Discuss what questions you would ask the patient, what physical exam elements you would include, what further testing you would want to have performed, differential and working diagnosis, treatment plan, including inclusion of complementary and OTC therapy, referrals, and other team members needed to complete patient care.
Select one of the following case studies to address. In the subject line of your post, please identify which prompt you are responding to, for example, #1 Abeni 17-year old.
Discuss what questions you would ask the patient, what physical exam elements you would include, what further testing you would want to have performed, differential and working diagnosis, treatment plan, including inclusion of complementary and OTC therapy, referrals, and other team members needed to complete patient care.
Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.
In your peer replies, please reply to at least one peer who chose a different case study.
1. Mandy is a 10-year-old girl brought in by her mother for evaluation of a “high fever.” Her mother has been giving her acetaminophen every 4 hours and asks if she should also give her ibuprofen for her fever. On exam, you note that Mandy weighs 70 pounds and has an oral temperature of 101°F and a slight runny nose and moist cough. She is not in distress and appears non-toxic.
What more should the APRN know about Mandy’s symptoms and fever?
What type of anticipatory guidance should the APRN share with the mother on pharmacological and nonpharmacological management of fever? Include dosage and instructions for administration.
What symptoms or behaviors would exclude Mandy from attending school?
2. Rebecca is a 13-year-old who is brought into the clinic today for a cough and runny nose for 2 days. You diagnose her with a mild upper respiratory infection. However, you are most concerned that her BMI is greater than 95%.
What information should the APRN include in her history to address Rebecca’s obesity?
What diagnostic tests should the APRN order?
What type of anticipatory guidance should the APRN offer Rebecca and her mother?
3. Robert is a 7-year-old boy who weighs 50 pounds. He is frequently teased because he soils his pants at school and he is known as the “stinky kid.” His mother states that he has been doing this for the past 8 months. She brought him into the clinic because she thinks he may have an intestinal infection. She also reports that once a week he has very large bowel movements that completely clog the toilet.
What more does the APRN need to know about Robert’s bowel problems?
What type of diagnostic testing should the APRN order?
What treatment plan should the APRN prescribe and what is the rationale for this treatment? Include dosages and administration instructions if appropriate.
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