Question

I want answer typed.                               1_Discuss the assessment of cough in the older adult
2. Discuss the assessment of the heart in a young child and include one usual abnormal finding
3 _Discuss the assessment of the peripheral lymphatic nodes and include one usual abnormal finding

Answer 1

1.Assessment of cough in older adults:

Taking history of smoking,alcohol intake,asthma and rhinitis or any illness in past 12 months.

Checking frequency of cough like coughing six times a day ,four or more days in a week to find out chronic persistent cough.

Duration of cough and timings of cough to find out nocturnal cough.

Spirometery test can be done to check vital capacity of lungs.

Chest radiographs can be obtained to find out bronchiectasis,emphysema,TB or more.

Sputum culture can be done.

2.Assessment of heart in a young child and one unusual abnormal finding-

Assessment of early signs-

Tachycardia,especially during rest and slight exertion.

Tachypnea,profuse scalp diaphoresis especially in infants.

Fatigue and irritability

Sudden weight gain and respiratory distress.(monitor apical pulse for 1 minute)

By monitoring strict intake and output,by monitoring daily weight to assess for fluid retention.

Abnormal findings like Atrial septal defect(ASD)-It is abnormak opening between the atria that causes an increased flow of oxygenated blood into right side of the heart.

3.assessment of peripheral lymphatic nodes-

Assessment for signs of infection like fever,pallor or fatigue.

Check for the size of lymph node and most common localization like head and neck region.

Check if node is palpable or not.

The child has a normal,elevated or low white blood cell count depending on the presence of infection or immature versus mature WBCs.

The child has decreased platelet count,decreased hemoglobin or hematocrit count.

Check for any break in skin,bleeding,increased intracranial pressure.

Assessment of nutritional diet of child.

Monitor signs of dehydration,fatigue,child's behaviour in past days.

Exisional biopsies helo to identify type of node if present.

Abnormal finding:Hodgkin's disease: it is type of malignancy of lymph noded that originates in a single lymph node or a chain of nodes.It is characterized by the presence of reed sternberg cells noted in a lymph node biopsy specimen.