Rasmussen College Pathophysiology of Bronchiolitis Discussion Questions

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Module 7 Assignment: Purpose of Assignment This assignment will help to identify the normal growth and development by topic for each age group. In the final column of the assignment you need to observe a child and apply the information you gathered and document your findings in comparison by the particular age of that child. Competency Apply the foundations of pediatric nursing when caring for clients with health alterations. Scenario You are working in a large urban pediatric clinic after-hours. A mother brings her 6-month-old daughter, Vivi Mitchell, to the clinic for rhinorrhea, congestion, fever, and cough. Upon assessment, you identify the child has wheezing upon auscultation and on inspection, you identify retractions. • The child is in less than 10th percentile of weight and has a cardiac history of Patent Ductus Arteriosus (PDA). • Born at 36 weeks gestation. • Mother states this child doesn’t go to day care but her two other children ages 2 and 3 do attend daycare. • T- 102.1 HR 140 RR 40 BP 83/58 Pulse ox 96% • A swab for respiratory syncytial virus (RSV) is positive. Doctor orders - Nasal bulb suction and saline drops PRN, Tylenol 15mg/kg Q4 PRN for fever, Albuterol nebulizer in office and push po fluids as tolerated. After the albuterol neb treatment, respirations are 36 and oxygen saturation is 100%. Wheezing has diminished. Mom is an ER nurse and the doctor feels comfortable that she has a nebulizer at home and can return to pediatric afterhours or ER if needed. Client is discharged with these orders: • methylprednisolone 0.4 mg/kg oral BID for 3 • Albuterol Q4 hours for 24 hours, then Q 6 hours for 24 hours, and Q6 as needed. • Call if needed prior to the Q4 dose. • Manage fever with Tylenol and continue hydration and nasal bulb suction Q6 while awake. • Return for re-evaluation in 3 days Instructions In a two to three-page APA formatted paper, provide reponses for these questions and requests for information: Criteria: 1. Describe the pathophysiology of bronchiolitis and identify the most common organism causing this infection. What laboratory testing can confirm your suspicion? 2. Describe the pathophysiology of PDA and why the history of PDA is significant in this scenario. 3. What risk factors place Vivi Mitchell at a greater risk for the development of bronchiolitis? 4. What are the characteristic signs/symptoms of bronchiolitis? 5. Vivi Mitchell been prescribed the following medications; acetaminophen, albuterol nebulizer, corticosteroids. Provide the rationale for why each medication has been included as part of her medical management and explain any potential contraindications related to these medications. 6. You are designing Vivi Mitchell’s plan of care. Identify two priority nursing diagnoses to include in your plan. For each nursing diagnosis, identify two SMART goals, and two interventions for each goal. 7. What short and long-term possible complications should the nurse anticipate? 8. What client education is appropriate for Vivi Mitchell as she is discharged from the after-care clinic? * Include a minimum of 2 scholarly sources Format • • • Standard American English (correct grammar, punctuation, etc.) Logical, original and insightful Professional organization, style, and mechanics in APA format
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Running Head: BRONCHIOLITIS

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Bronchiolitis
Student’s Name
Institutional Affiliation
Date

BRONCHIOLITIS

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1. Describe the pathophysiology of bronchiolitis and identify the most common
organism causing this infection. What laboratory testing can confirm your
suspicion?
The pathophysiology of bronchiolitis originates when the epithelial cells lining
the small airways within the lungs are acutely infected, leading to edema, increased
production of mucus, and ultimately, the necrosis and degeneration of the epithelial cells
(Nasrawi, 2017). Clinically, it presents as rhinitis, tachypnea, cough, hypoxia, use of
accessory respiratory muscles, and variable wheezing, as well as crackles upon
auscultation.
Bronchiolitis is caused by an acute viral infection. The most common infectious
agent is the respiratory syncytial virus (RSV). It can also be caused by adenovirus, human
metapneumovirus, influenza virus, and parainfluenza virus.
Tests to confirm if the child has bronchiolitis include a mucus sample test
(nasopharyngeal swab) to identify the presence of RSV and other viruses, chest x-ray,
urine or blood tests, and a pulse oximeter test to measure the amount of oxygen.
2. Describe the pathophysiology of PDA and why the history of PDA is significant in
this scenario.
The pulmonary artery and the aorta are connected by the ductus arteriosus which
is necessary for the normal functioning of fetal circulation. When the child is born, an
increase in PaO2 and a decrease in prostaglandin concentration result in the closure of the
ductus arteriosus. This happens within the first ten to fifteen hours of life. In the event
this normal process fails to occ...

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