Respiratory Case Study

For this question, please read the following case study and then respond to the questions noted below

Johnathan, age 7, presents to the office with symptoms of worsening cough and wheezing for the past 24 hours. He is accompanied by his mother, who is a good historian. She reports that her son started having symptoms of a viral upper respiratory infection 2 to 3 days ago, beginning with a runny nose, low-grade fever of 101.0 degrees F orally, and loose cough. Wheezing started on the day before the visit, so Johnathan ‘s mother started administering albuterol metered-dose inhaler (MDI) two puffs before bed and then two puffs at around 2 AM. The cough and wheezing appear worse today, according to the mother. He had difficulty taking deep-enough breaths to inhale this morning’s dose of albuterol, even using the spacer.

Johnathan has been a patient at the clinic since birth and is up to date on his immunizations. His growth and development have been normal, and he is generally healthy except for mild intermittent asthma. This is his first asthma exacerbation of the school year, and his mother expresses a concern about sending him to school with an inhaler.

Johnathan is afebrile with a respiratory rate of 36 and a tight cough every 1 or 2 minutes. He weighs 45 pounds (20.5 kgs.). The examination is all within normal limits except for his breath sounds. He has diffused expiratory wheezes and mild retractions. Pulse oximetry readings have been 93% of oxygen saturation.

1. What is the appropriate pharmacological therapies to be prescribed for Johnathan
2. What information is necessary to provide to Johnathan and his mother regarding asthma exacerbation?
3. What is an appropriate clinical assessment tool to be use with Johnathan?
4. What are the classification of asthma?
5. How would you as the NP address his mother’s concern regarding providing an inhaler at school?
6. What is an appropriate plan of care for Johnathan?

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 Outline the concept of professional accountability as it pertains to nursing. Provide examples of how a nurse demonstrates professional accountability in clinical expertise, the nursing process, and evidence-based practice 

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Select ONLY ONE question listed below to write an essay for this week’s discussion forum.

1.  From Chapter 7, p 182-191, Darr (2011, p. 150) writes, “Managers must achieve the difficult balance between loyalty to the organization and fidelity to their personal ethic and professional integrity. How far should a manager go in following the crowd or in standing alone?”.  Address this question with details and supporting/opposing opinions.

2.  From Chapter 7, whistle-blowing is discussed.  Define the term whistle-blowing.  Identify positive and negative outcomes of whistle-blowing for the party who exposed the issue(s).

No formal format required, 200-250 words required. This is a very short forum post, simple and to-the-point answer needed only.

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This week you will submit the Literature Review section of your proposal. Each week you have been adding to your growing body of evidence to support your problem and proposed innovation to address the problem. The review of literature is a critical, analytical summary and synthesis of the current knowledge of your research topic. Thus it should compare and relate different theories, findings, etc., rather than just summarize them individually.

The following resources will help guide you (in addition to our course textbooks):

THE WRITER’S HANDBOOK

Guidelines for writing a literature review

The Writing Center at UNC-Chapel Hill

Writing the Literature Review: Step-by-Step Tutorial for Graduate Students

Writing the Literature Review (Part Two): Step-by-Step Tutorial for Graduate Students

Submission Details:

• Submit your assignment to the Submissions Area by the due date assigned.

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