Discussion paper on Asthma

Discussion paper Hello follow instruction please to complete the discussion paper. Read the case study below, and then answer the following question as a discussion paper. APA format. I need at least 6 references, no older than 5 years old please. Case Study KH is a 16 y/o female who presents with a 3 week history of a dry cough and a 3 day history of exertional shortness of breath following a week of nasal congestion. On physical exam she is afebrile, tachypneic with O2 sat of 94%, diffuse bilateral wheezing and decreased breath sounds bilaterally. Past medical history and risk factors are: history of eczema, exposure to second hand smoke and cockroaches in her home. Diagnosis is Asthma Describe Asthma 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? a 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?
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Discussion paper
Hello follow instruction please to complete the discussion paper. Read the case
study below, and then answer the following question as a discussion paper. APA
format. I need at least 6 references, no older than 5 years old please.
Case Study
KH is a 16 y/o female who presents with a 3 week history of a dry cough and a 3
day history of exertional shortness of breath following a week of nasal
congestion. On physical exam she is afebrile, tachypneic with O2 sat of 94%,
diffuse bilateral wheezing and decreased breath sounds bilaterally. Past medical
history and risk factors are: history of eczema, exposure to second hand smoke
and cockroaches in her home.
Diagnosis is Asthma
Describe Asthma
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? a
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?
Case study
Name: K H
Age: 16 years
Sex: F
Height: 5′ 5″
Weight: 150 pounds (BMI 25.0)
Temperature: 98.6 F (oral)
Pulse: 88 bpm – regular
Blood pressure: 112/82 mmHg
Orthostatic blood pressure: 100/82 mmHg upon standing
Respiratory rate: 26 bpm
SpO2: 94% on room air
Chief complaint:
Cough and difficulty breathing
HPI (history of present illness)
Patient arrived to the clinic, report, which. She is not feeling well, she had been
coughing for the last three weeks specially through the night, which has been
getting worst. She also has trouble breathing when she is walking to her next class
when she is in school and that symptoms is the most distressing for her. She has to
stop and take a break. This has been happening for three days now and it’s made
her a little scare and she doesn’t know what causing that nor been expose to any six
people. She denies pain. Denies coughing sputum, blood, denies taking medications
for it. The cough causing her to wake on and off in the middle of the night. Patient
reported that the last few years, she had had a bad cough and shortness of breath
but it got better after few days, she did not get checked. This time, it is lasting
longer. I also didn’t want to stress out my parents because they have to work so
much so I never told them. She reports, that her dad lost his job three years ago so
he has been doing add jobs since then. We had to move to an older building and it
has cockroaches in it. Also the neighbors smoke inside the building sa I always smell
smoke everywhere. She has her first menarche when she was 13 years old. She
reported that she is happy for the most part, she reaches that the family was
financially stable
Allergies No known drug allergies.
PMH (previous medical history)
Patient reported that the last few years, she had had a bad cough and shortness of
breath but it got better after few days, she did not get checked.
She had been diagnosed with eczema in the past but she has been moisturizing her
skin daily and has not had any flares for several years.
Normal birth.
Full term.
No medical problems.
No major accidents or injuries.
No surgeries.
Last checkup one year ago.
All immunizations are up to date.
Medications
None
Family Hx
Father – has eczema, otherwise healthy
Mother- no medical problems
No other significant family history
Social Hx
She lives with her mother and her father
She lives at home with mother and father. She is an only child. Her father lost his
stable job recently and has been working odd jobs since then to pay the bills. Her
mother works at a fast food restaurant. They were also recently evicted from their
home and are looking for a new place to live.
She denies past or present use of alcohol, tobacco or illicit drugs. She has never been
sexually active. She states that she does get sad sometimes due to her family’s
recent financial and living situation but she does not feel like she is depressed. She
denies suicidal ideations.
Physical Exam
Neck – auscultate carotid arteries
Click on the guide icon if you need help finding the locations to auscultate. Use the
stethoscope on appropriate locations on the patient.
Breast – breast exam
Normal
Management Plan
ROS (review of systems)
General/Constitutional: not feeling well, she had been coughing and shortness of
breath
Skin/Breast: Skin: No rashes, no bruising, no petechial.
HEENT/Neck: No runny nose. No congestion. No eye or ear discharge. No
conjunctivitis. No recent head trauma.
Cardiovascular: Heart: No history of murmur. No history of fainting or excessive
sweating.
Respiratory: cough, shortness of breath, wheezing.
Abdomen/Gastrointestinal: No vomiting, no diarrhea, no constipation. No melena.
Genitourinary: No history of UTIs in the past. No dysuria.
Musculoskeletal: No recent trauma, no weakness, no limping.
Allergic/Immunologic: Up to date for all immunizations.
Lymphatic/Endocrine: No history of diabetes, adrenal or thyroid dysfunction.
Hematologic: No history of anemia.
Neurological: No history of seizures.
She states that she is generally happy. She does have some stress at home with the
financial situation of the family however overall, she is happy at school and at home.
Psychological: Denies anxiety, suicidal ideations.

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