Throat Disorders Diagnosis and Management Assignment
Diagnosis and Management of Eye, Ear, Nose, and Throat Disorders
Case Study 2:
Kaitlyn is a 4-year-old with a 2-day history of nasal congestion and cough in the early morning. Her mother reports thick, green nasal discharge. She is afebrile, and appetite and sleep are normal. Physical examination reveals: lungs clear to auscultation, tympanic membranes pearly gray without fluid in a neutral position, no cervical adenopathy, nasal turbinates are red, and clear rhinorrhea and postnasal drip.
To prepare for Throat Disorders Diagnosis and Management Assignment:
•Review “Eye Disorders” and “Ear Disorders” in the Burns et al. text.
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•Review your selected case studies. Analyze the patient information, including the parent’s perspective.
•Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
•Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
•Consider strategies for educating parents on the child’s disorder and reducing any concerns/fears presented in the case study.
Post 1 to 2 page paper on : An explanation of the differential diagnosis for the patient in the case study you selected.
Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis.
Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments.
Finally, explain strategies for educating parents on their child’s disorder and reducing any concerns/fears presented in the case study.
• Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier.
◦Chapter 28, “Eye Disorders” (pp. 622–651)
◦Chapter 29, “Ear Disorders” (pp. 652–668)
American Academy of Pediatrics. (2004). Clinical practice guideline: Diagnosis and management of acute otitis media. Pediatrics, 113(5), 1451–1465.
Chow , A.W., Benninger, M.S., Brook, I., Brozek, J.L., Goldstein, E.J.C., Hicks, L.A., Pankey, G.A., Seleznick, M., Volturo, G., Wald, E.R., & File Jr, T.M. (2012). IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults. Clinical Infectious Diseases , 54(8), 72-112.
Based on the information provided in the case study, the following are potential differential diagnoses for the 4-year-old patient:
Acute viral rhinosinusitis: This diagnosis is supported by the patient’s symptoms of nasal congestion, cough, clear rhinorrhea, and postnasal drip. Viral infections commonly cause these symptoms in children, and the absence of fever suggests a mild illness.
Acute bacterial rhinosinusitis: Although less likely than viral rhinosinusitis, this diagnosis cannot be completely ruled out due to the presence of thick, green nasal discharge. Additional symptoms such as facial pain or pressure, headache, or worsening symptoms after initial improvement may indicate bacterial involvement.
Allergic rhinitis: The presence of nasal congestion, rhinorrhea, and red nasal turbinates raises the possibility of allergic rhinitis. However, the absence of itching or sneezing makes this diagnosis less likely.
Most Likely Diagnosis:
The most likely diagnosis for the patient in this case study is acute viral rhinosinusitis. The absence of fever, along with the presence of mild symptoms and clear rhinorrhea, suggests a viral etiology. Additionally, the lack of significant systemic symptoms or complications further supports this diagnosis.
Unique Characteristics of Acute Viral Rhinosinusitis:
Acute viral rhinosinusitis, commonly known as a common cold, is typically caused by a viral infection, most commonly rhinovirus. It is characterized by nasal congestion, rhinorrhea, cough, and occasionally postnasal drip. Fever is usually absent or mild. The symptoms are self-limited and generally resolve within 7-10 days without specific treatment.
Treatment and Management Plan:
Since the most likely diagnosis is viral rhinosinusitis, the treatment focuses on symptomatic relief and supportive care. The following management plan can be considered:
Encourage rest and adequate fluid intake.
Provide nasal saline irrigation or saline drops to relieve nasal congestion.
Recommend over-the-counter analgesics, such as acetaminophen or ibuprofen, for relief of discomfort or low-grade fever.
Educate the parent about the self-limited nature of the illness and the expected duration of symptoms.
Advise against the routine use of antibiotics, as they are ineffective against viral infections and may contribute to antibiotic resistance.
Dosages for pharmacologic treatments should be based on the child’s weight and age, following appropriate pediatric dosing guidelines.
Strategies for Parent Education and Reducing Concerns/Fears:
Explain the expected course of the illness, emphasizing that viral rhinosinusitis is a self-limited condition that resolves on its own.
Educate parents about the importance of supportive care measures, such as rest, fluids, and symptom relief, in alleviating discomfort.
Provide information on proper administration of saline drops or nasal irrigation techniques to help relieve nasal congestion.
Reassure parents that viral infections are common in children and typically resolve without complications.
Address any concerns or fears the parents may have regarding the child’s symptoms or treatment, providing clear and accurate information to alleviate anxiety.
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier.
Chow, A. W., Benninger, M. S., Brook, I., Brozek, J. L., Goldstein, E. J. C., Hicks, L. A., Pankey, G. A., Seleznick, M., Volturo, G., Wald, E. R., & File Jr,