Upper Respiratory Tract Infections

Mr. Smith brings his 4-year-old son to your primary care office. He states the boy has been ill for three days. Mr. Smith indicates that he would like antibiotics so he can send his son back to pre-school the next day.

History – Child began with sneezing, mild cough, and low grade fever of 100 degrees three days ago. All immunizations UTD. Father reports that the child has had only two incidents of URI and no other illnesses.

Social – non-smoking household. Child attends preschool four mornings a week and is insured through his father’s employment. No other siblings in the household.

PE/ROS -T 99, R 20, P 100. Alert, cooperative, in good spirits, well-hydrated. Mildly erythemic throat, no exudate, tonsils +2. Both ears mild pink tympanic membrane with good movement. Lungs clear bilaterally. All other systems WNL.

Do not consider COVID-19 for this patient diagnosis.

For the assignment, do the following:

  1. Diagnose the child and describe how you arrived at the diagnosis (i.e. how you ruled out other diagnoses).
  2. Provide a specific treatment plan for this patient, pharmacologic and/or nonpharmacologic.
  3. Provide a communication plan for how the family will be involved in the treatment plan.
  4. Provide resources that Mr. Smith could access which would provide information concerning your treatment decisions.
  5. Utilize national standards, your pharm and/or patho book and medical or advanced practice professional sources. Do not use patient-facing sources or general nursing texts to support your diagnosis and treatment.
  6. Use references to support your concepts. Utilize correct APA formatting and mechanics of professional communication.

Answer

Upper Respiratory Tract Infections

Child Diagnosis and Differential Diagnoses

There are various upper respiratory tract infections. They include common cold, influenza, allergic and vasomotor rhinitis, intranasal foreign body, and sinus. Thomas & Bomar (2021) note that influenza is a more acute condition with more severe symptoms, occurring and worsening within twenty hours. The child has had the mild symptoms for three days, ruling out influenza. Allergic and vasomotor rhinitis primarily manifest with inflammation of the nasal mucosal hence nasal drainage, itching, and nasal congestion are absent in Mr. Smith’s son (Meng, Wang, $ Zang, 2019). Intranasal foreign bodies present with rhinorrhea, pain, swelling, and no fever except in severe cases. The child presents with different symptoms ruling out the foreign bodies. Sinusitis is the inflammation of the membrane of the sinuses, and the presentations depend on the affected sinuses. They include nasal congestion, facial pain (sinus inflammation), and nasal congestion absent in this child, ruling out the diagnosis (Leung et al., 2020). Common cold is prevalent in children and is caused by a viral infection of the upper respiratory tract. The symptoms have an acute onset (less critical than influenza), ranging from mild to severe (Thomas & Bomar, 2021). They include nasal congestion, stuffiness, sore throat, cough, and fever.

Management of Common Cold

Common cold is a mild healthcare condition that requires only supportive management. Decongestants and antiviral therapies in children below four years lack clinical trials showing their efficacy, and the FDA advises against their use (Thomas & Bomar, 2021). Symptomatic management using antipyretics and supportive therapy is the mainstay of treatment for Mr. Smith’s son. Ibuprofen 20mg/kg/day oral dosage will help reduce the fever. Nasal irrigation using saline nasal drops is another mainstay management to help dry secretions and congestion. Throat saline spray/irrigation will also help with the sore throat. Zinc sulfate supplement will help reduce the cold’s duration and reduce the severity of the symptoms. Minimizing exposure to a cold environment using warm jackets, gloves, and socks will help prevent severe common cold symptoms (Susan et al., 2022). These interventions will help manage the symptoms and reduce the severity and duration of the cold.

Communication Plan

The family’s involvement in managing this patent is vital. The parent must understand the medications, dosages, importance, routes, and precautions. Nasa drops are instilled twice daily, in the morning and evening, and nasal saline sprays are used similarly (Susaman et al., 2022). Ensure the baby’s nostrils are clear before instilling three drops in each nose. The father also educates on why his child will not receive antibiotics because it is the common cold. Education will also entail follow-up if the cold does not resolve after a week. Common cold resolves independently, and the parent also needs to understand that. Teaching the parent will ensure they participate in care delivery and promote better patient outcomes. Reminding the father to help monitor the child by frequent handwashing and avoiding touching eyes and face will be necessary (Thomas & Bomar, 2020).

Resources on Management of Common Cold

Various resources provide information about common cold, its causes, management, and prevention. Some resources also provide information on the management of common cold. The CDC investigates and releases reports on conditions and their management (CDC, 2021). It provides updated information on current common cold treatments for a common cold. The organization will also give more information to support my choices in managing the child’s cold.

Common cold in adults and children is a mild healthcare condition with mild upper respiratory tract symptoms and fever. It requires only supportive therapy and some medications such as antipyretics, antihistamines, and decongestants. Managing these symptoms hastens the resolution process because a common cold resolves independently. Proactive management of this patient will help prevent exacerbations and will also help him resume his everyday disease-free life.

References

Center for Disease Control and Prevention (CDC), (2021). Common Cold. Disease or Condition of the Week. https://www.cdc.gov/dotw/common-cold/index.html

Leung, A. K., Hon, K. L., & Chu, W. C. (2020). Acute bacterial sinusitis in children: an updated review. Drugs in Context9. https://doi.org/10.7573/dic.2020-9-3

Meng, Y., Wang, C., & Zhang, L. (2019). Recent developments and highlights in allergic rhinitis. Allergy74(12), 2320-2328. https://doi.org/10.1111/all.14067

Thomas, M., & Bomar, P. A. (2021). Upper Respiratory Tract Infection. In StatPearls [Internet]. StatPearls Publishing.

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