NU641_Week 7 Assignment 1: Interactive Upper Respiratory Case Study

NU641_Week 7 Assignment 1: Interactive Upper Respiratory Case Study

Week 7 Assignment 1: Interactive Upper Respiratory Case Study

The provided case study demonstrates a 45-year-old female patient by the name of Jackie with a history of eczema, controlled asthma, and controlled hypertension. The patient presents with symptoms of productive cough, sneezing, sore throat, headache, and nasal congestion for the past four days. She reports an allergy to ragweed and mums. None of the family members of the patient displayed similar symptoms. She reports taking mometasone, albuterol, lisinopril, and oxymetazoline hydrochloride nasal spray to manage her symptoms. The purpose of this paper is to evaluate and determine the most appropriate pharmacological interventions for the management of the patient’s condition.

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Most Appropriate Drug to Recommend

Based on Jackie’s presenting symptoms, the most appropriate drug to recommend is Naproxen 220mg, one tablet twice daily as needed until her symptoms completely resolve. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) used for the managementof fever, headache, and muscle pain associated with patients displaying common cold-like symptoms (Khoo et al., 2020). The patient should continue taking mometasone, albuterol, and lisinopril for the management of her hypertensive and asthmatic condition, in addition to the additional symptoms reported. However, prolonged use of Oxymetazoline hydrochloride for more than 3 days is associated with rebound congestion. As such, it is necessary to advise the patient to discontinue using the drug henceforth and turn on nonpharmacological approaches for the management of her nasal congestions.

Non-Pharmacological Therapies

            The use of steam inhalation is not recommended for the patients. According to a study conducted by Scarborough et al., (2021) use of steam inhalation did not display any consistent benefit in the management of the common cold, but instead, respiratory burn injuries were reported. As such, it was concluded that the harm associated with steam inhalation outweigh its benefits, hence should not be recommended anymore in clinical guidelines and patient brochures. Use of menthol lozenges is however recommended since they exhibit anesthetic and anti-irritating properties locally hence relieving minor throat irritations causing sore throat among patients with the common cold. Increased water intake is also recommended for the replacement of fluid lost to congestion and productive cough among other factors.

The use of saline gargles should be closely monitored since the patient has a history of controlled hypertension. Despite evidence showing great effectiveness in the management of sore throat with saline gargles, clinical guidelines recommend that hypertensive patients with a common cold should speak with their physician before gargling with salt water (Sánchez et al., 2021). Hypertensive patients are advised to reduce their intake of sodium as a dietary intervention to control their blood pressure. As such use of saline gargles can lead to an increased sodium intake which will, in turn, increase the patient’s blood pressure leading to avoidable complications.

Complementary Therapy

            Several complementary products are recommended to promote the immune system in addition to the prevention and management of symptoms associated with common cold and flu. Such products include high-dose vitamin C, echinacea, and zinc lozenges. However, for Jackie, the most appropriate recommendation is Vitamin C- 1g daily doses. Studies show that higher doses of vitamin C have been associated with improved immunity and reduction in the severity and length of presenting symptoms associated with common cold and flu (Van Driel et al., 2019). Vitamin C is also considered safe to take with mild gastrointestinal symptoms when taken in high doses such as diarrhea and nausea.

Echinacea purpureatincture, on the other hand, belongs to the daisy family, hence not recommended for the patient since she reported a ragweed allergy. Additionally, only limited studies have associated the herb with beneficial effects in treating common cold caused by influenza(David & Cunningham, 2019). Fresh garlic and cloves display both antibiotic and antiviral properties which can help manage cold but require prolonged use of the remedies. Consequently, limited research has been conducted to prove the safety of these complementary products. Lastly, Acidophilus probiotic is considered a preventive therapy rather than treatment therapy for common cold associated with the influenza virus. Studies show that prolonged use of Acidophilus probiotics reduces the incidences of fever, cough, and incidences of antibiotic prescription among patients with upper respiratory tract infections.

Conclusion

The patient in the provided case study presents with symptoms of common cold with a history of controlled hypertension, eczema, and controlled asthma. In addition to the drugs the patient is already taking, other than Oxymetazoline hydrochloride, it is necessary to recommend the use of naproxen 220mg, one tablet twice daily until symptoms resolve in addition to non-pharmacological interventions such as menthol lozenges, and increased water intake for the management of her symptoms. The patient will also need to take Vitamin C Ig every day to promote her immunity and treat her symptoms.

References

David, S., & Cunningham, R. (2019). Echinacea for the prevention and treatment of upper respiratory tract infections: A systematic review and meta-analysis. Complementary therapies in medicine, 44, 18-26. https://doi.org/10.1016/j.ctim.2019.03.011

Khoo, A., Kiley, M., &Goadsby, P. J. (2020). Managing external cold-stimulus headache with preventive naproxen. Cephalalgia Reports, 3, 251581632091569. https://doi.org/10.1177/2515816320915696

Sánchez, X., Orrico, M., Morillo, T., Manzano, A., Jimbo, R., & Armijos, L. (2021). Reducing unnecessary antibiotic prescription through implementation of a clinical guideline on self-limiting respiratory tract infections. Plos one, 16(4), e0249475. https://doi.org/10.1371/journal.pone.0249475

Scarborough, A., Scarborough, O., Abdi, H., & Atkins, J. (2021). Steam inhalation: More harm than good? Perspective from a UK burns center. Burns, 47(3), 721-727. https://doi.org/10.1016/j.burns.2020.08.010

Van Driel, M. L., Beller, E. M., Thielemans, E., Deckx, L., Price‐Haywood, E., Clark, J., & De Sutter, A. I. (2019). Oral vitamin C supplements to prevent and treat acute upper respiratory tract infections. The Cochrane Database of Systematic Reviews, 2019(3). https://doi.org/10.1002/14651858.CD013292

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Week 7 Assignment 1: Interactive Upper Respiratory Case Study
Value: 100 points
Due: Day 7
Grading Category: Case Studies (Assignments)
Instructions
In this assignment, you will review the interactive Upper Respiratory Case Study patient scenario and analyze the data to determine the health status of the patient. You will need a minimum of two evidence-based practice articles to include clinical practice guidelines, as well as the course textbook.
• Use the NU641 Upper Respiratory Case Study Questions (Word) document to complete the case study assignment.
• Follow the requirements posted in the rubric.
• This case study should be three to five pages, excluding title and references pages.
All papers must conform to the most recent APA standards.
Please refer to the Grading Rubric for details on how this activity will be graded.
To Submit Your Assignment:
1. Select the Add Submissions button.
2. Drag or upload your file to the File Picker.
3. Select Save Changes.
Week 7: Introduction and Objectives
Introduction
Respiratory is covered over two weeks — we will learn about acute this week and chronic next week. We will safely and appropriately select respiratory pharmacologic agents in the management of client health issues based on client variations, the problems being managed, and cost effectiveness. We will also discuss comprehensive and appropriate client education in relation to prescribed pharmacologic agents. Acute respiratory topics include: Allergy and Viral URI, Cough and Cold, Sinusitis, and Influenza and Pneumonia.
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Learning Objectives
By the end of this week, you will be able to:
1. Select the optimal pharmacologic agents in the management of chronic respiratory illnesses.
2. Discuss the pharmacological agents in the management of tobacco cessation.
3. Discuss comprehensive client education in relation to prescribed pharmacologic agents.
4. Analyze factors influencing adherence behavior to prescription medications and the use of medications as a means to promote, maintain, and restore health to clients.
Week 7: Learning Materials
Readings
Required
• Woo, T. M., & Robinson, M. V. (2020). Pharmacotherapeutics for advanced practice nurse prescribers (5th ed.). Philadelphia, PA: F.A. Davis Company.
o Chapter 14: Drugs Affecting the Respiratory System
o Chapter 45: Pneumonia
o Chapter 46: Tobacco Cessation
o Chapter 49: Upper Respiratory Infections: Otitis Media and Otitis Externa
The Writing for Publication e–book is available from the Regis College Library.
Recommended Texts
• Recommended for drug dosing desk reference of adult populations based practitioners: Lexicomp. (2017). Drug information handbook for advanced practice nursing (17th ed.). Hudson, OH: Wolters Kluwer Clinical Drug Information.
• Recommended for drug dosing desk reference of pediatric and family medicine populations based practitioners: Taketamo, C. K. (2017). Pediatric and neonatal dosage handbook (24th ed.). Hudson, OH: Lexicomp Incorporated
Recommended Resources
• AANP: State Practice Environment
• Nurse Practitioner Authority by State
• Pharmaceutical Online
Lecture Presentations
View the following presentations for more information regarding this week’s learning content.
• Drugs Affecting the Respiratory System Lecture (PPT)
• Pneumonia Lecture (PPT)
• Tobacco Cessation Lecture (PPT)
• Upper Respiratory Infections: Otitis Media and Otitis Externa Lecture (PPT)
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Videos
Treatment of Upper Respiratory Infections (2:02 Minutes)
Treatment of Upper Respiratory Infections Video Transcript
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Antibiotics and You (5:05 Minutes)
Antibiotics and You Video Transcript
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Combating Antibiotic Resistance: Antibiotic Use (2:27 Minutes)
Combating Antibiotic Resistance: Antibiotic Use Video Transcript
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Mechanisms and Classification of Antibiotics (24:20 Minutes)
Mechanisms and Classification of Antibiotics Video Transcript
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Side effects of Anti Tubercular drugs (4:04 Minutes)
Side effects of Anti Tubercular drugs Video Transcript
Clinical Case Study Rubric
Note: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.
Clinical Case Study Rubric – 100 Points
Criteria Exemplary
Exceeds Expectations Advanced
Meets Expectations Intermediate
Needs Improvement Novice
Inadequate Total Points
Content of Clinical Case Study The writer demonstrates a well-articulated understanding of the case study subject matter in a clear, complex, and informative manner. The case study content and theories are well developed and linked to the course content, assignment requirements, and practical experience. The case study includes relevant material that fulfills all objectives of the assignment.

Cites three or more references, using at least one new scholarly resource that was not provided in the course materials.

all instruction requirements noted

30 points The writer demonstrates an understanding of the subject matter, and the components of the case study are accurately represented with evidence-based practice, ethics, theory, and/or role content. Course materials and scholarly resources are present to support required concepts. The paper includes relevant material that fulfills all objectives of the case study.

Cites two references.

Most instruction requirements are noted.

26 points The writer demonstrates a moderate understanding of the subject matter. as evidenced by components of the case study and use of evidence-based practice, theory, or role-development. Course content is present but missing depth and or development.

Cites one reference.

23 points Absent application to evidence-based practice, theory, or role development.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Significant content of case study is vague, inaccurately portrayed, or missing.

No references cited.

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Submits assignment late.

20 points 30
Analysis and Synthesis of Case Study Content and Meaning with Content Related to Preventative Guidelines Through critical analysis, the submitted case study provides an accurate, clear, concise, and complete summary of the scenario.

Information from scholarly resources is synthesized, providing new information or insight related to the context of the assignment by providing both supportive and alternative information or viewpoints

Includes all major and minor relevant risk factors based on standard preventative guidelines for age and gender and treatment/follow-up plans.

all instruction requirements noted.

30 points Case study is complete, providing evidence of further synthesis of course content via scholarly resources.

Information is synthesized to help fulfill the case study requirements. The content supports at least one viewpoint.

Submission provides clarification of the assignment by correctly answering all posed questions within the instructions.

Includes all major risk factors and most minor relevant risk factors based on standard preventative guidelines for age and gender (i.e.’ to two minor risk factors are missing and/or one incorrect treatment plan).

Most instruction requirements are noted.

26 points Lacks clarification or new information. Scholarly reference supports the content without adding any new information or insight. Case study content may be confusing or unclear, and the summary may be incomplete.

Risk factors are partially complete (i.e., missing one to two major risk factors or three to four minor risk factors, or two incorrect treatment plans).

Missing some instruction requirements.

23 points Submission is primarily a summation of the assignment without further synthesis of course content or analysis of the scenario.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Multiple risk factors missing (e.g., three major risk or five to six minor risk factors or three incorrect treatment plans, or four or more major risk factors or seven or more minor risk factors or four or more incorrect treatment plans).

Scholarly reference(s) are incorrect or inappropriate for the topic case.

Missing several instruction requirements.

Submits assignment late.

20 points 30
Application of Knowledge To Clinical Aspect of Patient Encounter The summary of the case study provides validated information via scholarly resources that offer a multidisciplinary approach to the scenario provided.

The student’s application in practice is accurate and plausible, and additional scholarly resources supporting the application are provided.

all questions posed within the assignment are answered correctly in a well-developed manner, applying knowledge with citations for validation.

Includes all relevant subjective and objective data; diagnostic testing; routine care to be provided; patient education; anticipatory guidance; review of previous diagnostics; and follow-up of acute concern and chronic health issues, etc.—based on assignment instructions.

all instruction requirements noted.

30 points A summary of the study, findings, and knowledge gained from the assignment is presented.

Student indicates how the information will be used within their professional practice.

all questions posed by the study are answered correctly.

Includes most of the routine content (subjective and objective data; diagnostic testing; routine care to be provided; education; anticipatory guidance; review of previous diagnostics; and follow-up) (is missing two minor details or one major detail).

Most instruction requirements are noted.

26 points Components of the case study are summarized with minimal application to evidence-based practice, theory, or role development, thus presenting a more superficial analysis of content between the assignment and the broader course content. Synthesis of course content is present but missing depth and or development.

Student’s explanation of how the information will be used within their professional practice is vague or incomplete.

One of the questions posed is not answered and/or one of the questions is answered incorrectly.

Includes some of the routine content (subjective and objective data; diagnostic testing; routine care to be provided; education; anticipatory guidance; review of previous diagnostics; and follow-up) (is missing three minor details or two major details).

Cited one reference.

Missing some instruction requirements.

23 points Absent application to evidence-based practice, theory, or role development. Synthesis of course content is superficial.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Content of case study is inaccurately portrayed or missing.

Student’s explanation of how the information will be used within their professional practice is not feasible or appropriate, or student fails to explain how the information will be used within their personal practice.

Omits routine content (subjective and objective data; diagnostic testing; routine care to be provided; education; anticipatory guidance; review of previous diagnostics; and follow-up) (is missing four to five minor details or three major details or six or more minor details or four or more major details.

Two or more questions are not answered and/or are answered incorrectly.

No references cited.

Missing several instruction requirements.

Submits post late.

20 points 30
Organization Well-organized content with a clear and complex purpose statement and content argument. Writing is concise, with a logical flow of ideas.

5 points Organized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed, with minimal issues in content flow.

4 points Poor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.

Purpose statement is noted.

3 points Illogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points 5
APA, Grammar, and Spelling Correct APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 points Correct and consistent APA formatting of references and cites all references used.

No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 points Three to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 points Five or more unique formatting errors, or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

2 points 5
Total Points 100