Consider the following patient scenario:

A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart). 

Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.

Begin reviewing and replying to peer postings/responses early in the week to enhance peer discussion. See the rubric for participation points. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion. Always use constructive language, even in criticism, to work toward the goal of positive progress.

TASK

Post your initial response to one of the two topics below.

Epidemiology’s Role in Infectious and Communicable Diseases

Topic 1: Disease Outbreak

Select an infectious disease and research the CDC website for information about the disease including: 

• its natural history,
• presenting symptoms, and
• outbreak characteristics
• Identify an occurrence of the disease by searching the Internet for recent reports of this disease and compare that episode or occurrence with information from the CDC website.
• How closely did that outbreak resemble the case definition?

Topic 2: Epidemiological Applications

• Describe how the concept of multifactorial etiology relates to the natural history of disease and the different levels of prevention.
• How should the nurse incorporate these concepts into health promotion of clients in community settings?
• How should the nurse approach client risk in these health promotion activities?

Peer 1

In this week lecture we focus on the concept of epidemiology and the role it plays when dealing with communicable and infectious diseases. In addition, we also learned about environmental health in terms of disease prevention as it related to the 3 levels referred to as primary, secondary, tertiary prevention. Hence, disease prevention are important concepts to understand when dealing with infectious diseases (South University Online, 2019). In my discussion, the infectious disease I choose to talk about is Tuberculosis, also known as “TB”. TB is a bacterial disease caused by the bacterium known as Mycobacterium Tuberculosis. TB is known to primary cause damage in the lungs but can also affect other vital organs within the body spreading to the kidneys, brain, bones, and spine. TB is spread from person to person through “airborne Transmission”. Therefore, TB is spread through the air by an infected person when they cough, talks, or sing (Division of Tuberculosis Elimination, 2016). Common presenting symptoms of TB include sneezing, consistent coughing (that last more than 3 weeks) night sweats, fever, chills, and unexplained loss of appetite (National Health Concil , 2020). 

TB is not generally known to cause outbreaks, which can be described as the detection of more than 3 TB cases that has a epidemiology link associated with its transmission. In the years from 2009-2015, there were 21 outbreak cases of TB. Of these 21 cases reported over 80% of the individuals used drugs and illegal substances, which included some who also suffered from mental illness, and or were homeless. Hence, almost all of the TB outbreaks were due to a delayed diagnosis of the disease (Mindra et al., 2017). On the CDC website, there was a reported occurrences of TB outbreaks from 2002-2008.  In there report they found that the majority of outbreaks occurred among drug users and people who drink an excess amount of alcohol. Hence, both studies revealed that the majority of TB outbreaks was among the homeless, and people suffering with mental health conditions (Division of Tuberculosis Elimination, 2019).

References

Division of Tuberculosis Elimination. (2019, September 6). Data & Statistics. Centers for Disease Control and Prevention. https://www.cdc.gov/tb/statistics/default.htm. 

Division of Tuberculosis Elimination. (2016, March 17). Signs & Symptoms. Centers for Disease Control and Prevention. https://www.cdc.gov/tb/topic/basics/signsandsymptoms.htm. 

Mindra, G., Wortham, J. M., Haddad, M. B., & Powell, K. M. (2017, February 1). Tuberculosis Outbreaks in the United States, 2009-2015. Public health reports (Washington, D.C. : 1974). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5349481/. 

National Health Concil . (2020, March 9). Living With Tuberculosis. American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/tuberculosis/symptoms-diagnosis. 

Talwar, A., Tsang, C. A., Prince, S. F., Pratt, R. H., Walker, W. L., Schmit, K. M., & Langer, A. J. (2019, March 21). Tuberculosis – United States, 2018. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/68/wr/mm6811a2.htm.

Peer 2 

The infectious disease that I have chosen is Tuberculosis. The bacteria called Mycobacterium tuberculosis is what causes TB. Tuberculosis normally attacks the lungs, but it can also attack other body parts like the brain, kidney, or spine. Tuberculosis is spread through the air from one person to the next. The signs and symptoms that the person presents with usually depends on where in the body that the TB is. The signs and symptoms of pulmonary TB are: pain in the chest, coughing up blood or sputum, a bad cough that lasts 3 weeks or longer, no appetite, weight loss, fever, chills. sweating at night, weakness, fatigue. Other signs and symptoms depend on which body part is affected. There are also people who have TD and don’t get sick or presents with any signs and symptoms that are called Latent TB.

When it comes to outbreaks that pertain to TB, they do not happen often. Usually, the infectious period begins about 3 months before the initiation of any symptoms and usually ends when treatment starts. I did find one.  On an Indian Reservation, there were 5 people who tested positive. When the investigation begins the was doing contact tracing to see 1) who did these people come in contact with and 2) where did this all stem from. They were in contact with a total of 126 people, 121 of them did receive a PPD test. 21 of those had latent TB and 19 were started on treatment. The people were in contact with each other at a party where they were really close to each other. This case does resemble most outbreaks and how they present. The first five had a productive cough and sputum.

References

Basic TB Facts. (2016, March 20). Retrieved September 30, 2020, from https://www.cdc.gov/tb/topic/basics/default.htm

Tuberculosis Outbreak on an American Indian Reservation — Montana, 2000–2001. (2002). Retrieved September 30, 2020, from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5111a3.htm