A 38 year old woman is admitted for repair of a fracture left wrist.

For this discussion you will select one of the following case studies. You will then discuss pertinent differential diagnoses and identify a leading diagnosis. Consider treatment strategies and develop a management plan for the patient. Please state appropriate dosages for any recommended pharmacologic interventions and/or provide specific orders for nonpharmacologic treatments. Discuss age specific strategies for educating patients and families on the respiratory disorder and the management plan.

Case #3

A 38 year old woman is admitted for repair of a fracture left wrist. Patient states that she has a 3 month history of non-productive cough that has continued to get worse. The cough is nonproductive and worse at night or after exercise. She has gotten progressively more short of breath during her exercise routine and has had to stop exercising after 20 minutes due to coughing fits. She has never smoked and denies any nasal congestion, headache, fever, or weight loss.

PE BP 134/87 HR 82 RR 22 T 98.2

S1S2 with normal rate and rhythm

Lungs are clear with expiratory wheezes heard in the bases

Chest x-ray is normal.

To prepare:

• Select and review 1 of the 8 case studies provided. 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. Be sure to consider appropriate dosages for any recommended pharmacologic and/or nonpharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the respiratory disorder.

Post on or before Day 3 the case you selected along with a discussion of the pertinent differential diagnoses and a leading diagnosis. Present treatment strategies and a management plan for the patient. Please state appropriate dosages for any recommended pharmacologic interventions and/or provide specific orders for nonpharmacologic treatments. Finally, discuss age specific strategies for educating patients and families on the respiratory disorder and the management plan.

ANSWER

Discussion 5- Case #3

Diagnosis

The patient claims that she has been coughing for three months, which seems to be getting worse every day. A cough becomes worse during night hours and after exercises. She also experiences short breath progressively when doing exercises which forces her to stop and rest after every few minutes. When breathing, wheezes are heard at the base which indicates difficulty in respiration (Rochester, Fairburn & Crouch, 2014). Considering the patient has never smoked, does not experience headaches, nasal congestion and weight loss, the most likely disease she may be suffering from are Asthma.

Treatment and Management Plan

Scientific research to create asthma pharmacology treatment for a long time has posed a challenge to medical scientists. However, progress has occurred whereby medication procedures that can help reduce the signs and symptoms of asthma have been invented. Current asthma treatment approaches advocate for the use of stepwise method to treatment. This strategy of treatment is dependent on the severity of the disorder.  The goal is to maintain normal lung function, minimize symptoms, and prevent irreversible changes resulting from airway obstruction. Glucocorticoids and β2‐Adrenoceptor agonists are currently the most used drugs for the treatment and management of inflammation and airway obstruction, with anticholinergics, leukotriene receptor antagonists, and theophylline as second-line or third-line therapy (Chung, 2015). Severe asthma attacks pose danger to the patient’s life and can even lead to death. It is therefore critical to work closely with a trained medical practitioner to determine which actions to take when the symptoms worsen (Neuhaus, Bernier & Beauchaine, 2014).

Asthma medication depends on age, symptoms, triggers of the condition and the body compatibility to the medication. They include inhaled corticosteroids, leukotriene modifiers, and long-acting beta-agonists. Inhaled corticosteroids have low side effects making them efficient for long-term usage. Leukotriene modifiers lead to adverse psychological reactions, and therefore strict supervision from a medical practitioner is essential (Hanania et al., 2016). Flu and pneumonia play a role in triggering asthma and thus can be prevented by staying current with vaccinations of the two conditions.

Bronchial thermoplasty is also an asthma treatment option used for severe conditions where other medications have failed. It involves heating the inside of airways in the lungs with electrodes which help reduce the smooth muscle in the airways. Tightening of airways is decreased therefore which makes breathing easier hence treating asthma symptoms (Castro et al., 2014). The first step in asthma management is to create an action plan by the medical practitioner which should be followed perfectly. Asthma is a condition that demands regular monitoring which calls for a close relationship between the patient and the doctor (Hanania et al., 2016). Flu and pneumonia play a role in triggering…