Reference no: EM133881914

Question

You are working as a new family nurse practitioner at a rural family practice clinic, and you see a 3-year-old, 33 lb. female patient brought to the clinic by her mother. Her mother states she had an upper respiratory infection a couple of weeks ago which has improved, but now she has a persistent cough. She has also been tugging at her right ear for the past three days. Her mother is concerned since she has had six ear infections this past year. She has a PMH of ventricular septal defect. She lives at home with her parents. She attends daycare three days a week. She has no known drug allergies.

1. Perform a risk health assessment and identify the risk factors for this patient. What additional health history (subjective) and physical examination (objective) information do you need to formulate your primary (final) diagnosis? Perform a risk health assessment and identify the risk factors for this patient. Discuss three prioritized (urgent & emergent) differential diagnoses, one cardiac and one respiratory, based on this case scenario. Differentiate between viral and bacterial respiratory conditions.

2. Evaluate the criterion for prescribing antibiotics. Discuss the short and long-term consequences of over-prescribing antibiotics. Review evidence-based clinical guidelines to help determine if and what antibiotic would be appropriate. If antibiotics are indicated, what would you prescribe and what would be the dose and dosing interval? Should the formulation be a liquid, or a chewable pill? Why might the taste of the liquid be a consideration in prescribing? Why should the cost of the medication be a consideration in prescribing?

3. Create an education plan that you would provide to the patient/family regarding antibiotic therapy. Discuss the pathogenesis and clinical manifestations of the disease state of one differential diagnosis in a way the family will understand.