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Scenario

You are working in a large urban pediatric clinic after-hours.

A mother brings her 6-month-old daughter, Vivi Mitchell, to the clinic for rhinorrhea, congestion, fever, and cough. Upon assessment, you identify the child has wheezing upon auscultation and on inspection, you identify retractions.

• The child is in less than 10th percentile of weight and has a cardiac history of Patent Ductus Arteriosus (PDA).
• Born at 36 weeks gestation.
• Mother states this child doesn’t go to day care but her two other children ages 2 and 3 do attend daycare.
• T- 102.1 HR 140 RR 40 BP 83/58 Pulse ox 96%
• A swab for respiratory syncytial virus (RSV) is positive.

Doctor orders – Nasal bulb suction and saline drops PRN, Tylenol 15mg/kg Q4 PRN for fever, Albuterol nebulizer in office and push po fluids as tolerated.

After the albuterol neb treatment, respirations are 36 and oxygen saturation is 100%. Wheezing has diminished. Mom is an ER nurse and the doctor feels comfortable that she has a nebulizer at home and can return to pediatric afterhours or ER if needed.

Client is discharged with these orders:

• methylprednisolone 0.4 mg/kg oral BID for 3
• Albuterol Q4 hours for 24 hours, then Q 6 hours for 24 hours, and Q6 as needed.
• Call if needed prior to the Q4 dose.
• Manage fever with Tylenol and continue hydration and nasal bulb suction Q6 while awake.
• Return for re-evaluation in 3 days

Instructions:

Criteria:

1. Describe the pathophysiology of bronchiolitis and identify the most common organism causing this infection. What laboratory testing can confirm your suspicion?
2. Describe the pathophysiology of PDA and why the history of PDA is significant in this scenario.
3. What risk factors place Vivi Mitchell at a greater risk for the development of bronchiolitis?
4. What are the characteristic signs/symptoms of bronchiolitis?
5. Vivi Mitchell been prescribed the following medications; acetaminophen, albuterol nebulizer, corticosteroids. Provide the rationale for why each medication has been included as part of her medical management and explain any potential contraindications related to these medications.
6. You are designing Vivi Mitchell’s plan of care. Identify two priority nursing diagnoses to include in your plan. For each nursing diagnosis, identify two SMART goals, and two interventions for each goal.
7. What short and long-term possible complications should the nurse anticipate?
8. What client education is appropriate for Vivi Mitchell as she is discharged from the after-care clinic?

Format

• Standard American English (correct grammar, punctuation, etc.)
• Logical, original and insightful
• Professional organization, style, and mechanics in APA format
• Submit document through Grammarly to correct errors before submission

APA format

900 words

present a 900 words essay discussing the influence and contributions of the public health nursing the healthcare reform.  

As stated in the syllabus the assignment must be presented in an APA format word document, Arial 12 font attached to the forum on the discussion board.  A minimum of 3 evidenced-based references must be used (excluding the class textbook).   Only the assignment must be attached in a word document in the forum, replies do not.  References must be no older than 5 years.  A minimum of 900 words is required.  Please follow the instructions on how to present the first page and the name of the assignment when you post should be.

• Type of paper Essay (Any Type)
   
• Subject Nursing
   
• Number of pages 7
   
• Format of citation APA
   
• Number of cited resources  3
   
• Type of service  Writing
   

Write a paper  (2,000-2,500 words) in which you apply the concepts of epidemiology and  nursing research to a communicable disease. Refer to ″Communicable  Disease Chain,″ ″Chain of Infection,″ and the CDC website for assistance  completing this assignment.  Communicable Disease Selection  Choose one communicable disease from the following list:  Chickenpox Tuberculosis Influenza Mononucleosis Hepatitis B HIV Ebola Measles Polio Influenza Epidemiology Paper Requirements  Address the following:  Describe the communicable disease (causes, symptoms, mode of  transmission, complications, treatment) and the demographic of interest  (mortality, morbidity, incidence, and prevalence). Is this a reportable  disease? If so, provide details about reporting time, whom to report to,  etc. Describe the determinants of health and explain how those factors  contribute to the development of this disease. Discuss the epidemiologic triangle as it relates to the communicable  disease you have selected. Include the host factors, agent factors  (presence or absence), and environmental factors. (The textbook  describes each element of the epidemiologic triangle). Are there any  special considerations or notifications for the community, schools, or  general population? Explain the role of the community health nurse (case finding, reporting,  data collecting, data analysis, and follow-up). Identify at least one national agency or organization that addresses the  communicable disease chosen and describe how the organization(s)  contributes to resolving or reducing the impact of disease. Discuss a global implication of the disease. How is this addressed in  other countries or cultures? Is this disease endemic to a particular  area? Provide an example. A minimum of three peer-reviewed or professional references is required.

Researchers are increasingly looking for answers as allergic diseases continue to rise in the population. The predominant explanation, coined the “hygiene hypothesis” by Professor David Strachan in 1989, states that a lack of early childhood exposure to microbes and other infectious agents increases susceptibility to allergic diseases by suppressing the natural development of the immune system. The idea was widely reported by the media that developed societies, like the United States, have become “too clean”.

Read the following article about the hygiene hypothesis to learn more, then answer the questions below in your initial post:

Bradford, A. (2016). What is the Hygiene Hypothesis? Live Science. Accessed at http://www.livescience.com/54078-hygiene-hypothesis.html on September 14, 2016.

1. Conduct some independent research on the hygiene hypothesis. What contradictory evidence against the hypothesis can you find?
2. Have any new hypotheses been proposed to explain the increase in allergic conditions? How does it support the original hygiene hypothesis?

Do you think the hygiene hypothesis needs to be renamed? Why or why not?

250 words