Heres another one. It is only a discussion but I need to reference the text and one outside source at least. You may choose any factor you like.
Discussion: Respiratory Alterations
In clinical settings patients often present with various respiratory symptoms such as congestion coughing and wheezing. While identifying a symptoms 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:
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. Its 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 infants 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.
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 cant 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 dont 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.
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 rhinitisthe primary problem is the cough. She develops these coughing fits that are prolonged very deep and productive of a lot of green sputum. She hasnt 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.
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.