Discussion – Week 6
In clinical settings, patients often present with various
respiratory symptoms such as congestion, coughing, and wheezing. While
identifying a symptomâ€™s underlying illness can be challenging, it is essential
because even basic symptoms such as persistent coughing can be a sign of a more
severe disorder. Advanced practice nurses must be able to differentiate between
moderate and severe respiratory disorders, as well as properly diagnose and
prescribe treatment for their patients. For this reason, you must have an
understanding of the pathophysiology of respiratory disorders.
Consider the following three scenarios:
Ms. Teel brings in her 7-month-old infant for evaluation.
She is afraid that the baby might have respiratory syncytial virus (RSV) because
she seems to be coughing a lot, and Ms. Teel heard that RSV is a common
condition for infants. A detailed patient history reveals that the infant has
been coughing consistently for several months. Itâ€™s never seemed all that bad.
Ms. Teel thought it was just a normal thing, but then she read about RSV.
Closer evaluation indicates that the infant coughs mostly at night; and, in
fact, most nights the baby coughs to some extent. Additionally, Ms. Teel
confirms that the infant seems to cough more when she cries. Physical
examination reveals an apparently healthy age- and weight-appropriate,
7-month-old infant with breath sounds that are clear to auscultation. The
infantâ€™s medical history is significant only for eczema that was actually quite
bad a few months back. Otherwise, the only remarkable history is an allergic
reaction to amoxicillin that she experienced 3 months ago when she had an ear
Kevin is a 6-year-old boy who is brought in for evaluation
by his parents. The parents are concerned that he has a really deep cough that
he just canâ€™t seem to get over. The history reveals that he was in his usual
state of good health until approximately 1 week ago when he developed a
profound cough. His parents say that it is deep and sounds like he is barking.
He coughs so hard that sometimes he actually vomits. The cough is productive
for mucus, but there is no blood in it. Kevin has had a low-grade temperature
but nothing really high. His parents do not have a thermometer and donâ€™t know
for sure how high it got. His past medical history is negative. He has never
had childhood asthma or RSV. His mother says that they moved around a lot in
his first 2 years and she is not sure that his immunizations are up to date.
She does not have a current vaccination record.
Maria is a 36-year-old who presents for evaluation of a
cough. She is normally a healthy young lady with no significant medical
history. She takes no medications and does not smoke. She reports that she was
in her usual state of good health until approximately 3 weeks ago when she
developed a â€œreally bad cold.â€ The cold is characterized by a profound, deep,
mucus-producing cough. She denies any rhinorrhea or rhinitisâ€”the primary
problem is the cough. She develops these coughing fits that are prolonged, very
deep, and productive of a lot of green sputum. She hasnâ€™t had any fever but
does have a scratchy throat. Maria has tried over-the-counter cough medicines
but has not had much relief. The cough keeps her awake at night and sometimes
gets so bad that she gags and dry heaves.
Â· Review the
three scenarios, as well as Chapter 26 and Chapter 27 in the Huether and
Â· Select one
of the scenarios and consider the respiratory disorder and underlying
alteration associated with the type of cough described.
Â· Identify the
pathophysiology of the alteration that you associated with the cough.
Â· Select two
of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect
on how the factors you selected might impact the disorder.
By Day 3
Post a description of the disorder and underlying
respiratory alteration associated with the type of cough in your selected
scenario. Then, explain the pathophysiology of the respiratory alteration.
Finally, explain how the factors you selected might impact the disorder.
Read a selection of your colleaguesâ€™ responses.
By Day 6
Respond to at least two of your colleagues on two different
days who selected a different scenario than you, in one or more of the
insights on how the factor you selected impacts the disorder your colleague
Â· Ask a
probing question regarding the disorder that your colleague identified.
Â· Suggest an
alternative disorder for the scenario your colleague selected.
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