Question

OVERVIEW:
Four-year-old Tim has developed some strange new physical health symptoms. Alone, none seem too concerning, but together they must be taken seriously.
Can you determine whether Tim is facing a benign or serious illness? Can you help develop a treatment plan to help him?

GOALS:
1. Identify objective data to gather in order to make a diagnosis.
2. Create an aligned, thoughtful, and evidence-based plan.

ROLE:
You are a team working at a comprehensive pediatrics primary care clinic. Some of the roles on your team include: a Pathologist, Geneticist, General Pediatrician, Physician Assistant (PA), Nurse, a Respiratory
Therapist, and a Child Psychiatrist.

OBJECTIVE:
Identify the structures, functions, and pathophysiology of the respiratory system.

DELIVERABLE:
1) SOAP Note
2) Post-Assessment Questions

ASSESSMENT CRITERIA:
Objective & Assessment Sections: 1) one or more tests or labs is run in order to provide evidence for/against a diagnosis; 2) test or lab to collect objective data is explained clearly and results are interpreted logically
Plan Sections: 1) comprehensive (includes physical, social & mental health); 2)
aligned to facts of the case; 3) evidence-based; 4) addresses short- & long-term
Case Information:

Jane brings in her four-year-old named Tim to a comprehensive pediatrics clinic in order to assess his health status. Jane reports that Tim is very curious and smart and gets along socially with other children. Jane says that Tim’s preschool teacher suggested she take him into the doctor for a health screening, because she has noticed his stools looking oily when he uses the bathroom.

Patient History:

Tim’s mother Jane is a former drug user and has no family in the area. For these reasons, along with the socioeconomic status of his household (below the poverty line), Tim had a difficult first few years of life. However, recently his mom got help from social services and has been drug-free for six months. They are living in a new rental home and Tim is adjusting well to his new living situation, but is still struggling at school. He recently had several accidents and so they temporarily put him in pull-up diapers. He has also shown to be hesitant in engaging in physical activity and seems more tired and exhausted than a typical four-year-old should be.

Measurements & Vital Signs
Age: 4.5 yrs Height: 3 ft. 7 inch Weight: 32 lbs. Pulse: 108 bpm
Respiratory Rate: 30 breaths/min Temperature: 99.1 degrees F Blood pressure: 100/55 mmHg

Physical Exam:
General appearance: Good-natured, active, secure
Ear, Nose & Throat: Runny nose. Ears do not show sign of infection
Abdominal: Normal; no pain reported upon touching
Neuro: Normal
Respiratory: Cracking/wheezing sounds; slight cough
Cardio: Normal
Nails: Nails normal in color but nail beds are slightly curved

Post-Assessment Questions:

1. What does a spirometer measure? How does it work? Who would it be used on?






2. What are the main functions of the respiratory system? Which are currently or may be in the future compromised in Tim?








3. Describe normal developmental changes in the respiratory system?








4. Name & describe a few of the most common respiratory illnesses to affected children and teenagers.

Answer 1

Post assessment questions;

1.spirometry;

Spisomeday >> It is a common Test used to assess how well your lungs work by measuring how much air you inhale, how much you Enhale and how quickly you Eschake » spirometry used to diagnose asthma, chronic ob steeletive pulmonary disease (COPD), and other conditions coffects breathing

What does spirometry measures?

It measures Forced vital capacity and forced expiratory volume.

Forced vital capacity (FVC): 1 cose This is the largest amount of air That you can forcefully Exhale after breathing is as deeply as you can a lower than normal Ere gerne endocales restricted breathing 1.) Wormally fre 0 equal to vital capacity but in pulmonary diseases, forced vital capacity decreased

Foaced Expiratory volume (FEV): → This is how much air you can force from your lungs is one second. fore It helps to assess the severity & your breathing problems > lower Forced Expircitery volume readings Edicate more significant obstau etios

How does it work?

=> It works by measuring airflow ito and out of your lungs. To take a spirometry Test, you sit and breathe sto a small machère called a spirometer. This device records The amount of air you breathe is and out and speed of your breath

forced Expiratory Healthy volume] FEV 4 - FVC (forud vital capacity LO volume, liters N - Time, seconds

Who would it be used on?

For diagnosis of respiratory disease and monitor your lung conditions.

>> Spinometay is a pulmonary function test. >>It helps to diagnose, asthma, chionic obstauetive Pulmonary disease (COPD) and other condition that affect breathing 2 It is also used to monitor your ling condition and chock whether a Treatment for a chronic lung condition is helping you breathe better