Week 4 DS post
Cristy____see attachment
PICK ONE SCENARIO
2 months ago
20
files (2)Week4DiscussionPartI.pdf
week4DS.pdf
Week4DiscussionPartI.pdf
Week 4 Discussion Part I
Table 1 Innocent versus Pathologic Murmur
Table 2 Pediatric Cardiac Conditions
Auscultatory Findings- Innocent versus Pathologic Murmur
Innocent Murmur - list 4 and describe the auscultatory findings
Pathologic Murmur – list 4 and describe the auscultatory findings
Complete the table.
Cardiac Condition Description Clinical Findings Treatment/ Management
Atrial Septal Defect
Ventricular Septal Defect
Tetralogy of Fallot
Coarctation of the Aorta
Transposition of the Great Arteries
Table 3 Differential Diagnoses for vomiting
Table 4 Do Not Miss GI Conditions
Fill in the table with 5 common differential diagnoses for a chief complaint of vomiting.
Differential Description Clinical Findings/ Presentation
Management
1.
2.
3.
4.
Fill in the following
Condition Description Clinical Features/ Presentation
Management
Foreign Body Ingestion
Appendicitis
Intussusception
Hirschsprung Disease
Pyloric Stenosis
Table 5 Enuresis
Table 6
GU Anomalies
List 4 differential diagnoses for enuresis.
Differentials Description Clinical Findings/ Presentation
Management
1.
2.
3.
4.
Complete the requested information related to Common Genitourinary Anomalies
Brief Pathyphysiolog y
Description Clinical Features
Management
Hypospadias
Epispadias
Hydrocele
Cryptorchidis m Testicular Torsion
Table 7 Respiratory Conditions in Children
Table 8
Differential Diagnoses for Pediatric Cough
Complete the information.
Condition Causative Agents Clinical Findings Treatment/ Management
URI "common cold"
Allergic rhinitis
Rhinosinusitis
Bronchiolitis
RSV
Pneumonia
Asthma
List the top 3 differential diagnoses for cc: “cough” in pediatric patients
Differentials Description Clinical Findings Treatment/ Management
1.
2.
3.
Table 9 National Asthma Education and Prevention Program Expert Panel Report (EPR3)
Complete the information below.
Asthma Classification and Step Before Treatment
Symptoms Nighttime Symptoms
Lung Function
Step 1: Intermittent
Step 2: Mild Persistent
Step 3: Moderate Persistent Step 4: Severe Persistent
week4DS.pdf
Case Scenario 1: Keisha has come in for her annual well-child visit. Keisha enjoys preschool, she has been a healthy child, and she is at the 50% for height and weight. On exam, you note a Grade III/VI, mid-systolic murmur, heard best in the left sternal border.
• What additional information should the APRN know about Keisha? • What tests should the APRN order? • What should the APRN specifically include in the cardiac physical examination? • How should the APRN approach referrals?
Case Scenario 2: Mr. Jones has brought in his 3-year-old daughter Clara to be seen for vomiting and diarrhea for 2 days. He states that last night she vomited 3 times. She weighs 15kg. This morning she vomited her breakfast of pancakes and sausage.
• What more does the APRN need to know about Clara’s symptoms? • What should the APRN look for in the physical examination? • What are the signs and symptoms of dehydration? • What are 3 differentials the APRN should consider? • What is the calculation for pediatric volume replacement? • What type of anticipatory guidance should the APRN give Clara’s father?
Case Scenario 3: Mark is a 5-year-old male who was brought into the clinic today for a well-child exam. His mother reports that she is concerned that Mark wets his bed at night 3 to 4 times per week. She is at her wit’s end and does not know what to do.
• What does the APRN need to know about Mark’s condition? • What are some of the possible causes for Mark’s condition? • What strategies should the APRN share with Mark’s mother to help him stay dry at
night?
Case Scenario 4: Lindsey is an 8-year-old female brought into the clinic today for an evaluation of a “bad cough” for 2 weeks. She was diagnosed with a URI a week ago. Her vital signs are the following: Temperature 98.6° F, HR: 80, RR: 24, BP 110/50, Pulse Ox: 95%. She is alert and does not appear to be in distress. On exam, you note that she has inspiratory and expiratory wheezes and mild tracheal retractions.
• What more does the APRN need to know about this child? • What treatment(s) should the APRN provide in clinic today and why? • What diagnostic tests should the APRN order today and why?
• What education should the APRN provide Lindsey and her family?
Case Scenario 5: Wendy is a 13-year-old female who comes into your clinic with a complain of a sore throat, pain with swallowing, fevers of 102 F, headache, and body aches x 3 days. She weighs 110 pounds and has NKA. On exam you note erythema on the tonsils and pharynx, tender cervical lymphadenopathy, and no exudates.
• What is the standardized Brodsky tonsils grading scale? • What is the Centor Criteria? • What diagnostic studies should the APRN consider? • How should the APRN manage her symptoms? Be specific about treatment and
rationale. If prescribing, include dosages, precautions, and follow-up • How would you manage Wendy’s treatment plan if she were allergic to penicillin? If
prescribing, include dosages, precautions, and follow-up. • When can Wendy return to school?
Case Scenario 6: Luis is a 12-year-old male who lives in a dilapidated, older apartment complex. He has had a chronic cough since moving into that apartment building 8 weeks ago. His asthma has worsened despite using his albuterol inhaler more than usual (3 times a day or more) and steroid inhaler, complains of shortness of breath, wheezing, and chest tightness, and a dry cough at night and early morning hours (waking him up 2-3 times a week). Luis has had to miss school and is too tired to play with his friends.
• What diagnostic tests might you perform and why? • What is the gold standard for diagnosing asthma? • How would you manage his asthma symptoms? • What type of education should you give parents and Luis? • What is the proper way to use a metered dose inhaler?
