Danny Rivera is a cooperative, pleasant 8 year old Puerto Rican male who presents to the clinic with a chief complaint of cough with fatigue
from lack of sleep.
He states that the cough began five days ago. It is occasionally productive, producing a clear, “slimy” mucous without odor. His cough is getting progressively worse. It is accompanied by a constantly runny nose that has worsened since the cough started.
Danny states that the mucous from his nose is also
clear. His cough is worse at night. Danny denies shortness of breath. He says he says he has no pain in his left ear, and 3 out of 10 pain in his right ear. Danny reports 2 out of 10 throat pain but
denies difficulties swallowing. The cough is frequent, every couple of minutes. Danny’s mother gave him some kind of medication to treat his cough with some relief, however the name of the
medication is unknown. Danny denies chest tightness, nasal congestion, headaches, fever, chills,
weight loss, vision problems, difficulty breathing,
or choking episodes. He states he does not have a history of asthma.
Danny, an only child, lives at home with his parents and his grandmother. No one in the home has been ill. His father has a history of childhood asthma. Both of his parents smoke; his father smokes cigars indoors. There are no pets in the home. Danny says he does not have any allergies.
Tired appearing boy sitting on the examination table.
Because Danny was alone during the examination, his privacy and confidentiality was protected at all times, all questions were
answered to the patient’s satisfaction prior to proceeding, and his dignity was maintained
throughout the visit. Respiratory illnesses are a top cause of hospitalization of young children in the United States (Maness, 2016). What initially appears as a run of the mill cold can actually turn out to be a dangerous virus in reality. In order to provide optimum patient care to Danny, a thorough focused examination of the head, lungs, eyes, ears, and throat was performed. Right and left eye areas were examined. Lids, sclera, and conjunctive were normal, but with dull appearance. His eyes are not sunken. Bilateral nares are red with boggy turbinates and clear mucous. The left tympanic membrane is normal with a pearly gray tympanic membrane and positive light reflex. The right tympanic membrane is red and opaque. Danny’s neck is normal. His anterior and posterior chest walls are symmetric with no deformities or lesions. Inspection of the oral cavity with a tongue blade reveals cobblestoning in the back of the throat. The patient’s anterior lung sounds were auscultated over all anterior fields with normal results and no adventitious breath sounds. The sounds of the patient’s posterior chest wall were auscultated with normal results; no adventitious breath sounds. Anterior and posterior broncophony revealed muffled sounds over all anterior and posterior fields. Percussion of anterior and posterior chest wall was resonant over all fields. The patient denied pain or discomfort upon palpation of frontal
and maxillary sinuses. Palpated fremitus normal over anterior and posterior chest wall. Right supraclavicular lymph node is enlarged and tender.The patient’s vital signs at the appointment were:
Blood pressure: 120/76
O2 Saturation: 96% R/A
Respiratory Rate: 28
Temperature: 37.2 C
3.91 = 80.5%
Clinical Reasoning and Differential Diagnosis
Because Danny reports that he has had the cough for five days, it should be classified as acute and a virus, bacteria, or allergies should be considered as possible causes (Dains, Baumann, & Scheibel, 2012; Crampton, 2013). While Danny’s vital signs do fall within normal limits for his age, they are at the upper limit of normal. His O2 saturation is slightly decreased. Decreased oxygenation may be an issue for Danny. Because the patient’s nasal and expectorated
mucous are clear and without odor, virus and allergies are corroborated (Dains, Baumann, & Scheibel, 2012). An increase in the light smoking rates of Puerto Rican men and women supports the finding of both of Danny’s parent’s smoking and, therefore, his exposure to smoke (Blanco et al., 2014). Taking these factors into consideration and based upon the patient’s presentation, my differential diagnoses for Danny are asthma, strep throat, rhinitis, allergies, and a cold.
Plan of Care
Danny’s plan of care will f Danny’s plan of care will focus on continuing to narrow down the cause of his symptoms.
A swab of the back of Danny’s throat will be sent to the lab for culture
to rule out strep throat. A consult to an allergist will be ordered. Danny will be ordered a prescription for an antitussive
and given a not to stay out of school for a few days so that he can stay home and rest. Danny’s parents both work and he is cared for by his grandmother a great deal of the time. Danny’s home is bilingual. A language comprehension evaluation will be done prior to giving post
-care instructions and they can be given in English and Spanish if needed. Danny’s grandmother will be instructed on administering Danny’s medication and in the importance not giving him any
more of the unidentified medicine that his mother gave him while he
is on prescription medication. The importance of no one smoking in the house will be emphasized. Danny will be given his pneumonia vaccine to update his shots. A followup will be scheduled for one week.
Vicarious Traumatization Concept Analysis Disclaimer: This work has been presented by an understudy. This isn't a case of the work composed by our expert scholarly journalists. You can see tests of our expert work here. Any sentiments, discoveries, ends or proposals communicated in this material are those of the writers and don't really mirror the perspectives of UK Essays. Distributed: Fri, 17 Aug 2018 Times of dynamic examination have watched all through this audit of the writing on mental injury and minimal precise discoveries have been infamous (Pearlman and Mac Ian (1995). In spite of that Pearlman and Saakvitine, (1995a) specified that advisors had all the earmarks of being pulled in to working with damaged populace. Regardless of this supposition, there are others ponders that have assessed the impact of sex as conceivable reason to a vicarious injury; in any case, no proof have been discovered showing that sex assumes a functioning job in creating vicarious injury (Nelson-Gardell and Harris, 2003; Pearlman and Mac lan, 1995). Then again, a past filled with earlier injury in emotional well-being specialists or experts might be a hazard factor. Cunningham (2003) demonstrated that a connection between experts having a lessened feeling of individual security and a larger amounts of introduction to awful materials, particularly in the event that they had encountered sexual maltreatment themselves. Nelson-Gardell and Harris (2003) reexamined various reason potential hazard factors in the number of inhabitants in youngster insurance specialists; and, found that a background marked by psychological mistreatment and sexual maltreatment related with an expanded danger of creating auxiliary awful pressure. In 2004, Kadambnd Truscott completed an examination with emotional wellness laborers, who worked with sexual maltreatment survivors, tumor patients, and experts and found no distinctions in the level of vicarious injury among these assorted gatherings. As per these examiners, these extraordinary populaces, who are seen as exceedingly defenseless and relying upon the idea of the injury, managed a conceivable reason that may add to the level of hazard for specialists or laborers in the emotional well-being field. Kadambi and Truscott (2004) cleared up there is constrained and opposing proof for this supposition. Closeness to horrible accidents appears to build the reason for creating vicarious injury. Despite the fact that, consequences of research with criminal legal counselors recommended that proof have demonstrated that the delayed introduction to horrible materials is related with a higher expanded danger of creating vicarious injury (Vrklevski and Franklin, 2008; Musa and Hamid, 2008). Vrklevski and Franklin (2008) proposed that the reason for having a past filled with a few injuries in their own narratives and vicinity to the horrible accident could be one of the reasons for presenting themselves to a higher danger of creating vicarious injury indications. Eventually, the working environment condition has been considered as a potential reason hazard factor. Experts who work for the general population division appeared to wind up at a higher danger of creating vicarious injury, than those working in the private practices (Vredenburgh, Carlozzi and Stein, 1999). By 2004, Goldsmith, Barlow, and Freyd recommended that specialists of open offices may likewise be presented to a higher level of damaged customers. This could prompt an impact on higher caseloads, insufficient or non-existent assets, and more confounded customers. They additionally recommended that organization specialists may be presented to an expanded level of damaged customers (Goldsmith, Barlow and Freyd, 2004; Cougle, Resnick and Kilpatrick, 2009). Boscarino, Figley and Adams (2004) proposed that customers will probably encounter numerous natural stressors, similar to destitution, joblessness and introduction to wrongdoing, and in addition less social backings and higher rates of customer comorbidity. By the by, the long work hours could likewise give off an impression of being one of the reasons for hazard factors in creating vicarious injury, as the caseloads with higher quantities of damaged people. Newell and MacNeil (2011) in their examination, contemplated laborers who were presented to awful stories or customers' with awful stories at the veteran's clinic, and uncovered that steady proof that working environment variables can build experts dangers of creating vicarious injury. In contrast with other potential hazard variables, Kadami and Truscott (2008) examined professionals who work with sexual maltreatment unfortunate casualties in Canada, detailed that the most vital factors in causing advisor's impression of vicarious injury in their work environment were incorporated the absence of help, extend periods of time of work, high caseloads and restricted assets. Their examination uncovered that introduction to reliably, nitty gritty elements of the injury, societal unfairness, and presentation to human savagery and countertransference or profoundly enthusiastic responses inside the specialists working with sexual maltreatment exploited people were signified. Then again, Kadami and Truscott (2008) brought up that those experts who were not working with sexual maltreatment exploited people did not score altogether extraordinary on enlisting vicarious injury with the others Canada experts. Thusly, this raises another security impact that achieves a moral issue. Injury specialists in tending to their countertransference responses, secure the customer and themselves. By not doing as such, the impacts are probably going to undesirably affect the advisors' associations with customers, individual and expert life (Trippany, White-Kress and Wilcoxon, 2004). In any case, as a circumstances and end results of the wonder of vicarious injury, Srdanovic (2007) and Hill (2003) have looked into among specialists who have been working casualties of sexual brutality and other horrible accidents. In looking into the intellectual, enthusiastic and social responses to being a defrauded person that there have revealed a few others elements at the individual level that may impact (Hill, 2003). In any case, its mental impacts continue as before, paying little mind to the kind of populace, ethnicity, age or working duties. Another suspicion that can cause vicarious injury side effects is indicated out the working environment social factors that seems to collaborate as an essential job in the advancement or in danger factor side effects for a vicarious exploitation. Schauben and Frazier (1995) featured that an absence of a bigger emotionally supportive networks adds to the improvement of injury related issues for professionals or specialists in psychological well-being. These analysts contended that societies that demoralize the statement of feeling, self-rule, and self-care put representatives expanded the danger of vicarious injury all through the foundation of a broken institutional standard. Those professionals who work inside these establishments, as per Schauben and Frazier (1995) work in an unfortunate social standard, in light of the fact that demoralize self-care, as well as, additionally debilitate people from these societies from being steady to each other. These people present an inclination to disguise these useless standards and refute their need to self-ensure and dodge the individual effect they may understanding by being presented to these injuries. Pearlman and Mac Ian (1995) unequivocally bolster their contention that injury specialists need to dynamic looking for expert interview and support with the end goal to change their passionate, confidence, subjective and social responses to the security impacts of injury work (Pearlman and Saakvitine, 1995a; Devilly, Wright and Varker, 2009). Since 2005, Marriage and Marriage concentrated on the significance of advisors on monitoring their sentiments, hence, utilizing their symptomatic and remedial mindfulness for their advantage and the customer. Moreover, Toren (2008) amid her examination procedure clarified that working with damaged populace more often than not can end up remunerating impact for the advisor. The constrained research on the proof stays hazy and restricted. The main variable that remaining parts steady with all the writing survey is the requirement for instruction among experienced and non-experienced specialists (Cunningham, 2003; Newell and MacNeil, 2010). The absence of appropriate institutionalized instruments to gauge these impacts, and its factors are deficient. And in addition, it ends up troublesome surveying which ethnic populace is more influenced than others (Newell and MacNeil, 2010). By and by, the discussion, of having clear and steady definitions for different hypothetical builds. This keeps on demonstrating that, despite the fact that, there have been different endeavors to give new writing that conceptualizes the marvel of vicarious injury and others hypothetical builds, for example, countertransference and empathy weariness the covering issue proceeds. The exploration proof shows that the marvel of vicarious injury were found in recounted accounts by injury advisors, demonstrating that influenced professionals and customers (Sexton, 1999).>GET ANSWER