21 hours ago
Main Post week 6 – Nicole
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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 “really bad cold.” The cold is characterized by a profound, deep, mucus-producing cough. She denies any rhinorrhea or rhinitis—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 hasn’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.
In the above scenario Maria most likely has acute bronchitis. Acute Bronchitis is characterized by productive/or non-productive cough, malaise, shortness of breath, and, wheezing (Singj & Zahn, 2019). With bronchitis it is common to experience paroxysmal coughing especially at night (Huether & McCance, 2017). Acute Bronchitis is usually caused by a viral infections the most common being influenza, rhinovirus or something similar (Arcangelo, Peterson, Wilbur, & Reinhold, 2017). Inflammation from an upper airway infections can travel down to the bronchi leading to bronchitis (Singi & Zahn, 2019). The cough from bronchitis usually lasts from 7-10 days but can be prolonged for weeks (Arcangelo et al., 2017). Treatment for bronchitis is typically rest, humidity and cough suppressants (Huether & McCance, 2017).
For people who smoke or are exposed to chemicals have an increased chances of developing bronchitis (National Heart, Lung & Blood Institute [NHLBI], n.d.). Elderly patients, children, and immune-compromised patients are at higher risk of contracting bronchitis as well (NHLBI, n.d.).
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
National Heart, Lung & Blood Institute [NHLBI], (n.d). Bronchitis. Retrieved from: https://www.nhlbi.nih.gov/health-topics/bronchitis
Singh, A. & Zahn, E. (2019). Acute bronchitis. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK448067/
1 day ago
Week 6 Main Post
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Week 6 Main Post
In scenario two, a six-year-old is taken by his parents to the doctor due to an ongoing cough that has lasted over one week. The parents state the cough sounds deep, almost like he is barking. The patient has also been coughing so hard that at times it makes him vomit. The cough does seem to be producing excess mucus at times. The patient has also been running a low-grade fever for several days. The parents also state they are not sure if the boy’s immunizations are up-to-date.
This patient appears to be suffering from whooping cough (pertussis). Pertussis is an infection that is caused by gram-negative bacteria called Bordetella. The bacteria attach themselves to the cilia in the respiratory tract. Since pertussis is a toxin-mediated disease it then releases toxins which paralyze the cilia, producing the cough. Pertussis can produce “multiple antigenic and biologically active products including Pertussis toxin, Filamentous hemagglutinin (FHA), Agglutinogens, Adenylate cyclase, Pertactin, and Tracheal cytotoxin” (CDC, 2019). If pertussis is not treated it can cause serious complications or even death, especially in babies or young children. Pertussis is also very contagious, especially to those who have not had their vaccinations. A patient can still have pertussis even if they have been vaccinated. Those who have been vaccinated tend to have milder symptoms and a shorter duration of the condition.
Symptoms of pertussis usually start around seven to ten days after someone has been exposed. Symptoms can occur in three stages. Stage one can last for a few weeks. It typically includes a runny nose, mild fever, and a mild cough. Stage one can look like a common cold. Stage two can last one to two months and the cough becomes much worse. “There are coughing fits that can be followed by a high- pitched whoop” (Department of Health, 2019). The whooping sound that is heard is the patient trying to catch their breath during the coughing spell. During this phase is when the person can cough so much and so hard that it makes them vomit. In some cases, the person may stop breathing while coughing. Stage three is the recovery phase. This phase can last from a few weeks to several months. This is a slow process and the person infected can actually get sick again if they contract another respiratory infection.
The two factors I chose are behaviors and age. Behaviors play a part when it comes to vaccinations. If parents do not vaccinate their children against pertussis it makes them more susceptible to the disease. It can also make it much worse and last much longer without a vaccination. Since pertussis is very contagious, it is important to keep children’s vaccinations up-to-date. Age can also play a big part in how pertussis affects someone. Anyone can contract pertussis, but it is more prevalent in children. “Symptoms are usually mild in adolescents and adults but in children, less than one year of age symptoms can be particularly severe” (Southern Cross, 2019).
CDC (2019) Pertussis (whooping cough).
Department of Health (2019) Pertussis or whooping cough fact sheet. New York state.
Southern Cross (2019). Whooping cough-symptoms, treatment, vaccination. Southern cross medical library.
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