AHPA W4 Response

C, a 30-year-old female, woke up from a nap and noticed her inability to voluntary move the right side of her face. Along with that, she also could not close the right side of her eye and had a noticeable slight droop at the corner of the mouth. Her husband, who was aware of the signs of a stroke, noticed the signs that matched some of the signs of a stroke, so he called 911 to rush her to the hospital. She presented to the hospital where stroke was ruled out based on her imaging and insignificant health history. She was, however, diagnosed with Bell’s palsy.SUBJECTIVE – 30 y/o female presented to the hospital with complaints of rapid and progressive weakness of the eyebrows, forehead, and angle of the mouth. She also reports inability to close the eyelid and lip on one side of the mouth. Additionally, she reports a difference in taste, sensitivity to sound, dry eye that worsens after a full day’s work looking at a computer screen. The symptoms have been progressing throughout the past week.OBJECTIVE – Noted partial to complete weakness of the forehead. Facial droop on right, as well as drooping at the right side of the mouth are present. Speech slightly slurred and some drooling noted. The House-Brackman Facial Nerve Grading System is at 4/6.ASSESSMENT – Bell’s palsy is a non-progressive neurological disorder of the 7th cranial nerve. It is characterized by the sudden onset of facial paralysis which may also be preceded by a mild fever, pain behind the ear, a stiff neck, or stiffness of on side of the face. Paralysis results from decreased blood supply to or compression of the 7th cranial nerve. The exact cause of bell’s palsy is unknown, but viral and immune disorders are frequently implicated as the cause (National Organization for Rare Disorders, 2021).PLAN – Cranial nerve assessment; electromyography for confirm diagnosis and measure extent of never damage; lubricating eyedrops, glasses, or temporary patching to help protect exposed eye from corneal abrasion or any other damage if unable to close it; corticosteroid regimen consisting of 60 to 80mg a day for a week, which is the mainstay pharmacologic treatment for bell’s palsy (Warner, et. al, 2021).            The topic of bell’s palsy as demonstrated by the short case study, can mimic some of the signs and symptoms of stroke, and therefore, it is a very appropriate condition for graduate nursing students to be familiar with as misdiagnosis is not uncommon. Treatment does not always result in immediate resolution, and therefore, such condition is primarily managed in the outpatient setting where FNPs can manage the patient, so it is important to know the clinical guidelines on treatment, in addition to knowing its clinical manifestations and careful assessment to differentiate it from other more or less serious conditions. As mentioned previously, it can mimic stroke like symptoms, and so I would say that I can certainly expect to see this in the inpatient setting initially where patient may receive their initial bell’s palsy diagnosis. However, for those who have established diagnosis of such condition, I expect to see it managed primarily in the outpatient setting.Response 2:Acute Otitis Media in Children            Acute otitis media is one of the most common diseases in childhood. According to Mousseau et al. (2018), about 75 percent of children have at least one episode of acute otitis media before their first birthday. Acute otitis media is an infection of the middle ear space. It can be viral, bacterial, or a coinfection. The most common causing bacteria are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. The most common causing viral pathogens are respiratory syncytial virus (RSV), coronavirus, influenza viruses, adenoviruses, human metapneumovirus, and picornaviruses (Danishyar