Discussion Prompt

Select one of the following discussion questions:

Discuss how you would respond to a parent that is on the fence in regards to vaccinating their child. What education would you give? Use recent evidence to support your response.

OR

A 27-year-old female patient is 29 weeks pregnant, G1P0A0. She has no medical history. She denies any cramping, vaginal bleeding or discharge. She complains of severe low back pain that occasionally radiates down the legs, worsened with walking. She presents to your clinic asking what she can do to help with the pain. Develop a safe and evidence-based plan for this patient to help her control her low back pain.

Expectations

Initial Post:

Due: Thursday, 11:59 pm PT

Length: A minimum of 250 words, not including references

Citations: At least one high-level scholarly reference in APA from within the last 5 years

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Vaccination Discussion

Vaccination Discussion

            Lack of vaccination education is the major contributor to immunization delays and vaccine hesitancy. A Parent is faced with a dilemma because s/she is worried about his/her child’s safety, the capability of healthcare systems, and the vaccines’ efficiency. Some health-related decisions also influence the uncertainty in dispensing vaccines in children (Damnjanović et al., 2018). Some parents have a perception that a healthy lifestyle promotes immunity to infections.  So, children are at high-risk of vaccine-preventable conditions. To change these attitudes, psychological l perceptions, and social norms, parents ought to access vaccine information. Increased access to vaccine information influences parents’ decision making (Damnjanović et al., 2018). Instead of focusing on the “produce,” which is the vaccine, parents want to know how safe the vaccines are to reduce the threat/danger perception. Health care practitioners should indoctrinate the purpose of the vaccine.

           During the health orientation, vaccine-related/ immunization-focused messages should not focus on scientific or anecdotal arguments only. The vaccine-hesitant spectrum ought to be informed to become knowledgeable (Damnjanović et al., 2018). During the education process, health care practitioners should listen to and acknowledged. Open ended questions would identify parents’ feelings and emotions towards vaccines (Manasseh-Zumbrunnen, Le Breton, & Blanchard-Rohner, 2017). In a vaccination process, parents should be partners. All information should be clarified, and their misconceptions ought to be changed. They should tell the benefits, pain associated with a vaccine, and the side effects. However, health practitioners should not threaten parents that their children stand to die if they do not get immunized. 

            Physicians should create an impression that there is a possibility of risks if the child is not immunized. Also, the indoctrinating process should focus on preventing an outbreak. The process should be somewhat like a dialogue, although parents’ authority should be respected. A positive strategy through personal stories and experiences would identify lives saved through immunization (Manasseh-Zumbrunnen, Le Breton, & Blanchard-Rohner, 2017). It is imperative if parents are informed about state laws that stress mandatory vaccination. Parents should reckon that they are not oppressed, or their rights violated.  Continuous conversations characterize ineffective vaccination education. Physicians should be open to questions throughout.

References

Damnjanović, K., Graeber, J., Ilić, S., Lam, W. Y., Lep, Ž., Morales, S., … & Vingerhoets, L. (2018). Parental decision-making on childhood vaccination. Frontiers in psychology9, 735.

Manasseh-Zumbrunnen, J., Le Breton, J., & Blanchard-Rohner, G. (2017). Talking with parents about vaccines, a challenge for the primary care physician. Revue Medicale Suisse13(576), 1650-1654.

prerequisite assignment: Week 7: Discussion Question – Heme or Endocrine

Pediatric – Week 6 Discussion

Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.

MB Discussion:

Which essential questions will you ask this pediatric patient or their caregiver during this well-child check? Why are these questions important? What lab tests or diagnostic studies will you order and why?

In this case study, the child is not at the appropriate weight. The parent did address that he is a selective eater. Therefore, I would begin with questions regarding his diet. How often is he eating? What is he eating? Does he eat vegetables or fruit? Is he still using a bottle? It is expected that children who still use bottles obtain most of their calories from milk or juice, which deters them from eating solid foods. I would inquire about how many ounces of milk does he drink a day? Does he drink water? It would be essential to address if he is meeting his developmental milestones. At three years old, he should be able to speak in 3-word sentences 75% of the time, feed himself, brush his teeth, use a cup, spoon, and crayon (Burns et al., 2019). He should draw a circle, build a tower of 6-8 cubes, ride a tricycle, and throw a ball overhand. These assignments help identify any areas of concern and activate early intervention if needed. The child’s safety would need to be assessed. Does the child sit in a car seat, booster, or wear their seat belt? Is there a gun in the house, and is it kept in a locked area? Is he potty trained or in training? In addition, I would inquire about the child’s sleep and if he exhibits healthy sleeping habits. Does he get the appropriate 10-13 hours a day that a preschooler should be obtaining each day? (Burns et al., 2019) Does he go to sleep at a reasonable hour? Does he wake during the night? I would also ask if there were any concerns with his behavior. Parents are typically to first to identify any medical or psychosocial problems. Does she have any concerns about the child’s hearing and vision? In addition, I would ask if there has been a change in his routine at home? Does he go to daycare? If so, for how long? A change in family routine can affect the child’s eating habits. I would ask if there has been any recent trauma or trips to the emergency department since the last visit? These questions are essential to help form a history and physical, diagnosis and treatment plan. The laboratory test I would obtain is the finger stick for hemoglobin and hematocrit. This will help identify if the child has anemia. Anemia is vital to assess in children that are nutrition deficit. This is a common medical condition, especially in children who are not eating adequate amounts of iron. Iron is required to form hemoglobin, allowing red blood cells to carry oxygen to other cells (Mantadakis et al., 2020).

What diagnoses would you give the patient in this case? Include the findings that support the diagnoses.

I would diagnosis this child with iron deficiency anemia (D50.9) because his hemoglobin result was 9.5 g/dL (100 g/L). The typical range is between 6 months old and six years old: 10.5-14 g/dL (105-140 g/L) (Mantadakis et al., 2020). The signs and symptoms include pale skin, weakness, cold intolerance, and dizziness. Furthermore, I would diagnose him with a nutritional deficiency (E63.9) due to his poor diet. Finally, I would diagnose him with eczema (L20.9) due to his persistent rash on the antecubital fossae of the elbow for several weeks.

What is your treatment recommendation and education for the patient and family? Why? Include anticipatory guidance.

The treatment plan would begin with replacing his iron by starting daily iron supplements. It is recommended to continue iron therapy for six months after correcting hemoglobin levels to replenish tissue stores (Mantadakis et al., 2020). If the treatment plan is followed accordingly, the anemia should be remedied within two months. The parents will be educated to stop using the bottle and encourage the child to drink water, and limit juice. This encourages the child to eat more solid food. In addition, the parents will be educated to reduce the amounts of desserts and unhealthy snacks to healthier food selections. To help the child’s eczema the parents will be educated to use topical anti-inflammatory agents for outbreaks (Gür Çetinkaya, & Şahiner, 2019). It will be essential to keep put a daily moisturizer on the child’s skin to prevent outbreaks.

References

Burns, C., Dunn, A., Brady, M., Starr, N., Blosser, C. (2019). Burns’ pediatric primary care (7th ed.). Saunders. ISBN:9780323581967

Gür Çetinkaya, P., & Şahiner, Ü. M. (2019). Childhood atopic dermatitis: current developments, treatment approaches, and future expectations. Turkish journal of medical sciences, 49(4), 963984. https://doi.org/10.3906/sag-1810-105

Mantadakis, E., Chatzimichael, E., & Zikidou, P. (2020). Iron Deficiency Anemia in Children Residing in High and Low-Income Countries: Risk Factors, Prevention, Diagnosis and Therapy. Mediterranean journal of hematology and infectious diseases, 12(1), e2020041. https://doi.org/10.4084/MJHID.2020.041