Cold Respiratory Illness: The Case Study

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Table of Contents

Background Information
Making the Diagnosis
Pathophysiology
Treatment Plan
Communication Plan
Resources
References

Background Information

This scenario explores the case of a three-year-old boy patient who has been ill for three days. The boy’s symptoms are similar to a cold respiratory illness — coughing, fever, and sneezing, even though the boy has had all of his vaccinations. The child’s blood pressure is within normal limits, although his respiratory rate is slightly decreased (Booth, 2022; Fleming, 2022). The boy also has a slight redness of the throat, which, combined with symptoms, suggest respiratory disease (Short et al., 2017). The following sections of this paper explore the patient’s diagnosis in detail, provide a treatment and communication plan, and recommendations for the boy’s continued rehabilitation after experiencing respiratory illness.

Making the Diagnosis

Based on the data obtained during the physical examination, combined with the family characteristics examined, it can be concluded that the boy suffers from respiratory disease. In other words, the patient’s illness is due to the development of a pathogen in the respiratory tract, but careful attention should be paid to the accompanying signs of illness to determine the nature of this pathogen. In particular, the child has a slightly affected throat, and the temperature does not reach high marks. Viral illnesses are known to have lower patient temperatures than those for bacterial illnesses (Staples, 2019). From this, it can be concluded that the patient is suffering from a viral infection of the upper respiratory tract or a common cold (Short et al., 2017). Lower respiratory tract infections were excluded because, in this case, the key symptom is defined as a persistent cough, whereas upper respiratory tract infections have a multiplicity of symptoms: sneezing, headaches, and coughing (Biggers, 2019; Short et al., 2017). Because the signs of the course of the disease are more similar to those of upper tract infections, lower tract infections were ruled out. However, alternative forms of URI can also be excluded because the patient did not have ear pain or more severe symptoms, including nasal congestion or muscle pain, as is the case with otitis media and influenza.

In addition, the epidemiologic environment, especially in relation to respiratory illnesses, should be taken into consideration when making a diagnosis. For example, during the COVID-19 pandemic, non-serious cases often had symptoms similar to the common viral cold, causing illnesses to be frequently confused (Paules et al., 2022). Consequently, the use of an epidemiological subpoena is essential for accurate diagnosis. However, no cases of local epidemics or pandemics were reported in this scenario. The epidemiologic subpoena only indicated that the child had vaccinations. This is essential information with regard to establishing the diagnosis since vaccinations usually protect the patient from repeated episodes of illness. Since the child has been sick before and even had vaccines, it can be assumed that the child has a seasonal cold caused by a modified virus.

Pathophysiology

Upper respiratory tract infection (URI) is a common illness, especially during the transient off-season years. Like any other infection, URI develops with the ingestion of a viral pathogen that begins development in the upper respiratory tract. It is well known that the seasonality of colds is not related to hypothermia but rather to a number of socio-demographic factors (Shahrajabian et al., 2020). These include an increase in population density due to the return of children from summer vacation and more intense indoor exposure compared to warmer seasons. Nevertheless, it is impossible to authentically identify the specific type of pathogen causing URI without instrumental methods of analysis — too many classes of viruses cause colds; these include rhinoviruses, coronaviruses, and RSV (Wein, 2009). Regardless of the specific type of virus that entered the body, the infection begins to form with entry. The entry gates to the body are the mucous membranes of the body, including the nasal and oral cavities and the eyes. If the individual does not observe sanitary hygiene, the pathogen can quickly enter the mucous membranes from the hands, where it begins to develop.

The pathogen is adsorbed on specific cells in the mucosal cavity, which activates reproduction processes. In reality, each specific type of pathogen has individual types of bound cells. Binding occurs through surface substances on the virus capsid, which is usually represented by glycoprotein, S-proteins, or hemagglutinin (Thomas & Bomar, 2018). Binding is based on the chemical nature between the molecules-the surface substances of the virus attach to the receptors of specific proteins. Notably, viruses can be adapted to different receptors in the host cell, so blocking one of them in a known way (vaccine, antiviral drugs) may not be enough. With this binding, the transduction process is activated, resulting in the function of the protein kinase — the membrane becomes more mobile and permeable, allowing the virion genetic material to enter the cell and initiate reverse transcription processes. In the event of a response, the body triggers an immune response, which leads to a fever and, consequently, a fever.

Treatment Plan

An important note is that respiratory diseases of the upper respiratory tract cannot be cured with antibiotics. The main reason for this is the very nature of antibiotics, which act on living organisms by blocking their reproductive or metabolic functions. This is unfair to viruses because, strictly speaking, they are not living systems and, as a result, do not respond to antibiotics (Alsuhaibani et al., 2019). That said, most viral respiratory infections, including URI, go away on their own and do not require special treatment (AHQR, n.d.; Mastalerz-Migas et al., 2019). Nevertheless, if the symptoms of the disease cause the patient discomfort, they may take antiviral medications (Short et al., 2017). Non-medicamental treatments include increased rest and frequent intake of metabolic-intensifying fluids. On the other hand, medications can be used to relieve symptoms. For example, a patient may take nasal sprays to relieve the effects of nasal congestion; for a sore throat, consumption of lollipops that induce sucking reflexes and increased salivation is sufficient (Mastalerz-Migas et al., 2019). During the off-season, individuals can also consume prophylaxis to prevent infection: such prophylaxis can include the consumption of Vitamin C or honey (Vorilhon et al., 2019; Seçilmiş & Silici, 2020). Hot drinks containing paracetamol and nutritional supplements can also be taken when feeling the adverse effects of a fever. After a few days, the cold will end on its own, but if the symptoms do not stop, it is advisable to see the doctor again. Costs are minimal with this treatment plan because generic medications exist for most anti-symptomatic medications.

Communication Plan

Established communication plays a special role in the rehabilitation plan. During the first session, as an NP, I must clearly communicate to Mr. Smith the greatest threats to the patient’s health. Smith as the official parent of the minor patient, the greatest threats to the child’s health and the essential need for a rest regimen. Young children may not accurately report what ails them, so I should elaborate on the most common signs of illness and how to manage them. As part of the communication, I will need to encourage the patient and parent to share their worries and pain with me so that I can create a recovery plan that takes the patient’s and parent’s best interests into account (Burke, n.d.). Additionally, Mr. Smith reported that he wanted his child to be able to go to kindergarten the very next day, so he asked for antibiotics. My job is to inform the parent that antibiotics are useless and expensive in this case and that the child’s infection poses a danger to others; in addition, being in public places with a suppressed immune system can be devastating to the patient’s health. Since there is a possibility that the child will not return for a follow-up appointment, I should tell the father about ways to detect the completion of the infection and the need for prophylaxis once the disease is over.

Resources

If desired, Mr. Smith can get a further consultation via video link: he needs to write to me in person and book a time to call for a follow-up. Telemedicine that uses video linking is proving to be a convenient time-saving tool (Danne et al., 2021). In addition, the patient should be given an antibiotic use memo to ensure that they will always have relevant information regarding aspects of antibiotic treatment (CDC, n.d.). Finally, it is also recommended to give out a guide with information about the steps of the URI to inform (JJustad, 2017). This guide will allow parents to refer to reliable information and contact me promptly in the event of unexpected symptoms.

References

AHQR. (n.d.). National institute of allergy and infectious diseases. AHQR Effective Health Care Program. Web.

Alsuhaibani, M. A., AlKheder, R. S., Alwanin, J. O., Alharbi, M. M., Alrasheedi, M. S., & Almousa, R. F. (2019). Parents awareness toward antibiotics use in upper respiratory tract infection in children in Al-Qassim region, Saudi Arabia.Journal of Family Medicine and Primary Care, 8(2), 583-589. Web.

Biggers, A. (2019). Lower respiratory tract infections: What to know. MNT. Web.

Booth, J. (2022). Normal blood pressure numbers by age. Forbes Health. Web.

Burke, A. (n.d.). Therapeutic communication: NCLEX-RN. RN. Web.

CDC. (n.d.). Viruses or bacteria what’s got you sick? [PDF document]. Web.

Danne, T., Limbert, C., Puig Domingo, M., Del Prato, S., Renard, E., Choudhary, P., & Seibold, A. (2021). Telemonitoring, telemedicine and time in range during the pandemic: paradigm change for diabetes risk management in the post-COVID future. Diabetes Therapy, 12(9), 2289-2310. Web.

Fleming, S. (2022). Pediatric respiratory rate and heart rate lower limit, normal range, and upper limit by age*.UpToDate. Web.

JJustad. (2017). The common cold [PDF document]. Web.

Mastalerz-Migas, A., Kuchar, E., Nitsch-Osuch, A., Mamcarz, A., Sybilski, A., Wełnicki, M.,… & Antczak, A. (2020). Recommendations for the prevention, diagnosis, and treatment of influenzas in adults for Primary care physicians: Flu compas PCP–adults. Family Medicine & Primary Care Review, 22(1), 81-96.

Paules, C. I., Marston, H. D., & Fauci, A. S. (2020). Coronavirus infections—more than just the common cold. Jama, 323(8), 707-708.

Seçilmiş, Y., & Silici, S. (2020). Bee product efficacy in children with upper respiratory tract infections. The Turkish Journal of Pediatrics, 62(4), 634-640.

Shahrajabian, M. H., Sun, W., & Cheng, Q. (2020). Traditional herbal medicine for the prevention and treatment of cold and flu in the autumn of 2020, overlapped with COVID-19. Natural Product Communications, 15(8), 1-10.

Short S, Bashir H, Marshall P, Miller N, Olmschenk D, Prigge K, Solyntjes L. (2017). Institute for clinical systems improvement [PDF document]. Web.

Short, S., Bashir, H., Marshall, P., Miller, N., Olmschenk, D., Prigge, K., & Solyntjes, L. (2017). Diagnosis and treatment of respiratory illness in children and adults [PDF document]. Web.

Staples, B. (2019). Is it a bacterial infection or virus? DukeHealth. Web.

Thomas, M., & Bomar, P. A. (2018). Upper respiratory tract infection. Europe PMC. Web.

Vorilhon, P., Arpajou, B., Vaillant Roussel, H., Merlin, É., Pereira, B., & Cabaillot, A. (2019). Efficacy of vitamin C for the prevention and treatment of upper respiratory tract infection. A meta-analysis in children. European Journal of Clinical Pharmacology, 75(3), 303-311.

Wein, H. (2009). Understanding a common cold virus. National Institutes of Health. Web.

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