Respiratory disorders form the crucial component of development in children (Dinwiddie, 1997). Based on the fact that these disorders may get manifested differently in the patient, a proper diagnostic and treatment plan is necessary. It is, however, important to recognize the various respiratory problems as severe health conditions and required diagnosis and treatment plan whenever they occur. Some of the common respiratory disorders that attack children include Asthma, cystic fibrosis, and bronchopulmonary dysplasia, tuberculosis (TB) among others.
Case Study at Hand
In the case study given, the physical examination and diagnosis reveal that the respiratory is 18, with the clear lungs about auscultation. Secondly, the slightly enlarged nasal turbinates and the moderate clear rhinorrhoea also offered the indication of the respiratory disorder that the child suffered. Following these signs and symptoms, it can be inferred that the child in this case study has the Asthma. Differentiating between the allergy symptoms and the turbinate hypertrophy may be impossible, especially for those who have grown to tolerate their symptoms (Bradley et al. 2011). The causes of the Asthma are not limited to the allergy related symptoms and also factors such as upper respiratory infections, drugs, hormones, changes in temperature, vasomotor rhinitis and the allergic rhinitis.
Differential Diagnosis
The three primary and differential diagnosis for the patient in the case study integrate a keen examination of the symptoms associated with the Asthma, the manner in which the symptoms get manifested within the patient and the effects (National Heart, Lung, and Blood Institute, 2007). However, the most useful diagnostic criteria which may be applied to the patient in this case study is through the use of symptoms portrayed by the disorder. Fundamentally, the nasal congestion has been identified as the most common symptom associated with this disease. Ideally, these signs may be mild, or congestion may be tremendous that the only way of relieving the patient is to overuse the topical decongestants such as the oxymetazoline or the phenylephrine.
Spirometry Testing
The diagnosis of asthma in children tremendously requires a careful examination of the current and the past medical information of the child. It is in addition to the family history and physical examination. The spirometry testing measures the volume of air blown out after a child takes a very deep breath and exhales afterward. Just like in the case study, the patients with Asthma usually report nasal congestion, postnasal drainage and sometimes the midfacial headache. In some occasion, the patient may demonstrate the anterior rhinorrhea. The lungs may also be clear to auscultation, with the patient being able to take deep breathes at some points without serious coughing. Notably, these symptoms may be accompanied by the slightly enlarged nasal turbinates with no cervical adenopathy. The test may be repeated upon utilization of an asthma inhaler or nebulizer by the child.
Bronchial Challenge Testing
A bronchial challenge test is recommended to check asthma in pediatrics. It is a form of medical therapy, which is the most common form of treatment and a control of this disorder (Gopakumar & Urmila, 2008). On a wider note, the primary challenge tests entail the inhalation of an agent such as the methacholine which induces bronchoconstriction or breathing cold air. Utilization of the nasal decongestants, both the topical and oral forms play important roles in reducing the congestions (Anbar, 2012 and Burns et al. 2013). However, the resistance and tolerance to medication such as the oxymetazoline may prove problematic in some occasion.
Additional Testing
Another testing that is applicable in the case is the chest X-ray, which reveals that status of the internal organs of the abdomen. Ideally, the additional testing is significant in the cases where the first two test have not generated sufficient outcomes.
Treatment and Management
The treatment should be given in a stepwise approach according to the persistence, severity, and frequency of symptom, and may involve the use of antifungal to control, relieve and treat. The prescriptions of the medications depend on various factors such as the symptoms observed. The medication available for asthma include Cromolyn sodium, Anti-IgE antibodies, and Sustained-release theophylline, The oral decongestants are effective, based on the fact they do not cause rebound swelling even after being applied for a considerably long time. The strategies that should be used to educate families and patients include providing knowledge regarding evidence-based guidelines, the clinical implications and management plans (Milunsky, 2004 and McLuckie, 2009). Assessing, diagnosing and treatment of the pediatric patients for respiratory, cardiovascular and genetic disorders may prove to be a challenging task. Patients and families need to be educated regarding the treatment and management plan for this group of disorders. An advanced medical practitioner or nurse must possess knowledge of current evidence-based guidelines. Families and patients must, therefore, know when to seek treatment, and when to ask for referral where necessary.
Conclusion
In conclusion, this paper has offered an expository assessment of diagnosis and management of a respiratory disorder, based on the case study provided. Notably, respiratory diseases form the crucial component of development in children. A proper diagnostic and treatment plan is necessary based on the fact that these disorders may get manifested differently in the patient.
References
Anbar, R. D. (2012). Functional respiratory disorders: When respiratory symptoms do not respond to pulmonary treatment. New York: Humana Press.
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier.
Bradley, J. S., Byington, C. L., Shah, S. S., Alverson, B., Carter, E. R., Harrison, C., .Swanson, J. T. (2011). The management of community-acquired pneumonia in infants and children older than 3 months of age: Clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clinical Infectious Diseases, 53(7), e25e76. Retrieved fromhttp://cid.oxfordjournals.org/content/53/7/e25.full.pdf+html
Dinwiddie, R. (1997). Diagnosis and management of paediatric respiratory disease. New York: Churchill Livingstone.
H, G., Gopakumar, R., & Urmila, K. E. (2008). Clinical pediatrics respiratory disorders. New Delhi: Jaypee Brothers Medical Publishers.
McLuckie, A. (2009). Respiratory disease and its management. London: Springer.
Milunsky, A. (2004). Genetic disorders and the fetus: Diagnosis, prevention, and treatment. Baltimore: Johns Hopkins University Press.
National Heart, Lung, and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm
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