu, bronchitis, most coughs, some ear infections, nisus infections and stomach flu. According to the antimicrobial stewardship programs, there is the need to stop the use of antibiotics treatment as there is no clear evidence of bacterial infections in respiratory-related diseases such as asthma (Nichols, Stoffella, Meyers, & Girotto, 2017).
Antibiotic use should only be administered when the signs and symptoms of bacterial infection have been confirmed or are suspected. As a result, it may be important to perform laboratory tests before administering antibiotics to a patient. According to a recent study that evaluates the efficacy of adding antibiotics in the treatment of asthma, there exists no measurable impact on lung function (Hekking, et al., 2015). Therefore, healthcare providers ought to embrace the evidence-based care delivery approach to facilitate high efficacy in the use of antibacterial drugs in the management of sepsis and other bacterial infections.
Using national guidelines and evidence-based literature, develop an Asthma Action Plan for this patient.
Asthma is classified into various categories based on the severity of the presenting symptoms. The condition may worsen if not managed, leading to shortness of breath and subsequently, lung collapse. Therefore, the priority in the management of the disease is opening the airways to facilitate the breathing process. The reliever medicines are usually administered to make the breathing easier and opening up of the airways. Albuterol HFA 90mcg/puff is commonly used as a reliever; patients are advised to take a puff as long as they experience difficulties in breathing. Additionally, preventive drugs are also administered to asthmatic patients to reduce inflammation and swelling of the airways. Patients can then be allowed to take about two puffs per day after they stabilize their breathing system.
Further reassessment is needed to determine the possible factors that could be triggering the inflammation, such as allergens, so that patients can receive proper advice. The etiology, diagnosis and the self-care management of children vary with age gaps. In younger children, the preschool age, wheezing may be as a result of bronchiolitis with/or RSV, whereas in older children wheezing may be as a result of asthma. The different diagnosis that can result from tests may include viral pneumonia, bacterial pneumonia, and bronchitis, among others (Horak et al., 2016). In children, asthma cases differ extensively, hence the need for parents to be educated on self-care management. In addition, education is an important component in the asthma action plan as it aims at preventing further triggers of the inflammation reactions by ensuring that the patient keeps warm and avoids all possible allergens. The written action plan is given to the clients so that they can refer even when they are discharged from the hospital.
Do the etiology, diagnosis, and management of a child who is wheezing vary according to the child’s age? Why or why not? Which objective of the clinical findings will guide your diagnosis? Why? When is a chest x-ray indicated in this case?
Various factors are likely to cause wheezing among children of different ages. As such, the treatment and management approaches used also vary depending on the age of the patient. For instance, wheezing among children may result from acute bronchitis or pneumonia, while for older children, it could most likely be a symptom of asthma. Therefore, the treatment and prescriptions made should be based on the differential diagnosis findings to avoid the adoption of a wrong treatment plan. In this case, the patient reported of having dynamics of shortness of breath that had persisted for some time and the condition got worse day after day. The objective data used to diagnose the patient’s condition included shortness of breath, coughing, hacks and spit ups, and decreased oxygen saturation. Asthma is characterized by difficulties in breathing and production of wheezing sound; the symptoms corroborate the findings as per the objective data (Aaron, Boulet, Reddel, & Gershon, 2018). The chest X-ray could be used in case pneumonia was suspected since it helps to identify the affected regions in the respiratory system.
References
Aaron, S. D., Boulet, L. P., Reddel, H. K., & Gershon, A. (2018). Under-diagnosis and Over-diagnosis of Asthma. American journal of respiratory and critical care medicine, (ja).
Bush, A., & Fleming, L. (2015). Diagnosis and management of asthma in children. bmj, 350, h996.
Hekking, P. P. W., Wener, R. R., Amelink, M., Zwinderman, A. H., Bouvy, M. L., & Bel, E. H. (2015). The prevalence of severe refractory asthma. Journal of Allergy and Clinical Immunology, 135(4), 896-902.
Horak, F., Doberer, D., Eber, E., Horak, E., Pohl, W., Riedler, J., … & Studnicka, M. (2016). Diagnosis and management of asthma–Statement on the 2015 GINA Guidelines. Wiener Klinische Wochenschrift, 128(15-16), 541-554.
Nichols, K., Stoffella, S., Meyers, R., & Girotto, J. (2017). Pediatric Antimicrobial Stewardship Programs. The Journal of Pediatric Pharmacology and Therapeutics, 22(1), 77-80.
Toich, L. (ed.) (2017). Pediatric Patients with Asthma overprescribed Antibiotics. The American Journal of Pharmacy Benefits. Retrieved from