Assignment: iHuman Case Study- HEENT and Respiratory Infections

Assignment: iHuman Case Study- HEENT and Respiratory Infections

Sample Answer for Assignment: iHuman Case Study- HEENT and Respiratory Infections Included After Question

For this 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.

Click here for information on how to access and navigate iHuman.

This week, complete the iHuman case titled \”Katherine Harris V3.1 PC.”

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?

A Sample Answer For the Assignment: Assignment: iHuman Case Study- HEENT and Respiratory Infections

Title:  Assignment: iHuman Case Study- HEENT and Respiratory Infections

Do you recommend limited or involved the use of antibiotics in the treatment of these diseases and other unconfirmed bacterial illnesses and why? What are the standards regarding the use of antibiotics in the pediatric population, and what assessment findings would warrant prescribing an antibiotic for Asthma symptoms?

Asthma is a reversible respiratory chronic condition which involves inflammation of the airways, increased mucus production and edema, which may trigger coughing, shortness of breath and wheezing. It can be a lifestyle limiting health condition with no cure but requires close monitoring and adequate management of the symptoms. Childhood asthma, on the other hand, has been classified by most treatment guidelines as mild, moderate and persistent, depending on the severity and persistence of the symptoms, of which differ in the type of medication that is recommended for the management of the symptoms (Baan et al., 2018). A diagnosis of asthma was made based on the findings from the pulmonary function tests that were conducted on Katherine Harris. According to the CDC, the triggers of asthma include indoor or outdoor allergens, medications, mold, pets, exercise, infections, pets and tobacco smoke among others.

The clinical report recommends that clinicians should use the most appropriate diagnostic criteria for pediatrics before deciding on what medication to prescribe. For instance, certain instances as acute bacterial sinusitis, pharyngitis, and acute otitis media will benefit from antibiotic therapy. The guideline by the American Academy of Pediatrics (AAP) recommends that acute otitis media be diagnosed based on the evidence of two main condition, that is, evidence of middle ear effusion, which is demonstrated by a moderate to severe bulging of the tympanic membrane or a new onset of otorrhea, which is not attributable to otitis externa. However, patients who display more severe symptoms, bilaterally involved and of young age have a higher likelihood of benefiting from antibiotic therapy. Watchful waiting is recommended for older patients with mild symptoms, which are unilaterally involved. Consequently, antibiotic therapy is also recommended for cases involving acute bacterial sinusitis with symptoms, which have persisted for more than 10 days or worsen as a result of a new onset of daytime cough, nasal discharge or fever after the improvement of a typical viral upper respiratory tract infection (Sheldon, Heaton, Palmer, & Paul, 2018). Diagnostically confirmed pharyngitis with β-hemolytic GAS also require antibiotic therapy appropriately prescribed in terms of dosage and frequency for the shortest time possible. Using antibiotics excessively or inappropriately leads to antibiotic resistance which makes it hard to treat other infections in the future.

Using national guidelines and evidence-based literature, develop an Asthma Action Plan for this patient.

The action plan for this patient will include the daily treatment, long-term control of asthma, how to deal with a worsening state of asthma or an attack, and when it is necessary to seek medical attention in the course of treatment (Tesse et al., 2018).

Classification of Asthma	Symptom frequency	Treatment	Patient education	Seek medical attention
Mild intermittent	Less than 2 days in a week	Bronchodilators which are short – 2 puffs of Albuterol after every 4-6 hours PRN.	Provide information on how to take the medication, proper inhaler techniques, and environmental triggers to avoid.	In case the symptoms persist for more than twice in a week or the patient has used short-acting beta antagonists (SABA)for more than 2 to 3 weeks.
Mild persistent	More than 2 days in a week and use of SABA for more than 2 to 3 weeks.	Low dose corticosteroid inhaler – 80-240 mcg/day beclomethasone or 180-600 mcg/day Pulmicort. SABA PRN for exacerbations.	Provide information on how to take the medication, proper inhaler techniques, and environmental triggers to avoid.	If daily use of SABA is required
Moderate persistent	Symptoms occur daily or for more one night in a week but not every night.	Low dose steroid inhaler, plus LABA, LTRB, or theophylline or medium dose steroid inhaler. SABA PRN for exacerbations.	Provide information adherence to daily prescription, proper inhaler techniques, and environmental triggers to avoid.	When symptoms persist.
Severe persistent	Symptoms occur all through the day and 7 nights in a week.	High dose corticosteroid inhaler plus, LABA and oral corticosteroid if needed – 2 mg/kg/day but should not exceed 60 mg/ day. SABA PRN for exacerbations.	Provide information adherence to daily prescription, proper inhaler techniques, and environmental triggers to avoid.	When symptoms persist.

 

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?

Wheezing is associated with breathing difficulties as a result of narrowing of the airways and is characterized by a high pitch whistling

sound that is heard during respiration. As such, any complication or infection of the airways might have a significant impact that might lead to a total restriction of the airways in such a patient. Nasal flashing, murmurs and retractions are signals indicating distress in respiration. The earliest symptom is a nonproductive cough, followed by expiratory wheezing, tachypnea, and shortness of breath, tachycardia, prolonged expiratory phase, and hyper-resonance (Hudgins et al., 2019). The use of accessory muscles is a sign of severe asthmatic attack that is accompanied by decreased exercise tolerance and sudden nocturnal dyspnea. Through auscultation, the physician can identify the location and presence of crackles, stridor, and wheezing. However, it might be hard for these physical findings to be realized in pediatric patients who are unable to take deep breaths. Most research has revealed that localized wheezing might not be an indication of asthma, and hence recommend further investigations. It is also recommended that pediatric patients who present with localized wheezing be given bronchodilators such as albuterol as trial treatment (Horak et al., 2016). In case the drug does not help to stop the wheezing, then the patient is not suffering from asthma, but other underlying pathological conditions of the large central airway. A chest x-ray is indicated for children who present with symptoms of unexplained wheezing, which is not responsive to bronchodilators or is recurrent.

 

Assignment: iHuman Case Study- HEENT and Respiratory Infections References

Baan, E.J., Janssens, H.M., Kerckaert, T., Bindels, P.J.E., Jongste, J.C., Sturkenboom, M.C.J.M., & Verhamme, K.M.C. (2018). Antibiotic use in children with asthma: cohort study in UK and Dutch primary care databases. BMJ Open 8(11), ,.

Hudgins, J. D., Neuman, M. I., Monuteaux, M. C., Porter, J., & Nelson, K. A. (January 07, 2019). Provision of Guideline-Based Pediatric Asthma Care in US Emergency Departments. Pediatric Emergency Care.

Horak, F., Doberer, D., Eber, E., Horak, E., Pohl, W., Riedler, J., Szepfalusi, Z., … Studnicka, M. (August 01, 2016). Diagnosis and management of asthma – Statement on the 2015 GINA Guidelines. Wiener Klinische Wochenschrift, 128, 541-554.

Tesse, R., Borrelli, G., Mongelli, G., Mastrorilli, V., & Cardinale, F. (January 01, 2018). Treating pediatric asthma according to guidelines. Frontiers in Pediatrics, 6.

Sheldon, G., Heaton, P. A., Palmer, S., & Paul, S. P. (January 01, 2018). Nursing management of pediatric asthma in emergency departments. Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association, 26(4), 32-42.

A Sample Answer 2 For the Assignment: Assignment: iHuman Case Study- HEENT and Respiratory Infections

Title:  Assignment: iHuman Case Study- HEENT and Respiratory Infections

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.

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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

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