I-HUMAN CASE STUDY: 18-MONTH-OLD WITH
COUGH NRNP 6541: Advanced Practice Care of
Children and Adolescents Week 4 | Complete Case
Study Solution
CASE OVERVIEW
Parameter Details
Patient 18-month-old toddler
Reason for Encounter Cough
Location Outpatient pediatric clinic
Accompanied by Primary caregiver
Assignment Type i-Human Case Play
Course NRNP 6541
Academic Year 2026
,Patient Identification
Parameter Details
Age 18 months
Gender Pediatric patient (assigned male/female based on case data)
Setting Primary Care / Outpatient Clinic
Source of Primary caregiver (reliable)
History
Height 2'10" (86 cm)
Weight 20 ⅜" (52.7 kg) – Note: Weight appears inconsistent with 18-month-old norms;
cross-check during physical exam
Chief Complaint (CC)
Caregiver reports: "My child has had a cough for the past few days."
History of Present Illness (HPI) – OLD CARTS Format
Component Findings
Onset Cough began approximately 3-4 days ago; gradual worsening over the past
2 days
Location Chest/throat; described as "coming from the chest"
Duration Persistent throughout the day; significantly worse at night
Characteristics Dry, hacking cough; occasionally productive of small amounts of clear
mucus; described as "barky" at times
Aggravating Lying down, crying, cold air exposure, nighttime; worse when supine
Factors
Relieving Factors Sitting upright, being held upright, cool-mist humidifier at night
Timing Worse at night and early morning; interferes with sleep; present during the
day but less frequent
Severity Moderate; caregiver reports child is "tired more easily" and "not acting like
himself"
, Treatment Tried Home humidifier, saline nasal drops with bulb suction, honey (age-
appropriate dose), rest
Associated Symptoms
Symptom Present? Details
Fever +/- Low-grade fever noted (38.2°C / 100.8°F per parent report);
afebrile at visit (37.8°C)
Nasal ✓ Clear rhinorrhea present
Congestion
Rhinorrhea ✓ Clear, non-purulent discharge
Decreased ✓ Reduced oral intake for 2-3 days; still drinking fluids well
Appetite
Fatigue ✓ Increased tiredness; reduced play activity
Vomiting ✗ No vomiting reported; occasional post-tussive gagging
Diarrhea ✗ None reported
Wheezing ✗ No reported or audible wheezing
Stridor ✗ No stridor at rest
Cyanosis ✗ None reported
Choking Episode ✗ No history of choking or foreign body ingestion
Dyspnea ✗ No respiratory distress at rest
Rash ✗ None reported
Past Medical History (PMH)
Component Details
Birth History Full-term, vaginal delivery, no NICU stay, birth weight within normal
range
Chronic Conditions None
COUGH NRNP 6541: Advanced Practice Care of
Children and Adolescents Week 4 | Complete Case
Study Solution
CASE OVERVIEW
Parameter Details
Patient 18-month-old toddler
Reason for Encounter Cough
Location Outpatient pediatric clinic
Accompanied by Primary caregiver
Assignment Type i-Human Case Play
Course NRNP 6541
Academic Year 2026
,Patient Identification
Parameter Details
Age 18 months
Gender Pediatric patient (assigned male/female based on case data)
Setting Primary Care / Outpatient Clinic
Source of Primary caregiver (reliable)
History
Height 2'10" (86 cm)
Weight 20 ⅜" (52.7 kg) – Note: Weight appears inconsistent with 18-month-old norms;
cross-check during physical exam
Chief Complaint (CC)
Caregiver reports: "My child has had a cough for the past few days."
History of Present Illness (HPI) – OLD CARTS Format
Component Findings
Onset Cough began approximately 3-4 days ago; gradual worsening over the past
2 days
Location Chest/throat; described as "coming from the chest"
Duration Persistent throughout the day; significantly worse at night
Characteristics Dry, hacking cough; occasionally productive of small amounts of clear
mucus; described as "barky" at times
Aggravating Lying down, crying, cold air exposure, nighttime; worse when supine
Factors
Relieving Factors Sitting upright, being held upright, cool-mist humidifier at night
Timing Worse at night and early morning; interferes with sleep; present during the
day but less frequent
Severity Moderate; caregiver reports child is "tired more easily" and "not acting like
himself"
, Treatment Tried Home humidifier, saline nasal drops with bulb suction, honey (age-
appropriate dose), rest
Associated Symptoms
Symptom Present? Details
Fever +/- Low-grade fever noted (38.2°C / 100.8°F per parent report);
afebrile at visit (37.8°C)
Nasal ✓ Clear rhinorrhea present
Congestion
Rhinorrhea ✓ Clear, non-purulent discharge
Decreased ✓ Reduced oral intake for 2-3 days; still drinking fluids well
Appetite
Fatigue ✓ Increased tiredness; reduced play activity
Vomiting ✗ No vomiting reported; occasional post-tussive gagging
Diarrhea ✗ None reported
Wheezing ✗ No reported or audible wheezing
Stridor ✗ No stridor at rest
Cyanosis ✗ None reported
Choking Episode ✗ No history of choking or foreign body ingestion
Dyspnea ✗ No respiratory distress at rest
Rash ✗ None reported
Past Medical History (PMH)
Component Details
Birth History Full-term, vaginal delivery, no NICU stay, birth weight within normal
range
Chronic Conditions None
