Week 4 Case Study Review the pharyngitis scenarios and determine the most likely cause, including pathogen and mode of transmission

Sample Answer

Case Studies

Accurate diagnosis is important in the management of health problems in healthcare and nursing practice. Nurses utilize evidence-based data to diagnose and develop accurate treatments for their patients. In doing so, nurses prioritize safety, quality, and efficiency of the adopted treatments. Therefore, this paper explores three case studies to determine the causes of the health problems, diagnosis, and potential treatments that should be adopted.

Case Study 1

Susan’s most likely diagnosis is pharyngitis. Pharyngitis is the inflammation of the oropharynx mucus membranes. The causes of the infection can be either viral or bacterial. Additional causes include cancer, trauma, allergies, toxins, and reflux. Most of the pharyngitis cases are attributable to viral origins such as influenza, rhinovirus, coronavirus, adenovirus, and parainfluenza. Most severe cases of pharyngitis are due to Group A beta-hemolytic streptococci.

Other bacteria that may cause pharyngitis include Group B and C streptococci, Hemophilus influenzae, and Neisseria meningitidis. Susan’s problem is pharyngitis because of some reasons. First, she has clinical manifestations that patients affected by the infection experience. They include fever, painful cervical adenopathy, tonsillar exudates, and pharyngeal erythema.

She also complains of dysphagia and oropharynx petechia. The cause is most likely to be Group A beta-hemolytic streptococci due to its acute onset. Some tests are indicated for use in pharyngitis. One of them is rapid antigen detection test. This test is specific for pharyngitis due to Group A beta-hemolytic streptococci. It also has moderate to high sensitivity of about 70-90%. Treatment should be initiated if the test is positive.

The other diagnostic test is throat culture. Throat culture is considered the ideal standard for diagnosing pharyngitis. However, it has variable sensitivity. A heterophile antibody or monospot test may also be conducted. It has sensitivity rate of 70-92% and specificity rate of 96-100%. Susan’s treatment options include initiating her on either Penicillin V or oral amoxicillin.

Macrolides, cephalosporins, and clindamycin may also be considered. Single-dose corticosteroids and acetaminophen may prescribed to relieve symptom severity and pain (Wolford et al., 2022). Patient should be monitored for incidences of drug resistance.

Case Study 2

Mr. Jones’s most likely diagnosis is influenza. Influenza is a contagious respiratory tract illness attributable to influenza viruses. They affect throat, nose, and lungs in some cases. Influenza symptoms can range from mild to severe and even death. The main mode of transmission of influenza is via droplet. Patients inhale infected droplet particles, which result in symptom development.

The symptoms that Mr. Jones has resemble those associated with influenza virus. They include fever, chills, cough, headaches, muscle aches, runny, stuffy nose, sore throat, and fatigue. Some patients may experience additional symptoms such as diarrhea and vomiting (CDC, 2022).

Influenza diagnosis is possible with some investigations. One of them is viral culture. Viral culture will aid the determination of the virus causing the infection. Rapid antigen testing is also utilized in the diagnosis. It provides highly reliable and sensitive results about the potential cause of the infection.

Reverse transcription polymerase chain reaction, rapid molecular assays, and immunofluorescence assays may also be performed to determine if the cause of the infection is viral (CDC, 2021). Nasopharyngeal specimens should be utilized for viral culture since they have a high yield compared to throat or nasal swabs.

Treatment of influenza is supportive. Antivirals such as oseltamivir and peramivir may be prescribed to treat viral the viral infection. Nonsteroidal anti-inflammatory drugs such as acetaminophen may also be prescribed to manage symptoms such as pain and fever.

The patient is also encouraged to increase fluid intake and engage in deep breathing and coughing exercises to promote adequate lung expansion and clearance. Influenza and pharyngitis vary. Influenza is mainly attributed to viral infections while pharyngitis is due to either viral, bacterial, or other causes such as cancer. The symptoms also vary.

Some symptoms in influenza such as headache, rhinorrhea, cough, and fatigue may not be present in pharyngitis (CDC, 2022; Wolford et al., 2022). The treatment approaches also differ since influenza is mainly supportive therapy while pharyngitis may be active treatment.

Case Study 3

Jane’s most likely diagnosis is influenza. Influenza is a contagious, viral infection associated with respiratory tract symptoms. The history shows that her sibling had a cold for a week, which implies that influenza is the most likely diagnosis for her. The causative agent for influenza is influenza viruses.

The patient exhibits symptoms that patients with influenza have. For example, she has cough, rhinorrhea, fever, fatigue, lethargy, and poor feeding. She also has a sour throat (CDC, 2022). Some children may experience additional symptoms such as diarrhea and vomiting. The spread of influenza is through droplet method, hence, the need for droplet and standard precautions.

Several diagnostic tests can be done to determine the cause of Jane’s problem. They include viral culture, rapid antigen testing, serology, immunofluorescence assays, reverse transcription polymerase chain reaction, and rapid molecular assays. Viral culture enables the determination of the different virus subtypes and influenza types such as A and B.

Rapid influenza diagnostic tests may also be performed to provide timely results about the virus types within a short period. Immunofluorescence detect influenza types A and B and their associated subtypes. Rapid molecular assays have high specificity and sensitivity in identifying the different types of viruses causing the problem (CDC, 2021). Treatment for influenza is supportive.

The aim is to manage symptoms such as fever, cough, and pain using non-steroidal anti-inflammatory medications, cough suppressants, and antivirals in severe cases. Aspirin should not be used due to the increased risk for Redman’s syndrome.
In summary, the patients in the case studies suffer from different illnesses including pharyngitis and influenza.

The treatment entails the use of antibiotics and supportive therapies for influenza. Different diagnostic studies can be adopted to diagnose patients with the above problems. Therefore, nurses should be informed about the effectiveness of the existing therapies for the management of the health problems affecting these patients.

References

• CDC. (2021, May 6). Influenza Signs and Symptoms and the Role of Laboratory Diagnostics | CDC. https //www.cdc.gov/flu/professionals/diagnosis/labrolesprocedures.htm
  CDC. (2022, August 25). Key Facts About Influenza (Flu) | CDC. https //www.cdc.gov/flu/about/keyfacts.htm
  
• Wolford, R. W., Goyal, A., Belgam Syed, S. Y., & Schaefer, T. J. (2022). Pharyngitis. In StatPearls. StatPearls Publishing. http //www.ncbi.nlm.nih.gov/books/NBK519550/