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Bronchiolitis Case Study

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1. Urticaria, unspecified (ICD 10 L50.9)- Drug reactions are a major health concern. These reactions usually occur on the skin. Most reactions occur as maculopapular or urticarial. Some reactions can also cause eosinophilia. The rash usually appears on the trunk and will expand to the extremities. These reactions can be caused by antihistamines, antibiotics, digoxin, steroid hormones, and acetaminophen (Hoetzenecker et al., 2016). S/S rash that started on the trunk and abdomen, now on the bilateral cheeks. The patient has also been given medications that contain antihistamines and acetaminophen.
2. Croup (ICD 10 J05.0)- Croup is an upper airway disease/obstruction. It usually presents with stridor, barking cough, fatigue or hoarseness. Most …show more content…

Bronchiolitis (ICD 10 J21.9)- Bronchiolitis is an infection of the bronchioles. Symptoms can present with rhinorrhea, cough, wheezing, and hypoxemia. It is usually caused by the Respiratory syncytial virus (RSV) (Schub, 2016). S/S rhinorrhea, cough and wheezing.
2. Fever (ICD 10 R50.9)- Fever is defined as a reading of 100.4 degrees F or above taken rectally. It is the bodies response to help fight infection. Patients often tolerate low grade fever but may become restless or irritable with high fever of persistent fever that goes untreated. Fever can be due to viral or bacterial illness (Schub, & Woten, 2017). S/S Mom reports fever of 101 in the evenings, diffuse rash, crying upon exam. Even though todays temp is 99.5 we are unaware when the patient had the last dose of Tylenol.
3. Dehydration (ICD 10 E86.0)- Dehydration is caused by negative fluid balance. This can be due to not taking in enough fluids. Weight change, appearance, mucus membranes, heart rate and urine output can all contribute to signs of dehydration (Al Sabbagh, 2013). S/S urine output has gone from 4 diapers yesterday to 1 today. Patient is lethargic and not playing. Mom states that he is not eating and drinking well.
P: …show more content…

The patient has a history of allergies and needs to be back on a continual daily dose. The patient can give Ibuprofen for fever. I would stop the Tylenol and Robitussin due to possible drug reaction from too much medication that was administered. Continue the multivitamin.
2. EDUCATION-
• Do not give OTC cough medications. The FDA does not recommend giving cough medications under the age of 4 because of adverse drug reactions and increased emergency room visits (Fan, Leonard-Segal, & Sahajwalla, 2013).
• Treat fever with medications. She can also try giving cool oral fluids, or trying cool compresses. If fever is left untreated then they could have a febrile seizure that is caused from a high core temperature (Schub, & Wooten, 2017).
• Push oral fluids. Pedialyte helps prevent dehydration by replacing electrolytes. Make sure that he is having 3-4 wet diapers a day.
• Red Flags: Take the patient to the ER if there are signs and symptoms of worsening condition before tomorrow. These would be increased work of breathing, stridor (high pitched sound with inspiration), not eating or drinking or high fever that will not break (Petrocheilou et al.,

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