According to the survey that was held in 1981 and 2001 years, children at the age from 5 to 18 consult general practitioners in most cases because of the respiratory problems (European Respiratory Society, 2017). They constitute 25 % of all medical consultations among children that took place in the above mentioned years (European Respiratory Society, 2017). In fact, approximately 10 % of all respiratory consultations refer to asthma diagnosis while bronchiolitis, acute bronchitis and respiratory infections were the other major respiratory diseases the young patients suffered from. The more up-to-date investigation that the USA has recently released provides the information that asthma, acute bronchitis, and pneumonia are nowadays viewed as the most widely spread respiratory diseases that appear to be the cause of the majority of medical consultations (European Respiratory Society, 2017). These data prove that the issue with respiratory illnesses is fairy urgent and needs thorough medical attention and investigation. Thereby, the aim of this paper is to investigate various respiratory diseases, including the most frequent like asthma, acute bronchitis, pneumonia, bronchiolitis, sinusitis, and tuberculosis, that affect children from 5 to 18 years.
Asthma is a respiratory disorder that can lead to the obstruction on the way of the air in respiratory organs, hypersensitivity of bronchi, and the inflammation (swelling) in airways (Mayo Clinic Staff, 2017b). The disease proceeds with different phenotypes dependent on genetics, age, and gender as well as environment and epigenetic factors. Despite the individual differences in the course of the disease, there are some common signs and symptoms that can help identify this respiratory disorder in children. These are, for instance, the frequent and occurring at irregular intervals cough, whistling or wheezing exhaling, tightness in chest, particular pain in chest that occurs predominantly in younger children, and breathlessness. These symptoms and signs are the most frequent in children with asthma. However, in some cases, difficulties with sleeping (because of coughing or wheezing), severe bouts of coughing or wheezing, problems with breathing, and fatigue (that might be caused by not sufficient sleeping) can point at asthma as well (Mayo Clinic Staff, 2017b). It is essential to provide necessary education and knowledge for parents who must be able to identify the disease and take a child to the pediatrician in time. Thus, parents must remember that in case of even some slightest signs of asthma, they should make an appointment with their general practitioner since early identification and treatment of the disease can help mitigate some of its symptoms and even reduce asthma attacks. Therefore, if a child coughs constantly and intermittently, complaints of chest congestion, breathes rapidly, produces wheezing or whistling sounds while breathing out, or is suspected of repeated cases of pneumonia or bronchitis, it is urgent for parents to consult a doctor (Mayo Clinic Staff, 2017b). In case one is diagnosed with asthma, the proper treatment should be chosen to avoid the disease development. Many instances show that in order to control asthma symptoms, it is better to avoid something that might cause them. Main asthma triggers are allergens (cockroaches, molds etc.), air irritants (fumes, odors etc.), certain medication, weather, stress, etc. Apart from this, the usage of the proper medication that includes quick-relief remedies (e.g. anticholinergics) and long-term medicaments (e.g. oral corticosteroids, immunomodulators and so on) can help mitigate the symptoms and obtain the control over the disease (American College of Allergy, Asthma, and Immunology, 2014). The diagnosis of asthma can be complicated, and in order to certainly exclude other possible respiratory disorders, the doctor might insist on physical tests. For example, lung (pulmonary) tests help determine the amount of air that moves in and out when one breathes (these are spirometry and peak flow tests). There are some additional tests such as methacholine challenge, allergy, or imaging tests (Mayo Clinic Staff, 2017c). The evolution of asthma in children is the following. Predominantly, it affects children at the age of 5; after the treatment, the remission is a common thing, especially among children who experience asthma triggers. However, in the majority of cases (60-80%), children become symptom-free in their adulthood providing the family with positive medical history and the removal of potential asthma triggers (Mayo Clinic Staff, 2017b). The early diagnosis and treatment are determinant in the positive evolution of the disease.
One more respiratory disease to be discussed is acute bronchitis, which is a swelling of the bronchial tree. It has the following symptoms and signs: dry cough or the cough with much mucus, chills, fever, vomiting, sore throat, wheezing, running nose, and pains in muscles or in the back. The symptoms of the disease usually last from 7 up to14 days; however, in some cases, it might continue till up to 4 weeks (Novant Health UVA Health System Bull Run, 2017). The sings of the disease are fairly tricky since they do not point exactly at the respiratory disease and bronchitis. Those might resemble other health problems connected with other organs. That is why it is important for parents to remember that for the relevant and exact diagnosis the face-to-face consultation with the pediatrician is incredibly crucial. The following list of signs might make parents immediately consult a doctor with their child: difficulties with breathing, pale skin, severe cough, skin sucking in in the area of ribs and throat, problems with food consumption, and fever (UpToDate, Inc., 2015). After the diagnosis of the disease, one should undergo the proper treatment. Acute bronchitis is never treated by antibiotics since, in most cases, the disease is caused by viruses. Thus, the treatment of the disease is primarily supportive. It includes the usage of analgesics (for fever and discomfort), medicine against cough, the increased consumption of fluids, and the cold humidifier in the room. Moreover, the avoidance of tobacco breathing and proper hand washing are essential for the efficient treatment as well (Novant Health UVA Health System Bull Run, 2017). Bronchitis is mainly diagnosed judging from the medical story or the physical examination. Nevertheless, in order to identify other possible respiratory diseases such as asthma or pneumonia, the doctor might propose the following tests: chest X-rays, pulse oximetry (the measurement of oxygen in blood), and sputum and nasal discharge culture test (aims to identify microorganisms that cause the infection) (Novant Health UVA Health System Bull Run, 2017). Concerning the evolution of the disease, it is possible to avoid it completely. Still, if after the treatment there are such symptoms as wheezing, coughing, cough with blood or some fluid in mouth, weakness and fever, one should consult the doctor because of possible complications.
The next respiratory disease is pneumonia, which is characterized by cough, congestion, fever, irritability, decreased feeding, retractions, fast breathing, etc. Parents must know that they should consult the doctor as soon as they start suspecting pneumonia in their child. These warning signs might help parents with recognition: antibiotics do not help and fever lasts, problems with breathing, evidence of the infection in some parts of body e.g., vomiting, swollen joints, pains in the back and others. (American Academy of Pediatricians, 2017). The treatment of pneumonia depends on whether it is caused by a virus or not. In the first case, the child does not need special medication and special treatment except for fever control medications and cough suppressants. Nevertheless, very often, it is extremely difficult to determine the cause of the disease for sure. In this situation, the doctor prescribes antibiotics that should be taken regularly during the course and in specific dosages. The evolution of the disease depends on the accuracy in the treatment plan. If antibiotics are not taken regularly during the whole the course, some bacteria might survive, and thus, the disease can return (American Academy of Pediatricians, 2017). Therefore, it is essential to follow pediatrician’s instructions and complete the entire course of treatment to avoid its relapse.
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Bronchiolitis in children is one more disease for the discussion. Bronchiolitis is a common illness among children caused by an infection. The symptoms of the disease are cough, runny and stuffy nose, fever, and, subsequently, difficulties with breathing and whistling sound while exhaling (Mayo Clinic Staff, 2017a). Parents must know that it is time to visit the pediatrician when their child vomits, produces wheezing sounds, breathes rapidly, cannot drink enough, and has blue skin, especially on fingernails and lips. Unfortunately, there is no definite therapy that treats the bronchiolitis. That is why the management of the disease revolves around taking the medicine for symptomatic relief and the huge consumption of water to sustain the proper hydration and oxygenation. While many medical therapies for the treatment of the illness are considered controversial, the oxygen has proved to improve the condition of children suffering from bronchiolitis. Thereby, the ways of treatment vary from country to country and from hospital to hospital. In order to diagnose the disease, one does not necessarily need to undertake some tests and X-rays since the pediatrician can diagnose the patient with the disease by physical examination, namely listening to his or her lungs. However, sometimes, when the symptoms become worse or more acute, doctors might order the additional tests. These are chest X-ray, viral testing, or blood tests (used for the white blood cells count). Concerning the evolution of the disease, it might be fraught with some severe complications including cyanosis (blue skin and lips) that is caused by the insufficient supply of oxygen to the tissues, apnea (sudden stops in breathing), and dehydration (Mayo Clinic Staff, 2017a). In case of any of the symptoms, parents must immediately go to a doctor, and in most cases, such children need hospitalization.
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One more disease of respiratory system typical of children is sinusitis, which is an inflammation of the tissues near sinuses. The symptoms of the disease can be the following: pain or pressure felt in a face, stuffy and runny nose, the loss of smells, cough, sore throat, tiredness, headache, etc. There might be some other symptoms as well, for example, fever, fatigue, bad breath, and dental pain (American Family Physician, 2017). It is essential to consult a doctor in time in order to start treating symptoms as soon as possible. Parents should remember that when they notice the above mentioned signs in their child and, in addition, they last for more than seven days and become even worse, the temperature reaches above 101 F, terrible headache appear, swellings around the eyes are observed, and antibiotics do not mitigate the condition, in this case, one should immediately fetch the child to the hospital and make him or her undergo the therapy (American Family Physician, 2017). The treatment of the disease does not necessarily include antibiotics because they cannot handle virus infection. Actually, if the symptoms do not aggravate, one can totally dispense with antibiotics and use some other ways of treatments, which include the application of some nasal sprays, pain killers such as aspirin or ibuprofen, nasal corticosteroids (used to prevent and treat swellings), and decongestants (medicine that relieves inflammation) (Mayo Clinic Staff, 2017). In order to diagnose sinusitis and identify other possible respiratory diseases, the pediatrician might resort to the following tests: nasal endoscopy (visual inspection of sinuses), nasal and sinus cultures (in case of aggravation, the sample of tissue culture might help understand the nature of the disease –bacterial or viral), allergy testing, etc. (Mayo Clinic Staff, 2017). The course of disease is complicated and, therefore, it might develop into severe complications such as viral infections, decreased perception of taste and smell, mucocele (caused by problems with drainage of mucus with sinusitis) and so on.
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The last disease to be discussed in the paper is tuberculosis that has the following set of symptoms: fever, the feeling of irritability, weakness, constant cough, sweating at nights, fatigue, the loss of weight, inflammation in glands and others. (American Academy of Pediatricians, 2017a). Parents are obliged to be careful about tuberculosis and in case someone among close people suffers from this disease, some member of the family has a positive tuberculosis test, the child was born in a country with increased tuberculosis level (e.g. not in Canada, Australia, the USA, or European countries) or the child travelled to such risky regions, there is a necessity to make a tuberculosis skin test that involves making an injection of TB germ in the forearm. Thus, if the child has tuberculosis, his or her skin will swell and become reddish (American Academy of Pediatricians, 2017a). After the identification of the disease, one should immediately start with the treatment. The therapy consists of 3 steps. Firstly, the doctor has to conduct the chest X-ray that helps determine the activeness of the infection in lungs and choose a relevant type of treatment according to the data received. Secondly, in case the skin test is positive but the child does not show any evidence of being ill, he or she is still infected and must take isoniazid (INH) every day for the minimum of nine months. Thirdly, the active infection needs special medication for approximately 6 to 12 months. In some situations, a child needs hospitalization; however, it is not a demand. The evolution of the disease is fairly tricky since a person can be a disease carrier and does not suspect that he or she spreads the disease unintentionally. Therefore, the slightest contact with people having tuberculosis should serve as a reason to undergo a tuberculosis skin test to identify the disease on time (American Academy of Pediatricians, 2017a).
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To conclude, one should admit that the course of these diseases in children in some cases differ from those in adults. Thus, children need special care and attention during the treatment. Moreover, any disease is fraught with possible complications. That is why the well-timed diagnosis can save child’s health.
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