iHuman Case Study Katherine Harris
iHuman Case Study _ Katherine Harris
iHuman Case Study: Katherine Harri... [Show More] s V3.1 PC
1. 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, that may trigger coughing, shortness of breath and wheeze. 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.
2. 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).
Classificatio n of Asthma
Seek medical attention
Less than 2
In case the
intermittent days in a rs which are information symptoms
week short – 2 on how to persist for
puffs of take the more than
Albuterol medication, twice in a
after every 4- proper week or the
6 hours PRN. inhaler patient has
techniques, used short-
and acting beta
al triggers to (SABA)for
avoid. more than 2
to 3 weeks.
More than 2
If daily use
persistent days in a corticosteroid information of SABA is
week and inhaler – 80- on how to required
use of SABA 240 mcg/day take the
for more beclomethaso medication,
than 2 to 3 ne or 180-600 proper
weeks. mcg/day inhaler
SABA PRN and
exacerbations al triggers to
persistent occur daily steroid information symptoms
or for more inhaler, plus adherence to persist.
one night in LABA, LTRB, daily
a week but or prescription,
not every theophylline proper
night. or medium inhaler
dose steroid techniques,
inhaler. SABA and
PRN for environment
exacerbations al triggers to
Severe Symptoms corticosteroid Provide When
persistent occur all inhaler plus, information symptoms
through the LABA and adherence to persist.
day and 7 oral daily
nights in a corticosteroid prescription,
week. if needed - 2 proper
but should techniques,
not exceed 60 and
mg/ day. environment
SABA PRN al triggers to
3. 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, 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 attach 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.
Baan, E.J. (Esmé J), Janssens, H.M. (Hettie), Kerckaert, T. (Tine), Bindels,
P.J.E. (Patrick), Jongste, J.C. (Johan) de, Sturkenboom, M.C.J.M. (Miriam), & Verhamme, K.M.C. (Katia). (2018). Antibiotic use in children with asthma: cohort study in UK and Dutch primary care databases. (BMJ Open vol. 8 no. 11.)
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.
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. [Show Less]