Miah Zavarro 21 month y.o. female 2’7” / 10.4kgs (BMI 16.8) C/O Swollen Hands / Feet V/S: BP 90/58; T 98.6; HR 134; RR 28; Ox 98% Interview Progress: 0/5 Progress: C/C Sx: Associated Symptoms

Miah Zavarro 21 month y.o. female 2’7” / 10.4kgs (BMI 16.8) C/O Swollen Hands / Feet V/S: BP 90/58; T 98.6; HR 134; RR 28; Ox 98% Interview Progress: 0/5 Progress: C/C Sx: Associated Symptoms: PMH: SH: Etiology: ROS: Questions: Interview Opening:  How can I help you today? HPI:  Has she had swelling like this before? a. Similar episodes at 6 and 11 months; seems like every 4 months  What do you think has caused this to happen?  Any other symptoms or concerns we should discuss? a. Decreased appetite & swollen belly  When did her swelling start? a. 2 days ago  Is there any pattern to when her selling occurs? a. Following colds  Has there been any changes in her swelling problem over time? a. Not really, just seems severe this time  Where more precisely is the swelling a. Hands and feet  Does anything make her swelling problem better or worse? a. Improves with rest, fluids, motrin, and time  Has she noticed swelling in any part of her body? a. Yes hands and feet  What treatment has she had for her swelling problems? a. Motrin, rest, and fluids  How severe is her swelling a. Severe  Is her swelling problem better or worse at any time of day, week, or year a. I don’t know but she’s had this before  How long doe her swelling last? This study source was downloaded by from CourseH on :51:52 GMT -05:00 a. Constant since it started  Does she have pain anywhere? If so, Where? a. She has pain and swelling in her hands and feet  Does she have pain/discomfort when she is at rest? a. Yes, hands and feet hurt all the time  Is she taking aspirin or NSAIDS? How much and how often? a. Motrin, just what the bottle says to give for fever  Does she have nausea and/or vomiting? a. No, appetite is off but hasn’t thrown up  Does she have diarrhea? a. No  How is her appetite? Any recent change? a. Fine, no recent change  How many wet diapers does your child make per day? a. I don’t know why you are asking me this  Does she have night sweats? a. No  What are the events surrounding the start of her swelling problem? a. She had a cold a week ago  Does she have new weakness in an arm, leg, or her face? a. No  Has she gained or lost weight unintentionally and despite normal appetite and exercise? a. No  Does she have a cough? a. No, she hasn’t had any cough or breathing symptoms in the last few days. Only minor cold symptoms last week  Is she short of breath? a. No  Does she wheeze? a. No  Do milk or dairy products worsen her symptoms? a. No  Does she have pain/discomfort when she urinates? a. No  Does she have a rash? a. None that I’m aware of  Does she have a sore throat? a. No  Are her swollen glands painful, tender, hard, ord draining? a. No  Does her swollen lymph nodes come and go? a. Not a problem  How often does she have swollen lymph nodes? a. She doesn’t have that problem This study source was downloaded by from CourseH on :51:52 GMT -05:00  Is she having any trouble with her vision? a. No  How many words does your child say? a. What does that have to do with this  Has your child seen a dentist yet? a. What does that have to do with this  How many stools diapers does your child have per day? a. Why are you asking me this  Any problem moving her ankles? a. No  Is there an stiffness in her ankles? a. No  Any problem moving her back? a. No  Is there any swelling in her eyes? a. No  Is there any swelling in her face? a. No  Any problem moving her feet? a. Yes, it seems to hurt her  Any problem moving her toes? a. Yes, it causes her pain  Is there any stiffness in her toes