NSG6440 Week 2 Discussion Essay

NSG6440 Week 2 Discussion Essay

NSG6440 Week 2 Discussion Essay

The chief complaints in the patient are shortness of breath, and nocturnal nonproductive cough, which have become continuous. Based on the subjective and objective information about the fifteen-year-old female presented, I came up with three differential diagnoses: asthma (J45)-the presumptive final diagnosis, allergic rhinitis (AR), and bronchitis. Asthma is a lifelong condition that makes the airways inflamed and narrows them. Asthma symptoms include shortness of breath, coughing, and wheezing (Hashmi et al., 2021). It frequently manifests in childhood, accompanied by such ailments as eczema and hay fever.

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Asthma is likely the cause of the patient’s nonproductive nighttime cough and physical exam findings of an expiratory wheeze and less airflow in the lungs. AR is an atopic disorder characterized by clear rhinorrhea, nasal pruritis, sneezing, and nasal congestion. It is an immune response to inhaled antigens that is mediated by IgE. The late phase is mediated by leukotrienes (Akhouri & House, 2022). The patient’s nonproductive cough and nasal symptoms were suggestive of allergic rhinitis. Besides, she has a significant history of seasonal allergies for which she uses a nasal steroid spray. Acute bronchitis is the self-limiting inflammation of the lining of the bronchi, mostly viral (Singh et al., 2019). Bacteria, irritants, and allergens can occasionally bring it on. While the patient’s wheezing and shortness of breath suggest they may have acute bronchitis, their cough is unproductive compared to most patients with this condition.
Each patient’s asthma treatment should be unique. To lower the risk of severe exacerbations, GINA advises that all adolescents with asthma take a controller prescription that contains inhaled corticosteroids (ICS) (Global Initiative for Asthma, 2022). The patient will be administered a reliever inhaler, either a short-acting beta agonist or a low-dosage ICS-formoterol. After that, we focus on modifiable risk factors and comorbidities and employ the proper non-pharmacological therapy where necessary. The patient will then receive instruction in fundamental skills and be advised on managing asthma.
 
References
Akhouri, S., & House, S. A. (2022). Allergic rhinitis. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538186/#:~:text=Allergic%20rhinitis%20(AR)%20is%20an
Global Initiative for Asthma. (2022). 2022 GINA main report – global initiative for asthma – GINA. Global Initiative for Asthma – GINA. https://ginasthma.org/gina-reports/
Hashmi, M. F., Tariq, M., & Cataletto, M. E. (2021). Asthma. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430901/#:~:text=Asthma%20is%20a%20chronic%20disease
Singh, A., Avula, A., & Zahn, E. (2019). Acute bronchitis. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK448067/

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WEEK 2 DISCUSSION

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.
1. What is the chief complaint?
2. Based on the subjective and objective information provided what are your 3 top differential diagnosis listing the presumptive final diagnosis first?
3. What treatment plan would you consider utilizing current evidence based practice guidelines?
RUBRIC
Response No Submission
0 points Emerging (F-D: 1-13)
13 points Satisfactory (C: 14-16)
16 points Proficient (B: 17-18)
18 points Exemplary (A: 19-20)
20 points Criterion Score
Quality of Initial Posting No initial posting exists to evaluate. The information provided is inaccurate, not focused on the assignment’s topic, and/or does not answer the question(s) fully. Response demonstrates incomplete understanding of the topic and/or inadequate preparation. The information provided is accurate, giving a basic understanding of the topic(s) covered. A basic understanding is when you are able to describe the terms and concepts covered. Despite this basic understanding, initial posting may not include complete development of all aspects of the assignment. The information provided is accurate, displaying a good understanding of the topic(s) covered. A good understanding is when you are able to explain the terms and topics covered. Initial posting demonstrates sincere reflection and addresses most aspects of the assignment, although all concepts may not be fully developed. The information provided is accurate, providing an in-depth, well thought-out understanding of the topic(s) covered. An in-depth understanding provides an analysis of the information, synthesizing what is learned from the course/assigned readings. Score of Quality of Initial Posting,
/ 20
Participation No Submission
0 points Emerging (F-D: 1-13)
13 points Satisfactory (C: 14-15)
15 points Proficient (B: 16-17)
17 points Exemplary (A: 18-20)
20 points Criterion Score
Participation in Discussion No responses to other classmates were posted in this discussion forum. May include one or more of the following:
*Comments to only one other student’s post.
*Comments are not substantive, such as just one line or saying, “Good job” or “I agree.
*Comments are off topic. Comments to two or more classmates’ initial posts but only on one day of the week. Comments are substantive, meaning they reflect and expand on what the other student wrote. Comments to two or more classmates’ initial posts on more than one day. Comments are substantive, meaning they reflect and expand on what the other student wrote. Comments to two or more classmates’ initial posts and to the instructor’s comment (if applicable) on two or more days. Responses demonstrate an analysis of peers’ comments, building on previous posts. Comments extend and deepen meaningful conversation and may include a follow-up question. Score of Participation in Discussion,
/ 20
Writing No Submission
0 points Emerging (F-D: 1-6)
6 points Satisfaction (C: 7-8)
8 points Proficient (B: 9)
9 points Exemplary (A: 10)
10 points Criterion Score
Writing Mechanics (Spelling, Grammar, Citation Style) and Information Literacy No postings for which to evaluate language and grammar exist. Numerous issues in any of the following: grammar, mechanics, spelling, use of slang, and incomplete or missing citations and references. If required for the assignment, did not use course, text, and/or outside readings (where relevant) to support work. Some spelling, grammatical, and/or structural errors are present. Some errors in formatting citations and references are present. If required for the assignment, utilizes sources to support work for initial post but not comments to other students. Sources include course/text readings but outside sources (when relevant) include non-academic/authoritative, such as Wikis and .com resources. Minor errors in grammar, mechanics, or spelling in the initial posting are present. Minor errors in formatting citations and references may exist. If required for the assignment, utilizes sources to support work for both the initial post and some of the comments to other students. Sources include course and text readings as well as outside sources (when relevant) that are academic and authoritative (e.g., journal articles, other text books, .gov Web sites, professional organization Web sites, cases, statutes, or administrative rules). Minor to no errors exist in grammar, mechanics, or spelling in both the initial post and comments to others. Formatting of citations and references is correct. If required for the assignment, utilizes sources to support work for both the initial post and the comments to other students. Sources include course and text readings as well as outside sources (when relevant) that are academic and authoritative (e.g., journal articles, other text books, .gov Web sites, professional organization Web sites, cases, statutes, or administrative rules). Score of Writing Mechanics (Spelling, Grammar, Citation Style) and Information Literacy,
/ 10
Total
Score of NSG6440 Discussion Rubric (50 points),
/ 50
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