Case Study 1 A 3-month-old female presents with a 4-day history of…
Question Answered step-by-step Case Study 1 A 3-month-old female presents with a 4-day history of… Case Study 1A 3-month-old female presents with a 4-day history of cough, rhinorrhea, congestion, and fevers. Today her mother noticed she was breathing faster and looked like she was having difficulty breathing. She has been taking less formula than normal. Her 3-year-old sister had a cold last week. On physical exam her temperature is 39.0°C, heart rate is 150 beats per minute,respiratory rate is 70 breaths per minute, and blood pressure is 90/50 mm Hg. Her oxygen saturation is 90%. She appears alert but agitated and is tachypneic and coughing with nasal congestion with a lot of secretions. She has significant work of breathing, with subcostal and intercostal retractions. On auscul-tation of her lungs, breath sounds are decreased and wheezing is heard on both inspiration and expiration. A prolonged expiratory phase is also noted. The wheezing has a “wet” quality to it. Sputum culture was sent at this time, patient is RSV+.1. You are requested to assess the child. What respiratory treatment considerations would you recommend at this time?The patient is admitted to the inpatient floor, where she received oxygen therapy by heated high-flow nasal cannulaat an FIO2 of 0.36. The patient required Q1 to Q2 hours suctioning for thick secretions. An IV was placed for decreased feeds and dehydration. The patient was weaned from heated high flow nasal cannula therapy to room air. Feeds improved, and she was discharged 2 days later.2. What are specific diagnostic tests for confirming RSV infection?3. When would you consider using palivizumab? Case Study 2An 18-month-old male presented to the emergency department with a chief complaint of cough. He had a two day history of rhinorrhea; fever; a hoarse cry; a progressively worsening, harsh, “barky” cough; and a whistling sound when he breathes. He has been drinking, but his appetite is diminished. His past medical history is unremarkable. His 5-year-old brother also has cold symptoms. Physical exam includes heart rate at 138 beats per minute, respiratory rate at 38 breaths per minute, blood pressure of 90/63 mm Hg, and oxygen satu-ration of 95% on room air. He is awake and alert, in moderate respiratory distress, and with subcostal and intercostal retractions. Work of breathing increases with nasal flaring when he gets upset. He has a dry, barking cough and a hoarse cry. He has some clear mucus rhinor-rhea but no nasal flaring. His pharynx is slightly injected. He has good aeration bilaterally upon auscultation and has inspiratory stridor at rest. No wheezing or rhonchi are noted. His extremities are warm and pink with good perfusion, capillary refill <2 seconds. 1. How would you classify this patient according to the Westley croup severity scale?2. You are called to the room to do an assessment. What respiratory treatment considerations would you recommend at this time?He is treated with nebulized racemic epinephrine; his coughing subsides and his stridor resolves. A lateral neck X-ray was also completed at this time, which reveals no prevertebral soft tissue widening or evidence of epiglottitis. The subglottic region is mildly narrowed. He is treated with oral dexamethasone. He is discharged home after 1 hour of monitoring, and his parents were instructed to treat him with humidified mist therapy. 3. What is the most common cause of laryngotracheobronchitis? Health Science Science Nursing SCIENCE / RSPT Share QuestionEmailCopy link Comments (0)
