NR 509 Week 6: Shadow Health Pediatric Physical Assessment Assignment Pre Brief Daniel “Danny” Rivera is an 8-year-old boy who is brought to the clinic by a family member for a cough. The adolescent has a number of questions … %����
Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data. All children with chronic cough require a chest x-ray. Testing is not necessary in such cases; however, if empiric treatment has been instituted and has not been successful, testing may be necessary. Her cough continued to improve. Not only does it cause discomfort for the child, cough … Causes of cough differ depending on whether the symptoms are acute (< 4 weeks) or chronic (> 4 weeks). We conducted a study to determine if a five-item pediatric cough questionnaire (PCQ) is a valid and reliable means of measuring cough-specific quality of life in children. Among children, the Parent Cough-Specific Quality of Life Questionnaire and Pediatric Cough Questionnaire were valid and reliable. For Shadow Health Focused Exam for Pediatric Patient with Cough When the student is taking the Digital Clinical Experience, they are required to take a focused respiratory exam, investigate related systems and symptoms, and practice communicating with a pediatric patient about his home life, health, and cultural beliefs. history in a pediatric patient. Questionnaire, Cough-Specifi c Quality-of-Life Ques-tionnaire [CQLQ], Pediatric Cough Questionnaire [PCQ], PC-QOL, and Adverse Cough Outcome Survey [ACOS]), whereas others focused on disease states for which cough is a predominant symptom Children … It is important for you to determine whether or not Danny is in distress, explore the underlying cause of his cough… Croup is a common, primarily pediatric viral respiratory tract illness. Discussion Questions (DQ) Initial responses to the DQ should address all components of the questions … Little evidence exists to support the use of cough suppressants and mucolytic agents. A paroxysmal cough is characteristic of pertussis or certain viral pneumonias (adenovirus). Antitussives and expectorants lack proof of effect in most cases. Evaluating cough assessment tools: a systematic review Chest. Please confirm that you are a health care professional. Children with repeated episodes of pneumonia, poor growth, or foul-smelling stools should have a chest x-ray and sweat testing for cystic fibrosis. Cough as a manifestation of respiratory disease can range from minor upper respiratory tract infections to serious conditions such as bronchiectasis. Foreign body aspiration and diseases such as cystic fibrosis and primary ciliary dyskinesia are less common, but they can all result in persistent cough. ^�;�VP��&����nծ��#����spV`��c>b�]Å�Pi��%���V�Q((�(��P��gG�f�q69���ByP���P��2�D[b�M� T�2�1n9^6K�q[Q^�@L�XJ? Denies difficulty breathing. 1 0 obj
Clinical history & physical examination. Coughing is an important mechanism for clearing secretions from the airways and can assist in recovery from respiratory infections. NR 509 Week 6: Shadow Health Pediatric Physical Assessment Assignment. Learn more about our commitment to Global Medical Knowledge. Acute cough in children … Children with stridor, drooling, fever, and marked anxiety need to be evaluated for epiglottitis, typically in the operating room by an ear, nose, and throat specialist prepared to immediately place an endotracheal or tracheostomy tube. Abdominal examination should focus on presence of abdominal pain, especially in the upper quadrants (indicating possible left or right lower lobe pneumonia). The nurse is most concerned that: A. [5.ohCGBa��iI����h�t�^GbQĸ�-�4�)%&审Y_�m�^��R�f�(^P&o@��P�g�h:=�1˗�ǙZ)�ⱩoI^TD���JGb��I��9�#�h2��R+ʌ��4�Y���)�)M�[�I?�Յw:u!�]�6����|>"_��!�#H�U��&v�+�1Ŋ�A44�?���4C�8�GM�uKHj�h�;�C�z@q!�W�*ۓ��F�v�����Z���Fk����r@�zijX�9E7%Jm�rBa��׃�Q���m��SY͕K=��Ū�*��S���v�z���n�~���{M��|�:�"��M���oY
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�F�280��u�|?�j/��ni����%��r����y�.����ͮD���X��$�X�}7;��Ğ���%�Dd�ք��g_ș,(�N�1C4g�'S��a3㢙�DSt�r�����w���w��(@��kh�ۧ6j���L���2V� f�&�0DC?��eʼnq2�cK�{�qb�\/ For children 6 months to 6 years, the parents should be asked about potential for foreign body aspiration, including older siblings or visitors with small toys, access to small objects, and consumption of small, smooth foods (eg, peanuts, grapes). Danny Rivera Pediatric Cough Shadow Health Assessment . 1. x��Ymo���)�a�]�J(�� ��Ji�vs�M�$��W����c��8�W���y���&I��"90���9���v�:rm���mO�? <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612.04 792.06] /Contents 4 0 R/Group<>/Tabs/S>>
Cough is a common reason for pediatric outpatient visits. The cervical and supraclavicular areas should be inspected and palpated for lymphadenopathy. History of present illness should cover duration and quality of cough (barky, staccato, paroxysmal) and onset (sudden or indolent). Other characteristics of the cough are helpful but less specific. Daniel "Danny" Rivera is an 8-year-old boy who is brought to the clinic by a family member for a cough. 2EY4U���-n��� w$ߧ?D�v�&��{��oI���5J��rA��B�I�� ), For acute cough, the most common cause is, For chronic cough, the most common causes are. All children experience head colds and many consult their doctor because of associated coughing.1 Cough with colds remedies are among the most commonly used medications in children in Western societies, despite evidence suggesting ineffectiveness of medication to treat cough as a symptom. We do not control or have responsibility for the content of any third-party site. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data. If foreign body aspiration is suspected, chest x-ray with inspiratory and expiratory views should be done (or in some centers a chest CT). Cough Pediatric After-Hours Version - Standard - 2020 A cough is the sound made when the cough reflex suddenly forces air and secretions from the lungs. Some of these symptoms are ubiquitous (eg, runny nose, sore throat, fever); others may suggest a specific cause: headache, itchy eyes, and sore throat (postnasal drip); wheezing and cough with exertion (asthma); night sweats (tuberculosis [TB]); and spitting up, irritability, or arching of the back after feedings in infants (gastroesophageal reflux). Children with TB risk factors or weight loss should have a chest x-ray and purified protein derivative (PPD) testing. Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. %PDF-1.5
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URI-like prodrome, stridor, barky cough, high fever, respiratory distress, toxic appearance, purulent secretions, Rhinorrhea, tachypnea, wheezing, crackles, retractions, nasal flaring, possible posttussive emesis, In infants up to 24 months; most common among those 3–6 months, Sometimes nasal swab for rapid viral antigen assays or viral culture, URI-like prodrome, barky cough (worsening at night), stridor, nasal flaring, retractions, tachypnea, Sometimes anteroposterior and lateral neck x-rays, Exposure to tobacco smoke, perfume, or ambient pollutants, Abrupt onset, high fever, irritability, marked anxiety, stridor, respiratory distress, drooling, toxic appearance, If patient is stable and clinical suspicion is low, lateral neck x-ray, Otherwise, examination in operating room with direct laryngoscopy, Chest x-ray (inspiratory and expiratory views), Viral: URI prodrome, fever, wheezing, staccato-like or paroxysmal cough, possible muscle soreness or pleuritic chest pain, Possible increased work of breathing, diffuse crackles, rhonchi, or wheezing, Bacterial: Fever, ill appearance, chest pain, shortness of breath, possible stomach pain or vomiting, Signs of focal consolidation including localized crackles, rhonchi, decreased breath sounds, egophony, and dullness to percussion, Coughing at the beginning of sleep or in the morning with waking, Sometimes nasal discharge, congestion; pain on either side of the nose; pain in the forehead, upper jaw, teeth, or between the eyes; headache and sore throat, Rhinorrhea, red swollen nasal mucosa, possible fever and sore throat, shotty cervical adenopathy (many small nontender nodes), Tracheomalacia: Congenital stridor or barky cough, possible respiratory distress, TEF: History of polyhydramnios (if accompanied by esophageal atresia), cough or respiratory distress with feeding, recurrent pneumonia, Tracheomalacia: Airway fluoroscopy and/or bronchoscopy, TEF: Attempt passage of a catheter into the stomach (helps in diagnosis of TEF with esophageal atresia), Contrast swallowing study, including esophagography, Intermittent episodes of cough with exercise, allergens, weather changes, or URIs, Atypical pneumonia (mycoplasma, Chlamydia), Possible ear pain, rhinitis, and sore throat, Birth defects of the lungs (eg, congenital adenomatoid malformation), Several episodes of pneumonia in the same part of the lungs, History of meconium ileus, recurrent pneumonia or wheezing, failure to thrive, foul-smelling stools, clubbing or cyanosis of nail beds, Molecular diagnosis with direct mutation analysis, History of acute onset of cough and choking followed by a period of persistent cough, Presence of small objects or toys near child, Infants and toddlers: History of spitting up after feedings, irritability with feeding, stiffening and arching of the back (Sandifer syndrome), failure to thrive, recurrent wheezing or pneumonia (see Gastroesophageal Reflux in Infants), Older children and adolescents: Chest pain or heartburn after meals and lying down, nighttime cough, wheezing, hoarseness, halitosis, water brash, nausea, abdominal pain, regurgitation (see Gastroesophageal Reflux Disease), Sometimes upper gastrointestinal study for determination of anatomy, Trial of H2 blockers or a proton pump inhibitor, Possible esophageal pH or impedance probe study, Trial of H2 blockers or proton pump inhibitors, 1–2 weeks catarrhal phase of mild URI symptoms, progression to paroxysmal cough, difficulty eating, apneic episodes in infants, inspiratory whoop in older children, posttussive emesis, Intranasal specimen for bacterial culture and polymerase chain reaction testing, Headache, itchy eyes, sore throat, pale nasal turbinates, cobblestoning of posterior oropharynx, history of allergies, nighttime cough, Trial of antihistamine and/or intranasal corticosteroids, Possible trial of a leukotriene inhibitor, History of respiratory infection followed by a persistent, staccato cough, History of repeated upper (otitis media, sinusitis) and lower (pneumonia) respiratory tract infections, Microscopic examination of living tissue (typically from sinus or airway mucosa) for cilia abnormalities, Persistent barky cough, possibly prominent during classes and absent during play and at night, Sometimes fever, chills, night sweats, lymphadenopathy, weight loss, Sputum culture (or morning gastric aspirate culture for children < 5 years), Interferon-gamma release assay (especially if there is a history of bacille Calmette-Guérin [BCG] vaccination). Note the similarities. The legacy of this great resource continues as the Merck Manual in the US and Canada and the MSD Manual outside of North America. Students determine if Danny is in distress, explore the underlying cause of his cough, and look for related symptoms in other … Past medical history should cover recent respiratory infections, repeated pneumonias, history of known allergies or asthma, risk factors for TB (eg, exposure to a person who has known or suspected TB infection, exposure to prisons, HIV infection, travel to or immigration from countries that have endemic infection), and exposure to respiratory irritants. The physician should ask about associated symptoms. Subjective Data Collection: 20 of 20 (100.0%) Hover To Reveal… Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions… The cough … Thefive questions, whichareanswered by the child'sparent orcaregiver, cover cough frequency (Q1), sleep disturbance of the child(Q2), sleep disturbance of ... parent's global assessment… ... strident cough, and lethargy. History of Present Illness . ������ɪ�)+�����$�e�G-�U��h�B���C\x����P�|m+P�r��x��C%ď���-Z:�-]�U�oasc��������ة@%N��O��?���͍�4:��@��뛳�v~=pZ� ��:�% Fd{�|� Acute cough in children with upper respiratory infection symptoms and no red flag findings is usually caused by a viral infection, and testing is rarely indicated. The history should focus on identifying the duration, quality, triggers, progress and diurnal/seasonal variation of the cough… The patient continued her post-operative course of antibiotics using PO medications. Daniel “Danny” Rivera is an 8-year-old boy who comes to the clinic with a cough. Jul 4, 2020 - Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data Subjective Data Collection: 20 of 20 (100.0%) Daniel “Danny” Rivera is an 8-year-old boy who has had a cough … Pre Brief. Pneumonia, bronchiolitis, whooping cough and airway foreign body (object) Cough Variant Asthma Asthma is the most common cause of chronic cough in children. * All patients require a chest x-ray when they present for the first time with chronic cough. Use of nonspecific drugs for cough suppression is discouraged in children. Pediatric chronic cough (ie, cough in children aged < 15 years) is defined as a daily cough lasting for > 4 weeks.This time frame was chosen based on the natural history of URTIs in children and differs from the definition of chronic cough … In young children with sudden cough and no fever or URI symptoms, the examiner should have a high index of suspicion for foreign body aspiration. �q��_�.���ݯB�16�m(�I�ݟ-�n���(�nI��`D��h���Uh�J9��ء%��qi���p�=,-TYkh"���JGv����[�*�e���x�x[�A��`�K3��J6f�� bw�V��D���_�m�JX����2k� �6��fԢ� /�9g�9)�Zjg敏їa����*�6��lD�EH�MӼr���� 6=d-h���ĕ2���*y���o���1k! The cough … Shadow Health: Focused Exam: Cough Results Danny Riviera. For example, if allergic sinusitis is suspected and treated with an antihistamine that does not alleviate symptoms, a head CT may be necessary for further evaluation. This respiratory illness, recognized by physicians for centuries, derives its name from an Anglo-Saxon word, kropan, or from an old Scottish w… The link you have selected will take you to a third-party website. 4 0 obj
4. It is important for you to determine whether or not Danny is in distress, explore the underlying cause of his cough…
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