Asthma Case Study Questions: I- Human Assignment
Case- 15 year old female with Asthma symptoms- newly diagnosed no other illnesses
- 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 are an essential component of quality healthcare that we can offer out patients, however, it is important for providers to know WHEN an antibiotic should be prescribed. Using key current clinical guidelines, provide recommendations of when antibiotics should be prescribed within the pediatric population
- Using national guidelines and evidence-based literature, develop an Asthma Action Plan for this patient.
Asthma is one of the most prevalent chronic diseases that you will encounter in the pediatric primary care setting, therefore, it is important for you to be familiar with the signs and symptoms of an asthma exacerbation, as well as how to base the management of the disease using current clinical guidelines. Using National Guidelines and Evidence Based literature develop a specific Asthma Action Plan for our iHuman patient.
Patient- 16 year old newly diagnosed with Asthma female
5’5 150 lbs
Shortness of breathe x3 days Pulse Oximetry 94
Patient is wheezing no other medical issues
- 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 not just due to asthma. Discuss the etiology, diagnosis and management of wheezing based on a child’s developmental age (e.g. infants, early childhood, late childhood, adolescence) and whether or not they would vary. What key OBJECTIVE clinical findings will help to develop your differential list of diagnoses. When and why should you order a chest x-ray for these patients?
PLEASE USE APA FORMATTTING AND PROVIDED A REFERENCE PAGE FOR ALL CITED WORK!!!!!!!
SOURCES NOT OLDER THAN 5 YEARS
Asthma Case Study Questions: I- Human Assignment
Question 1: Antibiotics and Asthma in Pediatrics
According to Valkonen et al. (2015), there is a co-existing relationship between asthma and bacterial infection. Antibiotics are a group of drugs that focus on a various range of infections entailing fungal, viral, bacterial and even protozoan infections. More so, the use of antibiotics drugs in the management of asthma is still disputed. Most physicians have found there selves use antibiotics in the management of asthma in the pediatric population as viral upper respiratory tract infections are closely associated with asthma exacerbations in children (Kloepfer et al., 2014). National and international guidelines of practice suggest that antibiotics should not be used in the treatment of chronic asthma or acute asthma exacerbations, but can only be utilized in the treatment of comorbid bacterial infections characterized by sinusitis and pneumonia (Mangione-Smith & Krogstad, 2011).
Regarding the case study, the patient presents symptoms associated with chronic asthma or acute asthma exacerbations, as such, the use of antibiotics will be imperative in this case. Other asthmatic cases that need antibiotic prescription include cases where a waiting approach is used to treat acute exacerbations of asthma, if the child does not improve in 1-2 days, use of antibiotics will be prescribed to treat cases of bronchitis or acute otitis media (Glasziou, Del Mar, & Rovers, 2011; Smith, 2013; Venekamp, Sanders, Glasziou, Del Mar, & Rovers, 2013).
Question 2: Action Plan for the Patient
Asthma in children has several severity levels. A child can depict healthy asthma, “Green Zone” which is associated with no wheeze or coughs and efficient breathing system. Also, there is the Caution level, “Yellow Zone,” where the patient coughs and depicts cases of wheezing coupled with tight chest (Dinakar & Portnoy, 2014). Last, the emergency asthma level, “Red Zone,” asthma in the child is getting worse since the quick-relief drugs are not effective. Also at this stage, the patient depicts shortness in breath (Guilbert, Bacharier, & Fitzpatrick, 2014). The patient’s symptoms are likely to fall under the “Red Zone.”
In this case, I will utilize an action plan for a “Red-Zone” Asthma level. Regarding the case study, the patient presents a BMI of 24.96 kg/m2- the risk of being overweight with normal blood oxygen saturation level of 94%. Additionally, the patient presents a shortness of breath and wheezing which is associated with acute asthma exacerbations.
My Asthma Action Plan will entail the use of Albuterol MDI. Xopenex®, four puffs every 20 minutes. These medications are bronchodilators that relax the muscles in a patient’s airway and increases air flow to the lungs. Additionally, cases of acute or chronic asthma can be managed by using Combivent Respimat® for the patient, prescribed 1 unit inhalation four times a day (Perriello & Sobieraj, 2016).Furthermore, after utilizing the action plan, I would recommend the patient to see a physician since acute asthma exacerbations are fatal (Szefler, 2013).
Question 3: Wheezing in Asthmatic Pediatrics
Etiological research in asthma
signs and symptoms suggest that wheezing in children is more often in that
infants and young children have small bronchi that are consequent to having a higher airway resistance. Additionally,
infants have a less elastic tissue recoil
and rarer collateral airways where asthma
can cause obstruction and atelectasis (Guilbert,
Mauger, & Lemanske, 2014). As such, age differences can
differentiate the diagnosis of asthma in
children. Furthermore, the clinical findings that will guide my diagnosis are based on the severity of shortness of
breath and wheezing. A chest x-ray test will be
needed the complications or alternative risk factors of wheezing or when
a patient depicts bronchial asthma (Lynch,
Fenta, Jacobson, Li, & Juhn, 2012).
Dinakar, C., & Portnoy, J. M. (2014). Empowering the Child and Caregiver: Yellow Zone Asthma Action Plan. Current Allergy and Asthma Reports. https://doi.org/10.1007/s11882-014-0475-z
Glasziou, P., Del Mar, C., & Rovers, M. (2011). Antibiotics and acute otitis media in children. JAMA : The Journal of the American Medical Association, 305(10), 997; author reply 997-998. https://doi.org/10.1001/jama.2011.240
Guilbert, T. W., Bacharier, L. B., & Fitzpatrick, A. M. (2014). Severe asthma in children. The Journal of Allergy and Clinical Immunology. In Practice, 2(5), 489–500. https://doi.org/10.1016/j.jaip.2014.06.022
Guilbert, T. W., Mauger, D. T., & Lemanske, R. F. (2014). Childhood Asthma-Predictive Phenotype. Journal of Allergy and Clinical Immunology: In Practice, 2(6), 664–670. https://doi.org/10.1016/j.jaip.2014.09.010
Kloepfer, K. M., Lee, W. M., Pappas, T. E., Kang, T. J., Vrtis, R. F., Evans, M. D., … Gern, J. E. (2014). Detection of pathogenic bacteria during rhinovirus infection is associated with increased respiratory symptoms and asthma exacerbations. The Journal of Allergy and Clinical Immunology, 133(5), 1301–7, 1307–3. https://doi.org/10.1016/j.jaci.2014.02.030
Lynch, B. A., Fenta, Y., Jacobson, R. M., Li, X., & Juhn, Y. J. (2012). Impact of delay in asthma diagnosis on chest X-ray and antibiotic utilization by clinicians. The Journal of Asthma : Official Journal of the Association for the Care of Asthma, 49(1), 23–8. https://doi.org/10.3109/02770903.2011.637596
Mangione-Smith, R., & Krogstad, P. (2011). Antibiotic Prescription With Asthma Medications: Why Is It So Common? Pediatrics, 127(6). Retrieved from http://pediatrics.aappublications.org/content/127/6/1174
Perriello, E. A., & Sobieraj, D. M. (2016). The Respimat Soft Mist Inhaler, a novel inhaled drug delivery device. Connecticut Medicine, 80(6), 359–364.
Smith, N. S. P. (2013). Antibiotic treatment for acute otitis media. International Journal of Pediatric Otorhinolaryngology, 77(5), 873–874. https://doi.org/10.1016/j.ijporl.2013.03.006
Szefler, S. J. (2013). Advances in pediatric asthma in 2012: Moving toward asthma prevention. Journal of Allergy and Clinical Immunology, 131(1), 36–46. https://doi.org/10.1016/j.jaci.2012.11.009
Valkonen, M., Wouters, I. M., Täubel, M., Rintala, H., Lenters, V., Vasara, R., … Hyvärinen, A. (2015). Bacterial Exposures and Associations with Atopy and Asthma in Children. PloS One, 10(6), e0131594. https://doi.org/10.1371/journal.pone.0131594
Venekamp, R. P., Sanders, S., Glasziou, P. P., Del Mar, C. B., & Rovers, M. M. (2013). Antibiotics for acute otitis media in children. Cochrane Database of Systematic Reviews (Online), 1(1), CD000219. https://doi.org/10.1002/14651858.CD000219.pub3