Assignment: Case Scenario of an Asthma Patient

Assignment: Case Scenario of an Asthma Patient

A Sample Answer For the Assignment: Assignment: Case Scenario of an Asthma Patient

Title: Assignment: Case Scenario of an Asthma Patient

Case Overview

The case scenario is of a 15-year-old female who presents with complaints of dyspnea, and a cough with no sputum that occurs at night. She reports that she used to have the symptoms only when she engages in extreme exercises, but lately, she has had the symptoms continuously. She reports no complaints in the respiratory, gastrointestinal, and urinary systems. In addition, she has a history of seasonal allergies, which she manages with nasal steroid spray and has no other relevant medical and surgical history. In her family history, the mother has a history of eczema and hypersensitivity reactions while the father has hypertension. On physical examination, she is in no distress. Vital signs include temperature of 98.6 F, pulse 80b/min, BP 120/80, and respiration rate of 20b/min. Auscultation of the chest reveals limited air flow and wheeze on expiration in the lungs. Chest percussion, reveals resonant lungs.

Chief Complaint

The chief complaint is continuous dyspnea and a cough with no sputum production that mostly occurs at night.

Differential Diagnosis

1. Asthma: Asthma is a chronic reversible condition resulting from inflammation of airways. Inflammation causes airway hyperactivity, edema, and production of mucus, causing bronchoconstriction (Drake, Simpson & Fowler, 2019). The narrowing of the airways results to obstruction of airflow in the lungs and leads to intermittent asthmatic episodes. The hallmark symptoms of asthma are wheezing non-productive cough, and shortness of breath (Drake, Simpson & Fowler, 2019). Wheezing, which is the most typical symptom, is a musical high-pitched whistling sound that is heard during expiration. The risk factors for exacerbation of asthma symptoms are allergens, exposure to cold, exercise, stress, and medications such as aspirin (Drake, Simpson & Fowler, 2019). Asthma is a probable diagnosis as per positive subjective findings of a dyspnea and a cough with no sputum production that occurs with extreme exercises and at night. There are also positive objective findings of limited air flow and wheeze on auscultation.
2. Vocal cord dysfunction (VCD): VCD occurs when vocal cords are adducted when inhaling. The adduction results in airflow

   

   obstruction at the laryngeal level (Weinberger & Doshi, 2017). Symptoms of VCD include wheezing, cough, stridor, shortness of breath, voice hoarseness, and a sensation of throat tightness. On auscultation, stridor is perceived in the laryngeal area, and wheezing is heard on the chest (Weinberger & Doshi, 2017). The symptoms are unresponsive to corticosteroids and bronchodilators. VCD is a likely diagnosis based on the patient’s positive symptoms of dyspnea, cough, and wheezing. There are negative findings, however, of airflow obstruction on the laryngeal area.

3.Bronchiectasis: The classic symptom is cough and prolonged daily production of mucopurulent sputum (Chalmers, Aliberti & Blasi, 2015). Other symptoms include shortness of breath, fever, chest pain, fatigue, and generalized body weakness. Physical findings include crackles, scattered wheeze, rhonchi, cyanosis, and muscle wasting (Chalmers, Aliberti & Blasi, 2015). Bronchiectasis is a probable diagnosis as per positive findings of shortness of breath, wheeze, and cough. However, there are negative findings of sputum production, chest pain, and fever.

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Treatment Plan

Workups

• Pulmonary function testing to assess the severity of airway obstruction and to make an asthma diagnosis.
• Methacholine challenge to assess airway hypersensitivity and guide in making an accurate diagnosis of asthma (Drake, Simpson & Fowler, 2019).
• Provocative tests to assess the severity of airway obstruction when exposed to cold or during physical activities

Medications

1. a) Ventolin HFA aerosol inhaler 2 puffs QID. This is a bronchodilator that acts by relaxing bronchial smooth muscles to relieve bronchospasm (Lommatzsch & Stoll, 2016). It prevents episodes of bronchospasm in exercise-related and nocturnal asthma.
2. b) Prednisolone 30 mg qDay. It acts by suppressing inflammatory receptors and reversing the inflammation process (Lommatzsch & Stoll, 2016). It is also used in the management of acute and chronic asthma to prevent exacerbation of asthma symptoms.
3. c) Beclomethasone inhalant 80mcg B.D. It is an anti-inflammatory drug that acts by inhibiting bronchoconstriction. It also relaxes bronchial smooth muscles resulting in Broncho-dilation.

Health Promotion

a). Allergen avoidance: I will offer health education on avoiding allergens such as cold, dust, and vigorous exercises to prevent exacerbation of asthma symptoms.

b). Medication adherence; health education will be offered on the importance of adhering to the drug regimen prescribed to prevent frequent asthma exacerbations.

c). Healthy diet; I will offer nutrition counseling on the importance of a healthy diet and advise the patient to take food having a high vitamin content and a lot of fruits to boost the immune system.

d). Exercises – I will advise the patient to engage in non-strenuous activities such as jogging, walking, and cycling. However, she will be advised not to engage in vigorous exercises and to rest when she experiences shortness of breath.

Referrals

Referral to an allergy specialist for a skin test that will help to identify specific allergens that trigger asthma exacerbations (Lommatzsch & Stoll, 2016). Identification of allergens will help in preventing the particular allergens.

Follow-up

The first clinic follow up of the patient will be after two weeks to assess for improvement in the alleviation of asthma symptoms. After the first visit, I will schedule follow-ups after every three months to assess comorbid conditions and assess improvement.

This week you learned about common conditions in the adolescent client. Please review the following case study and answer the following questions.
A fifteen-year-old female presents to your clinic complaining of shortness of breath and a nonproductive nocturnal cough. She states she used to feel this way only with extreme exercise, but lately, she has felt this way continuously. She denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her past medical history is significant only for seasonal allergies, for which she takes a nasal steroid spray but is otherwise on no other medications. She has had no surgeries. Her mother has allergies and eczema, and her father has high blood pressure. She is the only child. She denies smoking and illegal drug use. On examination, she is in no acute distress and her vital signs are: T 98.6, BP 120/80, pulse 80, and respirations 20. Her head, eyes, ears, nose, and throat examinations are essentially normal. Inspection of her anterior and posterior chest shows no abnormalities. On auscultation of her chest, there is decreased air movement and high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs.
What is the chief complaint?
Based on the subjective and objective information provided what are your 3 top differential diagnosis listing the presumptive final diagnosis first?
What treatment plan would you consider utilizing current evidence based practice guidelines?
Submission Details:

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource