course material

1. Case Studies 1–3 Respiratory disorders such as pneumonia and asthma
are among the leading causes of hospitalization in pediatric patients (U.S.
Department of Health and Human Services, 2011). With suc
QUESTIONJUL 07, 2019Case Studies 1–3 Respiratory disorders such as pneumonia and
asthma are among the leading causes of hospitalization in pediatric patients (U.S.
Department of Health and Human Services, 2011). With sucCase Studies 1–3Respiratory
disorders such as pneumonia and asthma are among the leading causes of hospitalization in
pediatric patients (U.S. Department of Health and Human Services, 2011). With such severe
implications associated with many respiratory disorders, advanced practice nurses must be
able to quickly identify symptoms, diagnose patients, and recommend appropriate
treatment. For this Discussion, consider potential diagnoses and treatments for the patients
in the following three case studies.Case Study 1:A 14-month-old female presents with a 4-
day history of nasal congestion and congested cough. This morning, the mother noted that
her daughter was breathing quickly and “it sounds like she has rice cereal popping in her
throat.” Oral intake is decreased. Physical examination reveals the following: respiratory
rate is 58, lung sounds are diminished in the bases, she has pronounced intercostal and
subcostal retractions, expiratory wheezes are heard in all lung fields, and her tympanic
membranes are normal. There is moderate, thick, clear rhinorrhea and postnasal drip. Her
capillary refill is less than 3 seconds, and she is alert and smiling. Her RSV rapid antigen test
is positive.Case Study 2:Brian is a 14-year-old known asthmatic with a 2-day history of
worsening cough and shortness of breath. He reports using a short-acting beta agonist
every 3 hours over the previous 24 hours. He has a long-acting inhaled corticosteroid, but
the prescription ran out, and he forgot to get it refilled. He says he came today because he
woke up at 2 a.m. coughing and couldn’t stop, thus preventing him from going back to sleep.
Over-the-counter cough suppressants don’t help. He denies cigarette smoking, but his
clothing smells like smoke. His respiratory rate is 18 and he has prolonged expiration and
expiratory wheezes in all lung fields. There are no signs of dyspnea. All other exam findings
are normal.Case Study 3:A father presents his 9-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. Physical examination reveals the
following: respiratory rate is 18, lungs are clear to auscultation, patient is able to take deep
breaths without coughing, there is no cervical adenopathy, nasal turbinates are slightly

2. enlarged, and there is moderate clear rhinorrhea.Case Studies 4–6Assessing, diagnosing,
and treating pediatric patients for many cardiovascular and genetic disorders can be
challenging. As an advanced practice nurse who facilitates care for patients presenting with
these types of disorders, you must be familiar with current evidence-based clinical
guidelines. Because of the clinical implications, you have to know when to treat patients
with these disorders and when to refer them for specialized care. In this Discussion, you
examine the following case studies and consider appropriate treatment and management
plans.Case Study 4:Miguel is a 15-year-old male who presents for a sports physical. He is a
healthy adolescent with no complaints. He plays basketball. He is 6 feet 5 inches tall and
weighs 198 pounds. You note long arms and long thin fingers. He has joint laxity in his
wrists, shoulders, and elbows.Case Study 5:Trina is a 9-year-old female who weighs 110
pounds. Vital signs are as follows: BP 122/79, P 98, R 20. Her mother reports she 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. Family
history is negative for myocardial infarction, but both parents take medication for
dyslipidemia.Case Study 6: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. Birth weight was 7 pounds 5
ounces. Weight gain over the last 2 weeks reveals gain of 5 ounces per week. Physical
examination reveals the following: HEENT exam is benign, lung sounds are clear, a new
III/VI systolic ejection murmur is noted along the left lower sternal border, cap refill is
brisk, skin is pink and moist, and abdominal exam is benign.To prepare: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 3Post an explanation of the differential diagnosis for the patient in the case
study you selected. Explain which is the most likely diagnosis for the patient and why.
Include an explanation of unique characteristics of the disorder you identified as the
primary diagnosis. Then, explain a treatment and management plan for the patient,
including appropriate dosages for any recommended treatments. Finally, explain strategies
for educating patients and families on the treatment and management of the respiratory,
cardiovascular, and/or genetic disorder.