NURS-6541 Primary Care Adolescnt & Child Week 6 Discussion

NURS-6541 Primary Care Adolescnt & Child Week 6 Discussion

Diagnosis and Management of Respiratory, Cardiovascular, and Genetic Disorders

Discussion board posting assignments are assigned alphabetically by FIRST NAME to ensure all cases are covered and discussed.

Case Study 1: A-F

Case Study 2: G-M

Case Study 3: N-T

Case Study 4: U-Z

Case Study 1:

HPI: A 14-month-old brought Native American boy by his mom due to cough, low grade fever and runny nose for the past 2 days. This morning, the mother noted that her son was breathing quickly and “it sounds like she has rice cereal popping in her throat.” Mom is worried because her son seems to have a lot of ‘bouts of colds”. Per mom, his oral intake is decreased. He didn’t want to eat this morning.

PE: Smiling, alert Caucasian boy.

VS: Temp of 99.9, pulse 112, resp. 42 reveals the following: respiratory rate is 58 HEENT: There is moderate, thick, clear rhinorrhea and postnasal drip.

CV: Her capillary refill is less than 3 seconds

PULM: lung sounds are diminished in the bases, she has pronounced intercostal and subcostal retractions, expiratory wheezes are heard in all lung fields.

Case Study 2:

HPI: Brian is a 14-year-old known asthmatic with a 2-day history of worsening cough and shortness of breath. He reports using every 3-4 hours over the previous 24 hours. He has a long-acting inhaled corticosteroid. He can’t recall which one. He said he ran out a few weeks ago and has not had time to obtain a refill. He denies cigarette smoking, but his clothing smells like smoke.

PE: Patient is sitting by himself. His parents are in the room during the visit. No purse lip breathing noted. Occasional nonproductive coughing during the interview.

PULM: You note prolonged expiration and expiratory wheezes in all lung fields. There are no signs of dyspnea.

Case Study 3:

HPI: A father brought his 7-year-old with a 3-day history of cough. Dad states that his son is coughing up yellow mucus. The boy is afebrile and is sleeping through the night, but the father’s sleep is disturbed listening to his son coughing. Dad says he thinks his son has bronchitis and is requesting treatment.

PE: VS: respiratory rate 18,

HEENT: there is no cervical adenopathy, nasal turbinates are slightly enlarged, and there is moderate clear rhinorrhea.

PULM: lungs are clear to auscultation, patient is able to take deep breaths without coughing.

Case Study 4

HPI: Miguel is a Latino 15-year-old male who presents for a sports physical. He is a healthy adolescent with no complaints. He plays basketball.

PE: He is 6 feet 5 inches tall and weighs 198 pounds.

MS: You note long arms and long thin fingers. He has joint laxity in his wrists, shoulders, and elbows.

Case Study 5:

HPI: Trina’s mother is concern that her daughter is a picky eater and refuses to eat fruits and vegetables. Her physical activity includes soccer practice for 1 hour a week with one game each weekend from September through November.

FMH: negative for myocardial infarction, but both parents take medication for dyslipidemia.

PE: Trina is a Native American 10-year-old female very engaging when answering questions. Vital signs are as follows: BP 122/79, P 98, R 20. Wt. 110, Ht. 4’11

Case Study 6:

HPI: You see a 2-month-old for a well-child visit. She is breastfed and nurses every 2 to 3 hours during the day, but her mother reports she is not nursing as vigorously as before. She sleeps one 4-hour block at night. PMH: Birth weight was 7 pounds 5 ounces. Weight gain over the last 2 weeks reveals gain of 5 ounces per week.

PE: Fussy two-month-old Chinese infant.

PULM: lung sounds are clear

CV: a new III/VI systolic ejection murmur is noted along the left lower sternal border, cap refill is brisk, skin is pink and moist.

ABD: bowel sounds noted in all quadrants.

To prepare for NURS-6541 Primary Care Adolescnt & Child Week 6 Discussion:

Review “Respiratory Disorders,” “Cardiovascular Disorders,” and “Genetic Disorders” in the Burns et al. text.

Review and select one of the six provided case studies. Analyze the patient information.

Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.

Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.

Consider strategies for educating patients and families on the treatment and management of the respiratory disorder.

By Day 3

Post an analysis of your assigned case by using the following:

What additional questions will you ask?

Has the case addressed the LOCATES mnemonic? If not, what else do you need to ask? What additional history will you need? (Think FMH, allergies, meds, and so forth that might be pertinent in arriving to your differential diagnoses)

What additional examinations or diagnostic tests, if any will you conduct?

What are your differential diagnoses? What historical and physical exam

features support your rationales? Provide at least 3 differentials.

What is your most likely diagnosis and why?

How will you treat this child?

Provide medication treatment and symptomatic care.

Provide correct medication dosage. Use the knowledge you learned from this week’s and previous weeks’ readings as well as what you have learned from pharmacology to help you with this area.

Patient Education, Health Promotion & Anticipatory guidance:

Explain strategies for educating parents on their child’s disorder and reducing any concerns/fears presented in the case study.

Include any socio-cultural barriers that might impact the treatment and management plans.

Health Promotion:

What immunizations should this child have had?

Based on the child’s age, when is the next well visit?

At the next well visit, what are the next set of immunizations?

What additional anticipatory guidance should be provided today?

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days in both of the ways listed below. Respond to a colleague who chose one of the first three case studies and a second colleague who chose one of the last three case studies. Choose colleagues who selected a different case study than you did.

Explain how culture might impact the diagnosis, management, and follow-up care of patients with the respiratory, cardiovascular, and/or genetic disorders your colleagues discussed.

Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or different perspectives. NURS-6541 Primary Care Adolescnt & Child Week 6 Discussion.

 

MORE INFO 

Primary Care Adolescnt & Child

Introduction

Pediatricians are physicians who specialize in the diagnosis and treatment of disease in children and adolescents. They provide care for children from birth through adolescence, including early childhood through adulthood. Pediatricians are trained in pediatric medicine and subspecialty training, and they often do research related to pediatric issues.

Pediatrician focuses on adolescents and children.

Pediatricians are trained to treat children and adolescents. They specialize in the health of children from birth through adolescence, with a focus on mental health issues as well as physical conditions such as asthma or diabetes. Pediatricians also have knowledge of developmental stages for children, including growth charts that show how much weight a child should gain over time (and when).

Pediatricians may see patients at any age but are most likely to do so during their first year of life or adolescence (ages 5-18).

The care of the adolescent can be provided by a primary care provider or through a managed health care organization.

When you are looking for a pediatrician, ask yourself these questions: What is my child’s age? Does he or she have any medical conditions that need to be monitored by a physician? What should I expect when visiting this office?

If you are asking these questions and feeling overwhelmed with the choices, it may be time to consider finding one of our many physicians who specialize in adolescent medicine. These doctors understand how challenging it can be for teens as they transition into adulthood; they have seen many patients go through similar issues at their own ages!

A pediatrician must have an excellent understanding of the physical and emotional changes that children undergo during puberty.

Puberty is a process that occurs in boys and girls, during which the body matures. It’s important to know what puberty is and how it affects your child because it can be confusing for parents and doctors alike.

During puberty, the body begins producing sex hormones (testosterone in boys, estrogen in girls) that cause physical changes such as hair growth, deepening voices and changes in skin texture. These physical changes are accompanied by emotional ones like increased self-confidence or depression related to sexual feelings. If you suspect your child has gone through puberty but aren’t sure which stage they’re at—or if you want more information about how these stages affect children—you should contact their pediatrician immediately!

A pediatrician is an internist who specializes in the diagnosis and treatment of disease in children and adolescents.

A pediatrician is a physician who specializes in the care of infants, children, and adolescents. Pediatricians are trained to diagnose and treat the medical problems that affect children. They also screen for conditions that may become serious if not treated.

Pediatricians offer advice on how best to manage health issues like asthma, diabetes or high blood pressure—conditions which could be life-threatening but are manageable with proper treatment by your child’s doctor. If you have concerns about your child’s health or feel they should see a specialist instead of their primary care doctor (PCP), talk with them first. Your PCP will take into account what you say as well as any other relevant information such as recent tests results before making any treatment recommendations based solely on these factors alone.”

Conclusion

Pediatricians are primary care providers who have special training and expertise in the diagnosis, treatment, and prevention of diseases in children. They are also qualified to provide the best possible care for their patients through a variety of services available at their office or clinic. The pediatrician is an excellent resource for parents looking for answers about their child’s health as well as information about how diet can affect his or her growth.