Treatment Option and Mononucleosis

¶ … fever and palpable cervical nodes indicates an infection. Jennifer appears to have bacterial tonsillitis. However, in order to confirm, a throat culture must be taken. Although mononucleosis is uncommon in toddlers, it is a possible diagnosis and typically comes from contact in daycares (Yokoyama et al., 2013). To confirm the mononucleosis diagnosis, serology is needed. While the clinical manifestation points to possible mononucleosis diagnosis, younger children do not have as pronounced symptoms. Bacterial or viral infections as well as other immunologic factors lead to development of tonsillitis.

The majority of acute tonsillitis may be caused by viruses such as Herpes simplex virus (Babakurban, Erbek, Terzi, Arslan, & Sahin, 2014). Although because the symptoms are so pronounced, it could be caused by mononucleosis. This making the origins bacterial. A possible treatment option is Augmentin. It is a broad spectrum penicillin antibiotic that has a combination of clauvulanate potassium and amoxicillin. However, another treatment option is penicillin V. Should Jennifer not respond to penicillin V, Augmentin will be the next course of treatment. Jack seems to have hand eczema.

The most common form is what is called Irritant Contact Dermatitis. By exposing his hands repeatedly to solvents, coolants, and other kinds of chemicals, he inhibited the repair of the skin barrier. Eventually this led to dry, red, flaky skin. His wife suggests allergies though allergies have other symptoms and may cause the skin to darken with later signs of scales and cracks. Jack does not show these signs. There is often no identifiable intrinsic cause to hand eczema (Schindler, Drozdenko, Kuhl, & Worm, 2014). There is no known underlying pathology.

Because there is little information on potential causes, the most common mode of treatment is reduction of exposure to any solvents or chemicals that could have generated the rash. His ear infections have little to do with what caused the itchy redness. To treat the condition, medicated ointments would be the first line of treatment (Soost, Abdollahnia, Kostev, & Worm, 2012). If the skin continues to remain dry it could lead to infection and thus antibiotics may be used.

Whatever caused the rash, whether it was allergies or prolonged exposure, Jack needs to wear gloves to avoid having the rash occur again. Protective gear remains an essential part of working with chemicals. Martha has hypertension and a changes in her appetite and sleep. With her mother in her mind, she has experienced additional anxiety and stress. Stress does not help with hypertension and may make her condition worse. This is because of the surge in hormones that the body releases when stressed.

The surge in hormones increases blood pressure, exacerbating hypertension. Anxiety can also be attributed to depression. She may feel depressed about her mother and her health and may feel overwhelmed. Depression in the past has been considered a simple mental disorder however, in terms of pathophysiology can affect several areas of the body.

"Dysfunction of the central noradrenergic system has been hypothesized to play a role in the pathophysiology of MDD, based upon evidence of decreased norepinephrine metabolism, increased activity of tyrosine hydroxylase, and decreased density of norepinephrine transporter in the locus coeruleus in depressed patients" (HASLER, 2010, p. 160). Along with imbalances is a potential serotonin deficiency. Serotonin helps a person deal with anxiety and get a good night's rest. Lack thereof leads to insomnia and anxiety. Martha needs to change her lifestyle and try to lower the stress level in her life.

Depression can lead to several changes such as loss of appetite and poor sleep. An evaluation with a psychiatrist or therapist may help Martha identify if she is depressed and figure out ways to generate positive coping mechanisms.