Review the following case study and answer the questions below.

Review the following case study and answer the questions below. Be sure to include rationales for each question to support data. Then include references to also support data (APA format). Module 5 Case Study A 7-month-old old female (Katie) is brought to your primary care clinic by her mother with the chief complaint of a cough and “breathing heavy” for the last two days. Mom says she has had a fever for the last couple days with a maximum temp of 101 F (rectal). Katie has also had a runny nose. Mom has tried over the counter pediatric medications with no relief. She notices that when Katie cries, her breathing gets worse. She is “eating ok so far” and BM pattern has not changed. Katie attends daycare and mom reports most of the kids there have coughs & runny noses. Mom also reports she has had a cold for the last 5 days. Past Medical History: Katie was a 40-weekk gestation, vaginal delivery with no complications. During pregnancy mom did not drink alcohol, take OTC or prescription medications (0ther than prenatal vitamins), use tobacco products, or use illicit drugs. Katie’s birth weight was 3300 g and her Apgar scores were 9 (1 min) & 9 (5 min). Family Medical History: Mother (28yo) & Father (30yo) in good health. Paternal grandfather (60yo) prostate cancer; Paternal grandmother (59yo) healthy; Maternal grandfather (deceased age 51 – auto accident) otherwise healthy; Maternal grandmother (58yo) asthma otherwise healthy. Social History: lives with mother (administrative assistant) & father (hospital maintenance worker). Daycare 5 days a week. No smoking or pets in the home. Medications: NKA. No prescription medications. Taking OTC children’s cough medication for last day. Allergies: NKA & is up to date on immunizations Physical Exam – Objective Vitals: T: 37.9 C (rectal) HR: 120 RR: 32 Pulse Ox: 95%; Wt: 7.1 kg Length: 65 cm Skin: Clear – no lesions noted, no cyanosis of skin, lips, nails; no diaphoresis and good skin turgor. Head: normocephalic, anterior fontanel is open and flat (1.5cm X 1.5 cm) Eyes: red reflex present bilaterally; PERRLA; no discharge noted. Ears: pinnae normal; TM gray bilaterally with positive light reflex Nose: both nostrils patent; no discharge; mild nasal flaring Oropharynx: mucous membranes mosite; no teeth present, no lesions Neck: supple, no nodes Respiratory: barking cough noted; inspiratory stridor with activity; no intercostal, suprasternal, or subcostal retractions, no grunting; no deformities of the thoracic cage noted. Cardiovascular: HR: 120 regular rhythm, no murmur, brachial & femoral pulses present and 2+ bilaterally. Abdomen: soft, nontender, non-distended, no evidence of hepatomegaly Genitourinary: normal female genitalia Back: spine straight Extremities: full ROM all extremities, extremities warm & pink with cap refill <2 seconds Neurological: Awake & alert with good tone in all extremities. Please answer the following questions: 1. What are your top four (4) differential diagnoses? 2. What is the most likely diagnosis and why? 3. What additional testing would you like to order to assist with or confirm your diagnosis? 4. What is your treatment plan? 5. What is your plan of follow-up care? 6. Are there any standardized guidelines that you should use to assess and treat this patient?

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