cASE STUDY 2 JAZZ 2025

MEDICAL MYSTERY FOR CHAPTER 2: Maddy Her mother noticed that Maddy was not eating well and seemed to be sick more often than her brothers. She had more than her share of respiratory infections, and despite all the antibiotics, these conditions persisted. Maddy’s mother noticed that her stools sometimes smelled bad, but their general practitioner said that this was probably due to a change in her diet. Despite regular visits to the doctor, Maddy’s chest was always congested. Recently, the doctor found some polyps in her nose and said that Maddy had developed an allergy that was the most likely reason for all her symptoms. Her mother was not satisfied and became worried because Maddy was not gaining weight and was very lethargic. Even during simple play with her brothers, she was always out of breath. Finally, Maddy’s mother decided to seek out a pediatric specialist. THE EVALUATION When I saw Maddy at our outpatient clinic at the children’s hospital, I noticed that she was underweight and looked ill. She also appeared dehydrated, so I decided to admit her for inpatient care. Her mother said that Maddy was the only sickly child in the family and that there was nothing unusual in their family history. A chest x-ray revealed that Maddy has had recurrent lung infections, so I ordered additional x-rays of her thoracic cavity. I decided to also evaluate the amount of salt in the sweat on Maddy’s skin. While I waited for these results, I also decided to do some genetic tests on a sample of Maddy’s blood. When these test results came back, I asked that the other children in the family be evaluated using the sweat test. Their results did not reveal unusually high levels of salt. THE DIAGNOSIS I had the difficult task of telling Maddy’s mother that her daughter has cystic fibrosis (CF). An inherited condition, CF affects the cells that produce mucus, sweat, saliva, and digestive juices. Normally, these secretions are thin and slippery, but in CF, a defective gene causes the secretions to be thick and sticky. Instead of acting as a lubricant, the secretions plug up tubes, ducts, and passageways, especially in the pancreas and lungs. Difficulty in breathing is the most common presentation, along with excess salt in the sweat and foul-smelling, greasy stools. Both of Maddy’s parents turned out to be carriers of the CF gene. Because the gene is recessive, it can only produce the disease if a child receives the gene from each parent. Maddy was unlucky enough to have this happen. THE TREATMENT Although CF shortens the life span of those it affects, early diagnosis and a comprehensive treatment plan can improve both survival rate and quality of life. I told Maddy’s mother that her daughter would need antibiotics for her lung infections and physical therapy to help her cough up the thick secretions. In addition, I prescribed some medications that would make her breathing easier. I recommended that the mother give Maddy special enzymes to allow her to absorb food better, and encouraged her to give Maddy a high-calorie diet. I told her that Maddy must be regularly seen in the CF clinic and that other treatment options would be discussed in due time. CASE CLOSED When I saw Maddy again 6 months later, both she and her mother were still learning to live with her condition and with her daily medical regimen. Maddy continues to be small for her age, but is not shy about expressing her opinions. Her older brothers have become very protective of their little sister now that they realize how vulnerable she is to lung infections. Although only about half of those diagnosed with CF as infants or young children live beyond their late twenties, this percentage is rising as an increasing number of patients survive into adult life. It is possible that in the future, she will be a candidate for a lung transplantation, which might extend her life considerably. Discussion Questions Cystic fibrosis is a genetic disorder. What does this mean? Can you name two other genetic disorders? The doctor requested x-rays of Maddy’s thoracic cavity. What is this? The CF gene is recessive. What does this mean?

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Assignment: Agenda Comparison Grid and Fact Sheet or Talking Points Brief 2025

It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember. Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since. As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news. In this Assignment, you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy. To Prepare: Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations. Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations. Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected. Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda. The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page Fact Sheet) Part 1: Agenda Comparison Grid Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following: Identify and provide a brief description of the population health concern you selected and the factors that contribute to it. Describe the administrative agenda focus related to the issue you selected. Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue. Explain how each of the presidential administrations approached the issue. Part 2: Agenda Comparison Grid Analysis Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following: Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected? How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there? Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents? Part 3: Fact Sheet or Talking Points Brief Using the information recorded on the template in Parts 1 and 2, develop a 1-page narrative that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following: Summarize why this healthcare issue is important and should be included in the agenda for legislation. Justify the role of the nurse in agenda setting for healthcare issues. By Day 7 of Week 2 Submit your final version of Part 1: Agenda Comparison Grid, Part 2: Agenda Comparison Grid Analysis, and Part 3: Fact Sheet or Talking Points Brief. Submission and Grading Information To submit your completed Assignment for review and grading, do the following: Please save your Assignment using the naming convention “WK2Assgn+last name+first initial.(extension)” as the name. Click the Week 2 Assignment Rubric to review the Grading Criteria for the Assignment. Click the Week 2 Assignment link. You will also be able to “View Rubric” for grading criteria from this area. Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn+last name+first initial.(extension)” and click Open . If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database . Click on the Submit button to complete your submission.

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