Posted: September 13th, 2017

Diagnosis and Management of Respiratory, Cardiovascular, and Genetic Disorders

Diagnosis and Management of Respiratory, Cardiovascular, and Genetic Disorders

To prepare:
• Review “Respiratory Disorders,” “Cardiovascular Disorders,” and “Genetic Disorders” in the Burns et al. text.
• Review and select one of the six provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the respiratory disorder.
Please address the following with bold headings:
An explanation of the differential diagnosis for the patient in the case study you selected.
Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis.
Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments.
Finally, explain strategies for educating patients and families on the treatment and management of the respiratory, cardiovascular, and/or genetic disorder.

Assessing, diagnosing, and treating pediatric patients for many cardiovascular and genetic disorders can be challenging. As an advanced practice nurse who facilitates care for patients presenting with these types of disorders, you must be familiar with current evidence-based clinical guidelines. Because of the clinical implications, you have to know when to treat patients with these disorders and when to refer them for specialized care. In this Discussion, you examine the following case studies and consider appropriate treatment and management plans.
Case Study 6:
You see a 2-month-old for a well-child visit. She is breastfed and nurses every 2 to 3 hours during the day, but her mother reports she is not nursing as vigorously as before. She sleeps one 4-hour block at night. Birth weight was 7 pounds 5 ounces. Weight gain over the last 2 weeks reveals gain of 5 ounces per week. Physical examination reveals the following: HEENT exam is benign, lung sounds are clear, a new III/VI systolic ejection murmur is noted along the left lower sternal border, cap refill is brisk, skin is pink and moist, and abdominal exam is benign.

Required Resources
Readings
• Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care(5th ed.). Philadelphia, PA: Elsevier.
• Chapter 30, “Cardiovascular Disorders” (pp. 669–707)

This chapter reviews normal cardiac structure and function in infants, toddlers, school-age children, and adolescents. It then covers assessment and management strategies for cardiovascular disorders including congenital and acquired heart diseases.
o Chapter 31, “Respiratory Disorders” (pp. 708–738)

This chapter covers the anatomy and physiology of the upper and lower respiratory tracts. It then explores assessment and management strategies for respiratory disorders including upper respiratory tract disorders, extrathoracic and intrathoracic airway disorders, and pectus deformity.
o Chapter 40, “Genetic Disorders” (pp. 1032–1054)

This chapter explores the scope of genetic screening, genetic variation, and genetic disorders. It also provides assessment and management strategies for health care providers caring for children and families with genetic disorders.
• American Academy of Pediatrics, Subcommittee on Diagnosis and Management of Bronchiolitis. (2006). Diagnosis and management of bronchiolitis. Pediatrics, 118(4), 1774–1793. Retrieved fromhttp://pediatrics.aappublications.org/content/118/4/1774.full?sid=cc35023c-502d-474a-9856-bfb5e38eed54

This article examines the diagnosis, management, and prevention of bronchiolitis. It also examines treatment options appropriate for children and provides recommendations for minimalizing the spread of infection.
• 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), e25–e76. Retrieved fromhttp://cid.oxfordjournals.org/content/53/7/e25.full.pdf+html

This article examines diagnosis, management, and treatment strategies for infants and children with community-acquired pneumonia. It also presents site-of-care management decisions and prevention strategies.
• National Heart, Lung, and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved fromhttp://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

These reports provided by the National Heart, Lung, and Blood Institute present guidelines for the diagnosis and management of asthma in children from infancy through adolescence. The pathophysiology of asthma, measures of assessment and monitoring, control of environmental factors, and medication are also covered.
• Zorc, J. J., & Hall, C. B. (2010). Bronchiolitis: Recent evidence on diagnosis and management.Pediatrics, 125(2), 342–349. Retrieved fromhttp://pediatrics.aappublications.org/content/125/2/342.full.pdf+html?sid=f844ba43-543f-4b56-8aa8-a50ee4122140

This article reviews the pathophysiology and epidemiology of bronchiolitis. It also examines the efficacy of treatment options used to treat bronchiolitis.