Bronchiolitis case study differential diagnosis
Case Study 1:
HPI: A 14-month-old Native American boy brought in by his mom due to cough, low grade fever and runny nose for the past 2 days. This morning, the mother noted that her son was breathing quickly and “it sounds like he has rice cereal popping in his throat.” Mom is worried because her son seems to have a lot of “bouts of colds”. Per mom, his oral intake is decreased. He didn’t want to eat this morning Bronchiolitis case study differential diagnosis.
PE: Smiling, alert Native American boy.
VS: Temp of 99.9, pulse 112, respiratory rate is 58, Pulse ox 96%
HEENT: There is moderate, thick, clear rhinorrhea and postnasal drip.
CV: His capillary refill is less than 3 seconds
PULM: lung sounds are diminished in the bases, he has pronounced intercostal and subcostal retractions, expiratory wheezes are heard in all lung fields. Bronchiolitis case study differential diagnosis.
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Analyze the patient information.
Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
Think about a treatment and management plan for the patient Bronchiolitis case study differential diagnosis. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
Consider strategies for educating patients and families on the treatment and management of the respiratory disorder Bronchiolitis case study differential diagnosis.
This paper examines a case of a 14-month-old Native American boy brought in by his mom due to cough, low grade fever and runny nose for the past 2 days. It provides a differential diagnosis for the patient and suggests the most likely diagnosis. Moreover, it recommends both the pharmacologic and non-pharmacologic treatments with their appropriate dosages as well as considers the education strategies for patients and families on the treatment and management of the respiratory disorder. Bronchiolitis case study differential diagnosis.
Differential diagnosis
The differential diagnosis for the patient in the case study includes bronchiolitis. This is a common disorder of the lungs in infants and young children. It is characterized by congestion and inflammation of the airways and most often it is caused by viruses (Meissner, 2016). The symptoms of the illness demonstrated by the patient include runny nose, cough, low grade fever, fast breathing, wheezing, moderate, thick, clear rhinorrhea and postnasal drip and respiratory distress for 2 days. Bronchiolitis case study differential diagnosis.
The second differential diagnosis is community-acquired pneumonia. This is bacterial pneumonia which affects the lungs thus causing problems with breathing. It is manifested through coughing, shortness of breath and fever as seen in the patient (Burns et al., 2017). This respiratory condition is acquires from the environment and not the hospital setting which relates to the name.
A third differential diagnosis of the patient is Reactive Airway Disease. This disease is associated with irritation or overreaction to substances which causes wheezing. This occurs in patients who haven’t been diagnosed with asthma. The patient in this case experiences wheezing, cough and shortness of breath which are the major symptoms of this disease (Burns et al., 2017) Bronchiolitis case study differential diagnosis. The most likely diagnosis for the patient is bronchiolitis since the patient conforms to most of the symptoms.
Treatment and management plan
The pharmacological management of the patient will be influenced by their weight. This will ensure the calculation of accurate doses of the medication. I would recommend an overnight hospital stay for the patient for better monitoring and treatment. This is due to his respiratory distress associated with wheezing, fast breathing, tachypnea, and subcostal and intercostal retractions which require immediate treatment. Depending on the findings of the patient’s weight, 0.15mg/kg of Albuterol nebulizer can be prescribed (Parlar-Chun & Arnold, 2020). This medication will be diluted in 2.5 to 3ml normal saline and administered every 4 hours. In order to maintain SpO2 >90% supplemental oxygen and nasal suctioning can be done Bronchiolitis case study differential diagnosis. For hydration, the patient will be given IV fluids of normal saline to prevent aspiration due to tachypnea and coughing. The daily use of energy will determine the level of hydration.
Education is important to promote recovery and adherence of treatment plans. In this case, health promotion will enlighten the parent on the immunizations essential in building up the child’s immunity for prevention of respiratory diseases. The family can also be trained through participatory learning experiences which will help in the development of change attitudes and necessary skills for treatment, management and maintenance of respiratory health. Another strategy is communication through individual instructions or counselling, lectures and discussions, audio-visual aids, mass media, social media as well as social media (Gates et al., 2019). These platforms will help the patient and the family to gain important information on the treatment interventions, use of medication, adherence, possible side effects and positive impacts of treatment. Bronchiolitis case study differential diagnosis. They are also easily accessible which makes the dispensation of the health information on respiratory disease treatment and management fast, efficient and effective.
References
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (Eds.). (2017). Pediatric primary care (6th ed.). St. Louis, Missouri: Elsevier
Gates, M., Shulhan-Kilroy, J., Featherstone, R., MacGregor, T., Scott, S. D., & Hartling, L. (2019). Parent experiences and information needs related to bronchiolitis: A mixed studies systematic review. Patient education and counseling, 102(5), 864-878.
Meissner, H. C. (2016). Viral bronchiolitis in children. New England Journal of Medicine, 374(1), 62-72.
Parlar-Chun, R., & Arnold, K. (2020). Association of Various Weight Based Doses of Continuous Albuterol on Hospital Length of Stay. Journal of Asthma, (just-accepted), 1-9 Bronchiolitis case study differential diagnosis.