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Case Study: Addressing Pediatric Adversity in an 8-year-old male Hispanic patient with

Chronic Asthma

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Case Study: Addressing Pediatric Adversity in an 8-year-old male Hispanic patient with

Asthma

Asthma is a chronic lung disease that affects people of all ages. It is mainly caused by

inflammation and muscles tightening around the airways, making it difficult to breathe. Its

symptoms include wheezing, coughing, shortness of breath, and chest tightening (Martin et al.,

2022). In childhood asthma, the lungs and airways become easily inflamed when the child is

exposed to specific triggers such as inhaling pollen. This paper assesses an 8-year-old patient

presenting with asthma.

Demographic Description

The patient is an 8-year-old Hispanic living in a rural, low-income neighborhood. He

lives with his parents and three older siblings. He is in third grade and goes to a public school.

His father is a factory worker, and his mother works in retail. Therefore, both parents have busy

schedules, making it difficult to schedule and attend medical appointments. The family is

religious and attends a nearby Catholic church every Sunday.

Presenting Problem

The patient was brought to the clinic by his mother, who noticed frequent wheezing and

shortness of breath at night. The mother also reported that the patient coughs, interfering with his

day-to-day activities and school attendance. He appeared quiet but continued coughing

throughout the visit. His breathing was labored, and he was wheezing from time to time.

However, he was clean and adequately dressed based on the weather. He was anxious during the

visit, and his mother answered most of his questions. His mood was low, but he looked hopeful.

The family’s neighborhood borders a factory despite living in a rural area. This indicates

that the air quality within the area is poor. Based on the patient’s condition, this triggers his
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asthma symptoms. Furthermore, the community has limited access to healthcare. To access

medical services, they must drive 40 minutes away or use public transport. Even though there is

adequate public safety, the neighborhood has limited recreational spaces, such as leisure parks

and playgrounds. This restricts children’s opportunities to engage in physical activities.

History

The mother reported that the patient’s symptoms started 14 months ago, shortly after

moving into the new house near the factory. The patient’s coughing symptoms have worsened

over the last two weeks. In addition, wheezing occurs 3 to 4 times, mostly at night. In the past

three months, the patient has had three emergency room visits for acute exacerbations. The

patient has been using an albuterol inhaler, but the symptoms continue to worsen. The mother

reported a family history of asthma. She stated that her sister was diagnosed with asthma at age

seven, and her brother was diagnosed at 10 years but outgrew the condition. There were no

reported allergies in the family, but the mother reported seasonal allergies on the maternal side.

The patient is a third-grade pupil at a public school within the neighborhood. He denied

physical abuse both at home and at school. He reported that he has a good relationship with his

peers and stated that he has two best friends. He reported that he enjoys going to school even

though his participation in physical activities is limited by frequent asthma symptoms. The

patient reports frequent absenteeism from school. However, he still performs at his grade level,

and his teachers commend him for keeping up with his academics despite his condition. In one of

his teacher’s reports presented by the mother, the patient is described as a highly motivated and

smart student who actively participates in class work. However, by missing school frequently,

his academic performance and social integration are slowly being affected. The patient also has a

history of seasonal allergies and eczema. He uses only an albuterol inhaler and has not been
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evaluated by a specialist for asthma recently. He uses the medication for acute episodes only. His

mother reported that she has been unable to keep up with hospital appointments due to the cost

of public transport.

Assessments and Recommendations

The primary goal for the patient is to achieve proper control of the patient’s asthma

symptoms. This will reduce the frequency and make the episodes less severe. In addition, the

secondary goal is to improve school attendance, educate his family about asthma and how to

manage it and help them identify the possible triggers for the patient. According to Stenberg et

al. (2019), patient education within the pediatric population allows children and their parents to

understand their health conditions as well as the significance of their treatments. As such, patient

education should be interactive, age-appropriate, and interest-capturing to ensure the children

learn about their health in an engaging and less intimidating way.

The resources needed in this patient’s case include referring him to a pulmonologist. The

specialist will be able to comprehensively evaluate his condition and devise a proper treatment

plan. In addition, a home visit or assessment should be conducted by a social worker. This will

help identify and mitigate any environmental triggers, including dust mold or emissions from the

factory nearby. The patient also needs community support. For instance, the mother should be

connected to a transportation assistance program to help facilitate her clinic visits. This will

ensure the patient attends all his hospital appointments. In this case, adjunct services include a

school nurse, community resources, and access to educational materials. It is essential to

coordinate with the school nurse to help monitor the patient’s symptoms and implement a proper

action plan. The family should also receive age-appropriate educational materials so that the

patient and his siblings can understand the condition and how to manage it.
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Ethical and Legal Considerations

It is essential that all recommendations align with the state laws about pediatric asthma

care. In addition, the family must understand and agree with any suggestions as well as

appreciate their cultural and linguistic diversity (Harrison et al., 2020). Possibly, the most

important ethical issues include offering information in Spanish and preserving confidentiality.

In legal terms, mandated reporting laws should be considered whenever any suspicion of abuse

occurs. The provider should also abide by the Family Education Rights and Privacy Act FERPA

to ensure the child’s records and education rights are not infringed.

In conclusion, the presented case demonstrates the complex challenges that most asthma

patients and their families face. These complexities range from social, environmental, and

medical factors that contribute to chronic asthma. It is therefore important to address the

immediate as well as long-term social determinants of health as this will ensure the patient has

access to a care plan that not only improves his quality of life but also considers his academic

success as well as overall well-being.

References

Harrison, R., Walton, M., Chitkara, U., Manias, E., Chauhan, A., Latanik, M., & Leone, D.

(2020). Beyond translation: Engaging with culturally and linguistically diverse

consumers. Health Expectations, 23(1), 159-168.

Martin, J., Townshend, J., & Brodlie, M. (2022). Diagnosis and management of asthma in

children. BMJ paediatrics open, 6(1), e001277. https://doi.org/10.1136/bmjpo-2021-

001277

Stenberg, U., Haaland-Øverby, M., Koricho, A. T., Trollvik, A., Kristoffersen, L. R., Dybvig, S.,

& Vågan, A. (2019). How can we support children, adolescents and young adults in

managing chronic health challenges? A scoping review on the effects of patient education

interventions. Health expectations : an international journal of public participation in

health care and health policy, 22(5), 849–862. https://doi.org/10.1111/hex.12906