A 2-month-old child is admitted to the ICU with fever, hypotension, tachycardia, and lethargy. The medical...

A 2-month-old child is admitted to the ICU with fever, hypotension, tachycardia, and lethargy. The medical history is notable for a similar hospitalization at 2 weeks of age. Physical examination is notable for a temperature of 102°F, oral thrush and rales in the right lung fields. Chest x-ray film reveals multilobular pneumonia. Given the history of recurrent severe infection, the pediatrician suspects an immunodeficiency disorder.

Explain the terms tachycardia, rales, and multilobular pneumonia.
What is the most likely immunodeficiency in this child? Why?
What is an underlying biochemical (genetic) defect in this patient?
Explain why this defect leads to the disease phenotype?
Explain the cellular defects associated with this disease?
What is the overall prognosis for patients with this disorder?

Solutions

Expert Solution

1) Tachycardia - Tachycardia is defined as increasing of the Pulse Rate above the normal Value..

Genarally if the Pulse Rate becomes more than 100 beats/ min.. Then It is Considered as Tachycardia..But here the child is 2 months Old ,, that means belongs to the catagory of infant..So, the normal pulse rate of a 2 months old child is 115-130 beats/min..

So,, In this case the 2 months Old Child Suffers from Tachycardia....that means heart rate is more than 115-130 beats/ min..

Rales - Crackles Or Rales are the abnormal Lung Sound that is heared in any kind of Respiratory Disease..This abnormal Sound is like rattling or Crackling Noise..

Multilobular Pneumonia - Multilobular Pneumonia is defined as an infectious condition which causes the inflammation of the parenchyma of lungs,,, that effect the multiple lobe of the Lungs..

It is a Very severe disease condition.. and it's Prognosis is worse..

2) In this Child the most likely Immunodeficiency is The presence Of Infection..

Because in this case the Child is in the Diagnosis of Multilobular Pneumonia..and the sign symptoms( Fever, Tachycardia, Oral Thrush, Rales ) which present in the child are the effect of any infection..

So, Here the immunodeficiency factor is Infection..

3)The presenting Underlining Genetic Defect may be-

Immunodeficiency Disorder
Poor diet & Nutrition
Premature Birth
Genetic Disorder like- Asthma, Sickle Cell anemia
Congenital heart Disease Like- Atrial septal Defect(ASD), Ventricular Septal Defect (VSD) etc..

4) These genetic defect are Responsible for the Immunodeficiency Condition Of the Child..And that leads to lower immunity level..Which is responsible for initiating any Infection and then grow and development of this infection and also the infectious Disease ( In this Case Multilobular Pneumonia ) Rapidly..and in this way Disease phenotype is developed..

5) Three Cellular Stage is Present in the Developing Of Pneumonia..

Early Consolidation- Red Hepatisation is occured in this Phase due to excessive Collection Of the RBC, Fibrin etc..
2nd Phase Of Consolidation- Gray Hepatisation is Occured due to process of Active Phagocytosis..
Resolution- This is the Last stage.. In This stage the intra-alveolar debris is removed..

6) The Prognosis Of Multilobular Pneumonia is Very Slow...Prognosis can be occured due to the proper medical Treatment,, Proper taking Of Medication & Also By the active Immunotherapy..

Nightingale answered 1 year ago

Next > < Previous

Related Solutions

A 4-month old baby is admitted to the hospital with a fever of 104o F (compared...

A 4-month old baby is admitted to the hospital with a fever of 104o F (compared to a normal temperature of 98.6o F) and a decreased blood pH. Why is it critical to reduce this fever as quickly as possible and restore normal pH? Discuss the role and sensitivity of proteins in (1) normal body chemical processes and (2) how enzyme activity is directly affected by changes in pH or temperature.

An 8-year-old child was admitted to the hospital with body aches, fatigue, cough and fever. He...

An 8-year-old child was admitted to the hospital with body aches, fatigue, cough and fever. He was diagnosed with a viral infection that spreads via large droplets. Nursing diagnoses established in the plan of care for this patient include Ineffective Thermoregulation, Social Isolation and Impaired Comfort. Initial Discussion Post: • Describe the precautions and personal protective equipment required to care for this patient. • Choose one (1) nursing diagnosis from this patient’s plan of care Identify three (3) interventions for...

An 8-year-old child was admitted to the hospital with body aches, fatigue, cough and fever. He...

Case Scenario Mr. W is an 80-year-old retired truck driver admitted to medical ICU for exacerbation...

Case Scenario Mr. W is an 80-year-old retired truck driver admitted to medical ICU for exacerbation of his COPD. He lives his wife, who is 78 years old. Mr. W continues to smoke one to two packs of cigarettes per day, as he has done since the age of 15.Over the past week, Mrs. W has noticed a decrease in Mr. W’s activity level and attention span. He has a productive cough of thick tenacious sputum, averaging 1 cup per...

Susan is a 4-year-old girl who presents with a 7-day history of fever and lethargy. Susan’s...

Susan is a 4-year-old girl who presents with a 7-day history of fever and lethargy. Susan’s physician has ordered laboratory work that includes a blood culture. Subjective Data Fever for 1 week Mother has noticed decreased activity level States she is “afraid” of needles Objective Data Weight 26.1 kg Vital signs: T 39.3, P 110, R 40, BP 108/54, O2 sat 100% No abnormal findings on physical examination Questions: When should Susan’s nurse explain the procedure to her? To give...

ICD 10 1. A 70-year-old female presented to the hospital with fever, myalgia, arthralgia, tachycardia, and...

ICD 10 1. A 70-year-old female presented to the hospital with fever, myalgia, arthralgia, tachycardia, and dehydration and was believed to be septic. This patient has a history of hypertension, CHF, and migraines. Routine medications include Lasix 40 milligrams by mouth each morning, if needed, for significant pedal edema and Isordil 20 milligrams by mouth four times a day. A variety of studies were obtained to further delineate the source of her problem. Urine cultures were negative. Blood cultures grew...

A 2-year-old child presents to the pediatrician’s office with a two-day history of fever, vomiting and...

A 2-year-old child presents to the pediatrician’s office with a two-day history of fever, vomiting and diarrhea. The nurse obtains the child’s temperature, pulse, and respirations. Temp was 101.3 (38.5 C), HR 156, Respirations 32. The child appears tired but alert and clings to mother when the nurse is obtaining vital signs. What other assessments are necessary and the nurse would need to complete next.

E.M., a 5-month-old girl, has been admitted for respiratory distress, hypoxia, and fever. Her viral respiratory...

E.M., a 5-month-old girl, has been admitted for respiratory distress, hypoxia, and fever. Her viral respiratory panel shows that she has respiratory syncytial virus (RSV). in the emergency department (ED), her Sao2 was 78% on room air, and she was placed on 1.5 L oxygen (O2). On admission to the floor, the patient is fussy and difficult to console. Vital signs (VS) are 130/72, 188, 83, 38.4C (rectal), and Sao2 94% on 1.5 L O2. 1. Based on the patient's...

64 year old patient admitted yesterday with CHF, treated in the ER, transferred to ICU and...

64 year old patient admitted yesterday with CHF, treated in the ER, transferred to ICU and improved. Patient is possible transfer out of the ICU in the morning, when patient develops increasing SOB over last 30 minutes. Feeling quite unwell, you notice the saturations have worsened and the BP is increased. Patient complaining of SOB, vitals show sats have dropped off and you have started O2. BP is elevated at 190/100. Past Medical History: CAD NSTEMI 2003 with RCA stent,...

A 70 year old male patient was just admitted to ICU after subarachnoid hemorrhage as a...

A 70 year old male patient was just admitted to ICU after subarachnoid hemorrhage as a result of aneurysm rupture in the middle cerebral artery. His blood pressure is 180/ 100, his heart rate is 85 BPM, and his RR is 20. He complains of severe headache and lightheadedness. Please develo NURSING INTERVENTION WITH RATIONAL for your interventions for this patient in the ICU.

Subjects