NR 602 Week 3 PBL Case Study Discussion: Assessment of a Child\t\u00a0\tChild with Fever and Respiratory or Skin Issues\t\u00a0\tKayla brings Riley, now 17 months, in for complaint of fever and rash.\u00a0 The fever began “a couple of days ago”\ufffd and is of normal levels in the morning then gets as high as 103 to 104 degrees in the afternoons.\u00a0 Riley has also had clear rhinorrhea and in the last 24 hours he has developed a red, diffuse rash to the torso and abdomen that does not itch and a dry cough in the last day. Mother reports he is drinking, but not as well as usual.\u00a0 He did have a good wet diaper this morning, but is not really eating much and is not playing.\t\u00a0\tMedications: Mother is giving OTC Robitussin cough and cold at 1 tsp last night and this morning.\u00a0 Liquid Tylenol \u00bd a tsp last night and this morning.\tShe is very concerned about the level of the fever and the fact that after 3 days he is not improving.\tDiscussion Questions Part One\t\u00a0\tWe will begin by focusing on gathering history in an ill child.\t\u00a0\tWhat “\ufffdred flags’ did you note in the historical data?\tWhat data is most important to include in this particular case and which historical data that might be gathered on a well-child exam can be left out of this ill visit?\tWhat are your differential diagnoses?\tWhat parts of the physical exam will you focus on today to rule in or out your differentials?\tDiscussion Part Two (graded)\t\u00a0\tPhysical Examination Riley:\tV\/S:\u00a0 Height: 81 cm (31.89 in), Weight: 13 kg (28.66 lbs), B\/P: 94\/60, T: 100.6, HR: 114 BMP\/reg., Resp: 28, reg, non-labored, SpO2: 97%\t17 months old, Height 51st percentile, Weight 87th percentile (CDC, 2016)\tGeneral: somewhat lethargic and cries some throughout exam. SKIN: Diffuse erythemamtous rash in fine popular patches across the torso and very erythematous to the cheeks.\u00a0 HEENT: Head normocephalicatraumiatic.\u00a0 Conjuctiva clear, non-icteric, but mildly injected PERRL.\u00a0 Unable to complete fundoscopic exam. Tympanic membranes intact with scant clear fluid posteriorly bill and mild injection. EAC unremarkable. Pinna\/tragus w\/o tenderness. Nares patent, mucosa mildly injected with sl. edema to the inferior and medial turbinates bill, moderate clear rhinorrhea. Pharynx with mild slight erythema, tonsils 2\/4 bill.\u00a0 Oral exam unremarkable.\u00a0 Neck supple w\/mild anterior cervical lymphadenopathy bill. Thyroid small, firm, equal bill. CARDIOPULMONARY: Heart RRR w\/o murmur. Lungs with mild expiratory wheeze in posterior bases. Respirations even and unlabored.\u00a0 Abdomen rounded normative bowel sounds throughout, soft, non-tender, no masses or organomegaly.\t\u00a0\tLab: WBC 6.9, Lymph 50%, Neutrophils 40%, Monocytes 6%, Eosinophils 3%\t\u00a0\tDiscussion Questions Part Two\t\u00a0\tAfter reviewing the physical exam.\tWhat were your “\ufffdred flags’ on physical exam?<\/p>\n","protected":false},"excerpt":{"rendered":"
NR 602 Week 3 PBL Case Study Discussion: Assessment of a Child \u00a0 Child with Fever and Respiratory or Skin Issues \u00a0 Kayla brings Riley, now 17 months, in for complaint of fever and rash.\u00a0 The fever began “a couple Read More …<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-230111","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/230111","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/comments?post=230111"}],"version-history":[{"count":0,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/230111\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/media?parent=230111"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/categories?post=230111"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/tags?post=230111"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}