please respond to: What you/your discipline can offer this patient and ways to s

please respond to:
What you/your discipline can offer this patient and ways to support her caregivers.
As a future Family Nurse Practitioner (FNP), there are many ways I could support the patient and her caregiver after the initial interaction. I would first want to assess the patient in the office before offering any specific referrals or resources. I would also want to address any of the caregivers’ concerns and provide help where needed. There are numerous down syndrome support groups offered within the community as well that can be a great resource for families.
2. Your immediate clinical response to the concerns mentioned in the case.
My immediate concern for this patient is the neck pain and headaches. I would conduct a full head to toe assessment, including a neurology exam, to understand more about these medical issues and identify any triggering factors. I would then complete a brief psychiatric assessment to see if there are any behavioral concerns. It should be noted that down syndrome children in grade school often have trouble with communication, compliance with teacher instructors, school rules, and behavior regulation (Daunhauer et al., 2014). This could explain why Jamie is displaying non-compliant behavior but should be examined further for additional problems.
3. Long-term health promotion recommendations based on your understanding of this diagnosis and the information provided in the case regarding the patient and her caregivers.
As mentioned previously, I would offer support and resources for Jamie and her caregiver as needed. I would further assess the mother’s understanding of trisomy 21 and see if she has any current concerns. Down syndrome children are at an increased risk for hearing impairment, obesity, and obstructive airway disease (Bull, 2017). It is extremely important to educate the mother on these trisomy 21 long-term concerns and provide ways to reduce these health risks. I would recommend annual physical assessments for the patient, including eye exams and hearing screenings. Also, occupational and speech therapy are a great resource for Jamie and should be continued at school.
4. Appropriate referrals (include the provider discipline, the purpose for the referral, how you would communicate and collaborate what that provider).
Depending on what is found during the physical assessment, there are intra-professional referrals that can be made. I would consider a neurologist referral if the patient’s headaches and neck pain persist. The neurologist can complete a more in-depth assessment and has specific tests that can identify potential causes. I would call the neurologist after the initial assessment and provide the details of the neurology concerns that are found. After communicating with the neurologist, a plan of action can be determined. Another referral that could be included in the patient’s care plan could be physical therapy for the neck pain. The neck pain could potentially be causing headaches due to a muscle strain or other injury. Physical therapy can help patients strengthen their muscles while decreasing pain levels. Both the neurologist and physical therapy referral could positively impact Jamie’s health.What you/your discipline can offer this patient and ways to support her caregivers.
As a future Family Nurse Practitioner (FNP), there are many ways I could support the patient and her caregiver after the initial interaction. I would first want to assess the patient in the office before offering any specific referrals or resources. I would also want to address any of the caregivers’ concerns and provide help where needed. There are numerous down syndrome support groups offered within the community as well that can be a great resource for families.
2. Your immediate clinical response to the concerns mentioned in the case.
My immediate concern for this patient is the neck pain and headaches. I would conduct a full head to toe assessment, including a neurology exam, to understand more about these medical issues and identify any triggering factors. I would then complete a brief psychiatric assessment to see if there are any behavioral concerns. It should be noted that down syndrome children in grade school often have trouble with communication, compliance with teacher instructors, school rules, and behavior regulation (Daunhauer et al., 2014). This could explain why Jamie is displaying non-compliant behavior but should be examined further for additional problems.
3. Long-term health promotion recommendations based on your understanding of this diagnosis and the information provided in the case regarding the patient and her caregivers.
As mentioned previously, I would offer support and resources for Jamie and her caregiver as needed. I would further assess the mother’s understanding of trisomy 21 and see if she has any current concerns. Down syndrome children are at an increased risk for hearing impairment, obesity, and obstructive airway disease (Bull, 2017). It is extremely important to educate the mother on these trisomy 21 long-term concerns and provide ways to reduce these health risks. I would recommend annual physical assessments for the patient, including eye exams and hearing screenings. Also, occupational and speech therapy are a great resource for Jamie and should be continued at school.
4. Appropriate referrals (include the provider discipline, the purpose for the referral, how you would communicate and collaborate what that provider).
Depending on what is found during the physical assessment, there are intra-professional referrals that can be made. I would consider a neurologist referral if the patient’s headaches and neck pain persist. The neurologist can complete a more in-depth assessment and has specific tests that can identify potential causes. I would call the neurologist after the initial assessment and provide the details of the neurology concerns that are found. After communicating with the neurologist, a plan of action can be determined. Another referral that could be included in the patient’s care plan could be physical therapy for the neck pain. The neck pain could potentially be causing headaches due to a muscle strain or other injury. Physical therapy can help patients strengthen their muscles while decreasing pain levels. Both the neurologist and physical therapy referral could positively impact Jamie’s health.What you/your discipline can offer this patient and ways to support her caregivers.
orginal discussion
Read the following case scenario and outline and reference:
What you/your discipline can offer this patient and ways to support her caregivers.
Your immediate clinical response to the concerns mentioned in the case.
Long-term health promotion recommendations based on your understanding of this diagnosis and the information provided in the case regarding the patient and her caregivers.
Appropriate referrals (include the provider discipline, the purpose for the referral, how you would communicate and collaborate what that provider).
Jamie Peters is an 8-year-old girl who comes to your primary healthcare clinic with a complaint of headaches and neck pain. She was born at full term to a 28-year-old Gravida 2/Para 1 mother. Pregnancy was unremarkable, and birth was by normal spontaneous vaginal delivery. Apgar scores were 8 and 9. A pediatrician was called to the delivery room because the nurses noticed that Jamie had distinctive palpebral fissures, flat occiput, and transverse palmar crease on her left hand. Subsequent chromosomal analysis indicated that Jamie had trisomy 21 (Down syndrome).
Her clinic record reveals that she had a small muscular ventricular septal defect that closed by the age of 18 months. She underwent surgical correction of duodenal atresia at age 3 days and had bilateral tympanostomy tube placement for recurrent otitis media at age 3 years. Aside from intermittent bouts of constipation, she has been well since that time.
Developmentally, she spoke her first words at 17 months, walked at age 22 months, and completed toilet training at 4 1/2 years of age. She is currently in the third grade, in a mainstream classroom, and her mother reports she can read at grade level.
A full-time paraprofessional instructor is assigned to Jamie and one other child. Jamie receives occupational therapy once weekly and speech therapy twice weekly at school. Last year, she was quite happy and well behaved in the classroom. This year, however, she has demonstrated occasional school avoidance and noncompliant behavior. She becomes somewhat oppositional when asked to transition from a favorite activity to one that is less enjoyable. For example, when recess is over, she will sit on the ground and refuse to go back to class.
She began to complain of headaches and neck pain three weeks ago. Her mother shares that she thinks Jamie’s complaints are an attempt to avoid school. She expresses concern that she is missing something and fears that that there may be a serious problem with Jaime.