Discussion: Respiratory Alterations

In clinical settings, patients often present with various respiratory symptoms such as congestion, coughing, and wheezing. While identifying a symptom’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:

Scenario 1:

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. It’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 infant’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 infection.

Scenario 2:

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 can’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 don’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.

Scenario 3:

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.

To Prepare

• Review the three scenarios, as well as Chapter 26 and Chapter 27 in the Huether and McCance text.
• Select one of the scenarios and consider the respiratory disorder and underlying alteration associated with the type of cough described.
• Identify the pathophysiology of the alteration that you associated with the cough.
• 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 colleagues’ 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 following ways:

• Share insights on how the factor you selected impacts the disorder your colleague identified.
• Ask a probing question regarding the disorder that your colleague identified.
• Suggest an alternative disorder for the scenario your colleague selected.

Topics in US Health Delivery

International Comparison of Data

The World Health Organization’s “Statistical Information System” is an interactive database that allows you to compare health indicators for multiple countries. For this Assignment, you will compare data from the two countries you selected for Discussion 2 with the United States (i.e., compare the same countries in both Discussion 2 and the Assignment).

In preparation for this Assignment, consider the value of using standardized quantitative health measures or indicators to compare information internationally. Examine the definitions of indicators presented in the Learning Resources, including pages 55–62 of the Shi and Singh (2015) textbook.

Use the WHO website found in this module’s Learning Resources to examine country statistics and profiles. Create a table to record data related to three health indicators for the three countries (i.e., the two you have selected to compare with the United States, for a total of three countries) as illustrated in the “Module 5 Example” document (located in the Learning Resources).

Once your table is complete, compare the data and analyze it in light of the information presented in this module’s Learning Resources and the research you conducted for Discussion 2. What insights does this comparison give you about health and disease within the U.S. health care delivery system and the systems of the two other countries you selected?

The Assignment

Write a 2- to 3-page paper in which you:

• Identify the two countries that you are comparing with the United States.
• Define the three health indicators you have selected for your analysis and explain why you chose them.
• Include the table you created to record and compare your data.
• Summarize the results of your comparison, sharing at least two insights that you gained through this analysis of health and disease in the United States and your two selected countries.

Due  Friday 09/30/2016 by 1:00 pm CST