pediatric cough assessment questions

Assessment of cough in children 4.1. Danny Rivera Pediatric Cough Shadow Health Assessment . ^�;�VP��&��nծ��#��spV`��c>b�]Å�Pi��%��V�Q((�(��P��gG�f�q69��ByP��P��2�D[b�M� T�2�1n9^6K�q[Q^�@L�XJ? Epiglottitis is suspected. <>/Font<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612.04 792.06] /Contents 4 0 R/Group<>/Tabs/S>> [5.ohCGBa��iI��h�t�^GbQĸ�-�4�)%&审Y_�m�^��R�f�(^P&o@��P�g�h:=�1˗�ǙZ)�ⱩoI^TD��JGb��I��9�#�h2��R+ʌ��4�Y��)�)M�[�I?�Յw:u!�]�6��|>"_��!�#H�U��&v�+�1Ŋ�A44�?��4C�8�GM�uKHj�h�;�C�z@q!�W�*ۓ��F�v��Z��Fk��r@�zĳX�9E7%Jm�rBa��׃�Q��m��SY͕K=��Ū�*��S��v�z��n�~��{M��|�:�"��M��oY D�Q��Z��Ǉڳ�M�J�3��i��Z!^P�UQ�jS�4u��!�#4I$�|��P�@P��"��Ҽl٤E� �F�280��u�|?�j/��ni��%��r��y�.��ͮD��X��$�X�}7;��Ğ��%�Dd�ք��g_ș,(�N�1C4g�'S��a3㢙�DSt�r��w��w��(@��kh�ۧ6j��L��2V� f�&�0DC?��eŉq2�cK�{�qb�\/ Daniel “Danny” Rivera is an 8-year-old boy who comes to the clinic with a cough. |�v�Ż��gh��3��/��|��9^o��!l>�"� #eD�_�en�B�F� Some of these symptoms are ubiquitous (eg, runny nose, sore throat, fever); others may suggest a specific cause: headache, itchy eyes, and sore throat (postnasal drip); wheezing and cough with exertion (asthma); night sweats (tuberculosis [TB]); and spitting up, irritability, or arching of the back after feedings in infants (gastroesophageal reflux). Merck & Co., Inc., Kenilworth, NJ, USA is a global healthcare leader working to help the world be well. <> To understand the appropriate wording of open-ended and directed questions, and appropriate use of each type of question. Other characteristics of the cough are helpful but less specific. Among children, the Parent Cough-Specific Quality of Life Questionnaire and Pediatric Cough Questionnaire were valid and reliable. Cough Pediatric After-Hours Version - Standard - 2020 A cough is the sound made when the cough reflex suddenly forces air and secretions from the lungs. In young children with sudden cough and no fever or URI symptoms, the examiner should have a high index of suspicion for foreign body aspiration. Cough is one of the most common complaints for which parents bring their children … A coughing spell or fit is over 5 minutes of continuous coughing. Past medical history should cover recent respiratory infections, repeated pneumonias, history of known allergies or asthma, risk factors for TB (eg, exposure to a person who has known or suspected TB infection, exposure to prisons, HIV infection, travel to or immigration from countries that have endemic infection), and exposure to respiratory irritants. Discussion Questions (DQ) Initial responses to the DQ should address all components of the questions … Pneumonia, bronchiolitis, whooping cough and airway foreign body (object) Cough Variant Asthma Asthma is the most common cause of chronic cough in children. The aetiology of coughing in children … It is important for you to determine whether or not Danny is in distress, explore the underlying cause of his cough… The cervical and supraclavicular areas should be inspected and palpated for lymphadenopathy. <>>> A paroxysmal cough is characteristic of pertussis or certain viral pneumonias (adenovirus). verify here. 2 0 obj Examination of extremities should note clubbing or cyanosis of nail beds (cystic fibrosis). NR 509 Week 6: Shadow Health Pediatric Physical Assessment Assignment Pre Brief Daniel “Danny” Rivera is an 8-year-old boy who is brought to the clinic by a family member for a cough. Identify children with cough who need evaluation by a specialist. Cough . 2. * All patients require a chest x-ray when they present for the first time with chronic cough. stream Review of systems should note symptoms of possible causes, including abdominal pain (some bacterial pneumonias), weight loss or poor weight gain and foul-smelling stools (cystic fibrosis), and muscle soreness (possible association with viral illness or atypical pneumonia but usually not with bacterial pneumonia). Paroxysmal coughing is even more prolonged and intense. Children with stridor, drooling, fever, and marked anxiety need to be evaluated for epiglottitis, typically in the operating room by an ear, nose, and throat specialist prepared to immediately place an endotracheal or tracheostomy tube. Cough is a reflex that helps clear the airways of secretions, protects the airway from foreign body aspiration, and can be the manifesting symptom of a disease. Coughing at the beginning of sleep and in the morning with waking usually indicates sinusitis; coughing in the middle of the night is more consistent with asthma. The nurse is most concerned that: A. For example, antibiotics should be given for bacterial pneumonia; bronchodilators and anti-inflammatory drugs should be given for asthma. Use of nonspecific drugs for cough suppression is discouraged in children. Detailed history and physical examination represent the cornerstones of the evaluation of a child complaining of cough. ... strident cough, and lethargy. Suspected Gastroesophageal reflux disorder unsuccessfully treated with an H2 blocker and/or proton pump inhibitor may require evaluation with a pH or impedance probe study or endoscopy. <> ;��(^}��ER8"��*�]Ik|)ۉ��h��ÃO�__�[I��{۪(��-�F ��l72�ݕpC[�^o�77 �{W��(��fzx� Daniel “Danny” Rivera is an 8-year-old boy who is brought to the clinic by a family member for a cough. The Merck Manual was first published in 1899 as a service to the community. 4. Asking about bluish discoloration around the lips or mouth is an important question for pediatric patients with respiratory symptoms. In children ages 6 months to 6 years it occurs as often as 6 cases per 100 children. _____ days _____ weeks _____ months _____ years 2. Pre Brief. TEF = tracheoesophageal fistula; URI = upper respiratory infection. Discussion: Croup and cough. Acute cough in children … 3. History of Present Illness . (See table Some Causes of Cough in Children. Cough is a reflex that helps clear the airways of secretions, protects the airway from foreign body aspiration, and can be the manifesting symptom of a disease. Obtain a chest x-ray if patients have red flag findings or chronic cough. URI-like prodrome, stridor, barky cough, high fever, respiratory distress, toxic appearance, purulent secretions, Rhinorrhea, tachypnea, wheezing, crackles, retractions, nasal flaring, possible posttussive emesis, In infants up to 24 months; most common among those 3–6 months, Sometimes nasal swab for rapid viral antigen assays or viral culture, URI-like prodrome, barky cough (worsening at night), stridor, nasal flaring, retractions, tachypnea, Sometimes anteroposterior and lateral neck x-rays, Exposure to tobacco smoke, perfume, or ambient pollutants, Abrupt onset, high fever, irritability, marked anxiety, stridor, respiratory distress, drooling, toxic appearance, If patient is stable and clinical suspicion is low, lateral neck x-ray, Otherwise, examination in operating room with direct laryngoscopy, Chest x-ray (inspiratory and expiratory views), Viral: URI prodrome, fever, wheezing, staccato-like or paroxysmal cough, possible muscle soreness or pleuritic chest pain, Possible increased work of breathing, diffuse crackles, rhonchi, or wheezing, Bacterial: Fever, ill appearance, chest pain, shortness of breath, possible stomach pain or vomiting, Signs of focal consolidation including localized crackles, rhonchi, decreased breath sounds, egophony, and dullness to percussion, Coughing at the beginning of sleep or in the morning with waking, Sometimes nasal discharge, congestion; pain on either side of the nose; pain in the forehead, upper jaw, teeth, or between the eyes; headache and sore throat, Rhinorrhea, red swollen nasal mucosa, possible fever and sore throat, shotty cervical adenopathy (many small nontender nodes), Tracheomalacia: Congenital stridor or barky cough, possible respiratory distress, TEF: History of polyhydramnios (if accompanied by esophageal atresia), cough or respiratory distress with feeding, recurrent pneumonia, Tracheomalacia: Airway fluoroscopy and/or bronchoscopy, TEF: Attempt passage of a catheter into the stomach (helps in diagnosis of TEF with esophageal atresia), Contrast swallowing study, including esophagography, Intermittent episodes of cough with exercise, allergens, weather changes, or URIs, Atypical pneumonia (mycoplasma, Chlamydia), Possible ear pain, rhinitis, and sore throat, Birth defects of the lungs (eg, congenital adenomatoid malformation), Several episodes of pneumonia in the same part of the lungs, History of meconium ileus, recurrent pneumonia or wheezing, failure to thrive, foul-smelling stools, clubbing or cyanosis of nail beds, Molecular diagnosis with direct mutation analysis, History of acute onset of cough and choking followed by a period of persistent cough, Presence of small objects or toys near child, Infants and toddlers: History of spitting up after feedings, irritability with feeding, stiffening and arching of the back (Sandifer syndrome), failure to thrive, recurrent wheezing or pneumonia (see Gastroesophageal Reflux in Infants), Older children and adolescents: Chest pain or heartburn after meals and lying down, nighttime cough, wheezing, hoarseness, halitosis, water brash, nausea, abdominal pain, regurgitation (see Gastroesophageal Reflux Disease), Sometimes upper gastrointestinal study for determination of anatomy, Trial of H2 blockers or a proton pump inhibitor, Possible esophageal pH or impedance probe study, Trial of H2 blockers or proton pump inhibitors, 1–2 weeks catarrhal phase of mild URI symptoms, progression to paroxysmal cough, difficulty eating, apneic episodes in infants, inspiratory whoop in older children, posttussive emesis, Intranasal specimen for bacterial culture and polymerase chain reaction testing, Headache, itchy eyes, sore throat, pale nasal turbinates, cobblestoning of posterior oropharynx, history of allergies, nighttime cough, Trial of antihistamine and/or intranasal corticosteroids, Possible trial of a leukotriene inhibitor, History of respiratory infection followed by a persistent, staccato cough, History of repeated upper (otitis media, sinusitis) and lower (pneumonia) respiratory tract infections, Microscopic examination of living tissue (typically from sinus or airway mucosa) for cilia abnormalities, Persistent barky cough, possibly prominent during classes and absent during play and at night, Sometimes fever, chills, night sweats, lymphadenopathy, weight loss, Sputum culture (or morning gastric aspirate culture for children < 5 years), Interferon-gamma release assay (especially if there is a history of bacille Calmette-Guérin [BCG] vaccination). We do not control or have responsibility for the content of any third-party site. Vital signs, including respiratory rate, temperature, and oxygen saturation, should be noted. Denies difficulty breathing. When does the cough … Viral croup is the most common cause of airway obstruction in children. How long have you had the cough? Learn more about our commitment to Global Medical Knowledge. The physician should ask about associated symptoms. She will follow up with the ENT as recommended. Jul 4, 2020 - Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data Subjective Data Collection: 20 of 20 (100.0%) Daniel “Danny” Rivera is an 8-year-old boy who has had a cough … Children with red flag findings should have pulse oximetry and chest x-ray. For children 6 months to 6 years, the parents should be asked about potential for foreign body aspiration, including older siblings or visitors with small toys, access to small objects, and consumption of small, smooth foods (eg, peanuts, grapes). A 15-month old with croup is admitted to the pediatric unit. Danny Rivera Pediatric Cough Shadow Health Assessment Subjective Data. 2EY4U��-n�� ΁w$ߧ?D�v�&��{��oI��5J��rA��B�I�� \��f2ؾ#�i��>�a�-#�JR1�� q\�w׎�P��}݉��i,3Ll��A�Wg�81�xW�O��#ߖ��Џ�%�Ǔ[��8h��r1�f�cm�G�e�/`�cߪ�7xi�2_]�qfZ�oa�M��*�hz��B��.q�dq�[g�g�,�NB:�H[�C��0�*�\��C/�`��r4�˱#{X�~�Z��U;��u�E)\H�ox1��|� �"��'�Q�\�wU�v qe��a�D�3�%�a��բI�)��b"f�Ĉ��}!H$��K$-�^Ms� �Z/&�7E�0uZVc\hjru�U"�=k3Ƹ�MV��K+�u��o��ER��A��^Y��&��xQ�Ѐ坩��ϲb��W �2�/ From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. To develop an awareness of which clinical … Acute cough in children with upper respiratory infection symptoms and no red flag findings is usually caused by a viral infection, and testing is rarely indicated. A high index of suspicion for foreign body aspiration is needed if children are age 6 months to 6 years. Thefive questions, whichareanswered by the child'sparent orcaregiver, cover cough frequency (Q1), sleep disturbance of the child(Q2), sleep disturbance of ... parent's global assessment… 1. A Word About Children and Cough Medicine. The patient continued her post-operative course of antibiotics using PO medications. Little evidence exists to support the use of cough suppressants and mucolytic agents. Shadow Health: Focused Exam: Cough Results Danny Riviera. Acute cough is most commonly associated with the common cold, but it also can be associated with life-threatening conditions (e.g., pulmonary embolism, congestive heart failure, pneumonia). This site complies with the HONcode standard for trustworthy health information: Questionnaire, Cough-Speciﬁ c Quality-of-Life Ques-tionnaire [CQLQ], Pediatric Cough Questionnaire [PCQ], PC-QOL, and Adverse Cough Outcome Survey [ACOS]), whereas others focused on disease states for which cough is a predominant symptom Children … endobj Subjective Data Collection: 20 of 20 (100.0%) Hover To Reveal… Hover over the Patient Data items below to reveal important information, including Pro Tips and Example Questions… Medication can't cure colds or flu, but honey, hard candies or cough drops can help relieve a sore throat caused by coughing. 3 0 obj history in a pediatric patient. Health Details: Danny Rivera Pediatric Cough Shadow Health Assessment Transcript Transcript Started: Apr 08, 2020 | Total Time: 74 min All Lines (176)Interview Questions … 4. endobj The history should focus on identifying the duration, quality, triggers, progress and diurnal/seasonal variation of the cough… x��Ymo��)�a�]�J(�� Ji�vs�M�$��W��c��8�W��y��&I��"90��9��v�:rm��mO�? Abdominal examination should focus on presence of abdominal pain, especially in the upper quadrants (indicating possible left or right lower lobe pneumonia). If foreign body aspiration is suspected, chest x-ray with inspiratory and expiratory views should be done (or in some centers a chest CT). Not only does it cause discomfort for the child, cough … Children with TB risk factors or weight loss should have a chest x-ray and purified protein derivative (PPD) testing. All children experience head colds and many consult their doctor because of associated coughing.1 Cough with colds remedies are among the most commonly used medications in children in Western societies, despite evidence suggesting ineffectiveness of medication to treat cough as a symptom. �q��_�.��ݯB�16�m(�I�ݟ-�n��(�nI��`D��h��Uh�J9��ء%��qi��p�=,-TYkh"��JGv��[�*�e��x�x[�A��`�K3��J6f�� bw�V��D��_�m�JX�͹��2k� �6��fԢ� /�9g�9)�Zjg敏їa��*�6��lD�EH�MӼr�� 6=d-h��ĕ2��*y��o��1k! Pediatric chronic cough (ie, cough in children aged < 15 years) is defined as a daily cough lasting for > 4 weeks.This time frame was chosen based on the natural history of URTIs in children and differs from the definition of chronic cough … The cough … Foreign body aspiration and diseases such as cystic fibrosis and primary ciliary dyskinesia are less common, but they can all result in persistent cough. The adolescent has a number of questions … Conclusions: Electronic recording devices can be valid assessments of cough frequency. Clinical history & physical examination. Specific questions should be asked about previous medical problems, even if the patient doesn’t notice current … The trusted provider of medical information since 1899, Nausea and Vomiting in Infants and Children, Obsessive-Compulsive Disorder (OCD) and Related Disorders in Children and Adolescents, Adolescent patients who have obsessive-compulsive disorder (OCD) are most likely to also have which of the following, Last full review/revision Jun 2020| Content last modified Jun 2020, © 2020 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA), © 2021 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, Musculoskeletal and Connective Tissue Disorders. Tested lung capacity with spirometer: FEV1: 3.15 L, FVC 3.91L (FEV1/FVC: 80.5%) Danny Rivera Pediatric Cough Shadow Health Assessment Transcript Exam Action 04/09/20 11:12 AM PDT The pharynx should be checked for postnasal drip. Evaluating cough assessment tools: a systematic review Chest. Cough Questionnaire San Francisco Otolaryngology – Patient Self-Assessment Questionnaire www.sfotomed.com 1. For Shadow Health Focused Exam for Pediatric Patient with Cough When the student is taking the Digital Clinical Experience, they are required to take a focused respiratory exam, investigate related systems and symptoms, and practice communicating with a pediatric patient about his home life, health, and cultural beliefs.

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