Lindsey is an 8-year-old female brought into the clinic today for an evaluation of a “bad cough” for 2 weeks.

Lindsey is an 8-year-old female brought into the clinic today for an evaluation of a “bad cough” for 2 weeks. 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?

2.  Sara is a 14-year-old brought into the clinic for an “annoying cough” for the past 4 weeks. The cough is worse at night, but is present during the day as well. Her mother reports no fever and no other symptoms, but states that Sara appears a little tired because she is not able to sleep well at night due to her coughing. No one else in the family has had a cough.

What more does the APRN need to know about Sara’s condition?

What should the APRN focus on during the physical examination?

What tests might the APRN order and/or anticipatory guidance regarding Sara’s condition?

3. Lucy has come in for her annual well-child visit. Lucy 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 Lucy?

What tests should the APRN order?

What should the APRN specifically include in the cardiac physical examination?