Signature Assignment: Current EBP – Acute Bronchitis
Primary Health of Acute Clients/Families Across the Lifespan-xxxx
Signature Assignment: Current EBP – Acute Bronchitis
This paper has a lot to say about acute bronchitis, which is a sudden health problem. The paper is based on two original pieces of research, articles that have been reviewed by experts in the field, and the clinical experience of a client with acute bronchitis who needed at least two visits. Using these sources, the paper looks at key ideas and different points of view about acute bronchitis, as well as the effects of cultural, spiritual, and socioeconomic factors and evidence-based medical guidelines, among other things that are important to the acute health problem. The goal is to give the reader a deep understanding of acute bronchitis in terms of clinical evaluation, symptoms, evaluation, and clinical guidelines for treatment.
Subject and Why It Was Chosen
Singh, Avula, and Zahn (2021) say that acute bronchitis is caused by inflammation of the bronchial tubes (bronchi), which are the airways that lead from the trachea to the small airways and alveoli. A cough, sputum production, nausea, fever, diarrhea, vomiting, sore throat, tiredness, headache, and aches and pains in the muscles are common signs of an acute health problem. This topic was chosen because most primary care offices, urgent care centers, and emergency rooms see a lot of people with acute bronchitis. Singh, Avula, and Zahn (2021) say that 5 percent of adults in the US are diagnosed with acute bronchitis every year. This makes it one of the top ten most common acute health problems for outpatients. This means that about 10 million people go to health care facilities every year. The health problem is the same as flu season, which is common in the US in the winter and fall. The disease can happen after a viral upper respiratory infection. Common pathogens are parainfluenza, influenza virus A or B, rhinovirus, and respiratory syncytial virus. Risk factors like asthma, living in a crowded area, living in a polluted area, and a history of smoking all make the condition worse. Because these are things that a lot of people in the US have in common, the topic was chosen because of how important it is for public health.
An Analysis of Key Ideas
According to Kinkade and Long (2016), acute bronchitis is caused by sudden inflammation of the bronchi, which can be caused by a virus, allergens, pollution, and other things (p. 560). Inflammation of the bronchial wall also causes the basement membrane to break down, the epithelial cells to shed their outer layers, and the mucosa to thicken. There are times when a viral infection of the upper respiratory tract moves down to the lower respiratory tract and causes acute bronchitis. When a person has acute bronchitis, a physical exam can show many different things. Some of these are bullous myringitis, rhinorrhea, adenopathy, conjunctivitis, diffuse wheezes, inspiratory stridor, and peripheral cyanosis. Overall, people with a cough and a short-term respiratory infection are more likely to have acute bronchitis. But it’s important to remember that a cough can be caused by other, more serious illnesses of the lower respiratory tract. So, Albert (2016) suggests the following studies to help with the correct diagnosis of acute bronchitis: (a) spirometry, (b) influenza tests, (c) blood culture if there is a suspicion of a bacterial super-infection, (d) sputum cytology if there is a persistent cough, (e) chest radiography if there is a suspicion of pneumonia or the patient is older, (f) procalcitonin levels to tell the difference between
Complete the client’s H&P (history and physical) from the first visit.
The client is a man who is 45 years old and works in a company that deals with dangerous chemicals that give off strong smells. He has been overweight for the past three years and smokes a lot. Since 12 days ago, the client has been coughing up a lot of sputum. At the moment, the sputum is clear. Over the past six days, the client has also had extreme fatigue, sore muscles, a headache, a stuffy nose, and a sore throat. Because of these symptoms, it has been hard for him to work. Since his job pays him based on how much he does, his current illness is not only bad for his health, but also for his finances. So, the client wants a quick and effective way out of his situation.
Checking out the body During a physical exam, the client had rough rhonchi and wheezes, which changed in intensity and location after a deep and productive cough. The client also makes high-pitched sounds that don’t stop and wheezes all over, which shows that he has a severe case of an acute health problem. Sometimes the patient has a general decrease in air intake, which means that the trachea or major bronchi are blocked. The client also has a steady heave along the left side of his sternum. This is a sign of right ventricular hypertrophy, which is the same thing as bronchitis.
SOAP Note for the Next Visit with the Client
Subjective
The client is a man who is 45 years old and went to the clinic on February 18, 2022. He said he had a constant cough, a lot of phlegm, extreme tiredness, sore muscles, a headache, a stuffy nose, and a sore throat. A review of his systems showed that, other than a cough, the client’s health had not changed much in the past few weeks. A skin exam didn’t find any rashes or itching, and a HEENT exam showed that the client’s eyes and ears were working normally, but that they had a stuffy nose and sore throat. The cardiovascular system and digestive system were also working fine. No allergies are known about the client. He has tried over-the-counter medicines to stop coughing, but they haven’t worked.
Objective
The following were the client’s vital signs: “BP 115/75, HR 85, RR 17, Temp 96.2 (oral), SPO2 96% RA. Height: 5ft 8inch, Weight: 143 lb., BMI: 21.7.” A general survey showed that the client was calm, spoke clearly, and answered all questions in a consistent way. But his skin was dry and he looked older than he said he was.
Assessment
Acute bronchitis is the main diagnosis (ICD-10: J20.9). The symptoms that led to this diagnosis were a severe cough, tiredness, mucus, and pain in the chest. The client’s diaphragm looked flatter and lower than usual. He also had a liver that could be felt, which means that it could have been moved by too much inflation. Bronchitis is more likely to happen to him because he smokes and is often exposed to toxic fumes at work. To prove or disprove this diagnosis, however, standard lab tests must be done.
Plan
The patient is going to be given azithromycin. This drug is good at killing bacteria, which is one of the main reasons why people get bronchitis. Also, Naproxen and Sumatriptan can work better when used together. Albert (2016) says that when these medications are taken together, good clinical outcomes happen. The client doesn’t have any allergies, so it’s likely that these drugs will help her. In terms of lab tests, an x-ray of the chest will be done to look at the lungs and bronchial tubes, a blood test will look for infections, a respiratory mucus test will show where the mucus is coming from, a urine test will show where inflammation is likely coming from, and spirometry will show how well the lungs are working. Lastly, the patient will be taught how to take his medicine and make the changes to his lifestyle that he needs to make to get better quickly and keep his acute bronchitis from becoming chronic.
Description of Different Points of View
Singh, Avula, and Zahn (2021) say that secondary pneumonia can happen in some cases. Symptoms like fever, a productive cough, and getting worse are often signs of this. So, x-rays of the chest might be needed. This trend is important for smokers, babies and newborns, older people, and adults with weak immune systems. Fahey et al. (2014) show that patients who have shortness of breath and a cough must be checked for pulmonary emboli. Sometimes, coughing too hard can cause spontaneous pneumomediastinum or pneumothorax. Again, if your symptoms get worse quickly, you may need a chest X-ray. People with acute bronchitis should know how important it is to make changes to their lives, like staying away from pollution or quitting smoking, in order to prevent the disease from coming back or causing other problems. Also, immunizations against pneumonia and flu may be important for people in high-risk groups. To keep antibiotics from becoming less effective, patients may also need to be taught not to take antibiotics when they are not needed. But most people don’t follow these rules. For example, a lot of people self-medicate with antibiotics, some people refuse to get vaccinated, and some people won’t give up bad habits.
How Good the Evidence Is/How Good the Research Is
The research mentioned in this article was very reliable for a number of reasons, such as the use of scientific research methods, large sample sizes, long study times, randomization, and the fact that the results were very close to the scientifically established guidelines for treatment and diagnosis. Also, the research in the articles was done by people who were qualified, with good grades and a lot of experience in their fields. The research was also written up in scholarly journals that were reviewed by other experts and cited other credible and trustworthy primary and secondary sources.
Review of the EBM Guidelines in Place
Current EBM guidelines say that antibiotics should be used to treat adults with simple acute bronchitis. In nine randomized, controlled trials of antibiotics, the length of coughing spells was found to be slightly shorter. However, there was no notable reduction in the period of illness (Fahey et al., 2014). Consequently, the use of antibiotics is not recommended in simple cases, taking into account the cost of antibiotics, possible side effects, and antibiotic resistance. For viral acute bronchitis, there are medical societies that advise against the use of antibiotics. Nevertheless, the majority of healthcare practitioners still prescribe antibiotics for individuals diagnosed with acute bronchitis. Current EBM guidelines not only focus on treatment but preventive measures as well. People with acute bronchitis should know how important it is to make changes to their lives, like staying away from pollution or quitting smoking, in order to prevent the disease from coming back or causing other problems.
Cultural, Spiritual, and Socioeconomic Considerations
When interacting with patients, healthcare practitioners should consider the role played by the client’s cultural, spiritual, and socioeconomic backgrounds. These are factors that directly impact the healthcare outcomes of the patient. For instance, there are cultural and spiritual beliefs that may cause a client to forego vital medical care. The client may choose traditional medication or adhere to his religious beliefs and stop the necessary medication. McHale (2018) advises healthcare practitioners not to get offended by such outcomes but to respect the choices of the client. More so, they can try and see the perspective of the client in order to open a proper line of communication and find alternative ways of helping their patients that will not seem offensive to them. Socioeconomic considerations should also be made. For instance, the client presented above works in a company that deals with toxic fumes. It might not be possible for the healthcare practitioner to ask the client to quit his job in order to improve his healthcare outcomes. Hence, alternative preventive solutions should be sought.
Standardized Procedure for this Diagnosis
Acute bronchitis is likely to be diagnosed in individuals having an acute respiratory infection combined with a cough. However, it is vital to acknowledge that there are other more serious illnesses associated with the lower respiratory tract that cause a cough. Hence, as aforementioned, Albert (2016) suggests the following studies to help in the proper diagnosis of acute bronchitis: (a) spirometry, (b) influenza tests, (c) blood culture in case there is suspicion of a bacterial super-infection, (d) sputum cytology in case there is a persistent cough, (e) chest radiography in case there is suspicion of pneumonia or the patient is elderly, (f) procalcitonin levels in order to differentiate nonbacterial and bacterial infections, and (g), complete blood count with differential.
How the Evidence Would Impact Practice
The evidence collected in this paper would positively impact my practice and allow me to offer high-quality healthcare services to my clients. For starters, the evidence collected has revealed the significance of offering holistic care to patients to achieve the best outcomes possible. In my practice, I would not only focus on treatment options, but I would also educate my clients to ensure that they take preventive actions in order to avoid chronic illnesses caused by the acute health problem. I would also consider how their cultures, religion, and socioeconomic backgrounds impact their ability to comprehensively accept healthcare services. The evidence collected has also shown me the importance of carrying out diverse tests during the diagnosis of a client in order to ensure accurate diagnoses are made and differential diagnoses are accurately ruled out.
Conclusion
This paper has presented a comprehensive discussion of an acute health problem called acute bronchitis. Acute bronchitis is a common presentation in most primary care offices, urgent care centers, and emergency departments. It accounts for approximately 10 million visits to healthcare organizations each year. Therefore, it is a major problem that warranted this discussion. Current EBM guidelines recommend treating simple acute bronchitis using antibiotics in healthy adults. Nevertheless, comprehensive tests should be done during diagnosis to rule out other diseases that have similar symptoms to acute bronchitis. Furthermore, his paper has revealed the significance of educating patients on preventive measures to ensure they adopt healthier lifestyles and can alleviate the risk of developing long-term illnesses. Overall, this discussion has enhanced my knowledge of a common acute health problem and has added great value to my future practice.
References
Albert, R. H. (2016). Diagnosis and treatment of acute bronchitis. American Family Physician, 82(11), 1345-1350.
Fahey, T., Smucny, J., Becker, L., & Glazier, R. (2014). Antibiotics for acute bronchitis (Cochrane Review). The Cochrane Library, (4).
Kinkade, S., & Long, N. A. (2016). Acute bronchitis. American Family Physician, 94(7), 560-565.
McHale, J. V. (2018). Ethical, cultural, and spiritual dimensions of healthcare practice. Nursing Ethics, 20(4), 365-365.
Singh, A., Avula, A., & Zahn, E. (2021). Acute bronchitis. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK448067/
