Swift River Pediatrics Exam with precise detailed ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
answers
Terms in this set (40) ||//\\|| ||//\\|| ||//\\|| ||//\\||
Original
Bridgett Allen - Room 301 ||//\\|| ||//\\|| ||//\\|| ||//\\||
Patient Overview: ||//\\||
6-year-old girl with Down syndrome. Her mother brings her to the community clinic for an ill ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
visit. The mother states "Bridgett just isn't acting like herself these days. She is tired all the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
time and is short of breath just after climbing the stairs. She doesn't keep up with her older
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
brothers at all. She's usually always moving. She just wants to sit and watch television." The ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
nurse notes that Bridgett is demonstrating increased work of breathing and an oxygen
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
saturation of 91% with the pulse correlating with her heart rate of 138 beats/minute. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Bridgett's other vital signs include: 30 breaths/minute, 98/60 mmHg, 37.4o C./99.3o F. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Bridgett's capillary refill is 2 seconds, her fingers and toes are warm and dry. The nurse notes ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
a murmur during auscultation of heart sounds. Bridget is found to be 26.4 kg which is
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
approximately 3 kg greater than Bridgett's weight one month ago. During that visit, Bridgett ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
was treated for an otitis media. Bridgett has frequent ear infections requiring antibiotic
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
therapy. Bridgett is referred to the local children's hospital. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Educational
Health
Safety
Hannah Johnson - Room 302 ||//\\|| ||//\\|| ||//\\|| ||//\\||
Patient Overview ||//\\||
10-year-old female presented to the ED 45 minutes ago with dehydration, dysuria, and ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
significant weight loss of 18 pounds over the last 2 months. Both parents are with the child, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
the father is insisting that he be notified of all interventions before they are initiated. Initial
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
assessment reveals: Skin dry and warm to touch, B/P 90/58, T 99.2, HR 110, RR 30. Child ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
appears thin. Breathing is fast and deep. Noted fruity odor to breath. Initial labs: CBC WNL,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
K+ 2.89, BG 459, Urinalysis: Positive for ketones, glucose, and bacteria. Orders: IV 0.9%
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
normal Saline at 150 ml/hour, Add 20 mEq K+ after first liter, Ampicillin 250 mg PO q 6
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hours, finger stick blood glucose (FSBG) q 1 hour. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, Educational Needs ||//\\||
Health
Pain
Safety
Higher numbered acuities are at most risk. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Hannah Johnson, acuity 3, room 302 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
10-year-old female presented to the ED 45 minutes ago with dehydration, dysuria, and ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
significant weight loss of 18 pounds over the last 2 months. Both parents are with the child, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
the father is insisting that he be notified of all interventions before they are initiated. Initial
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
assessment reveals: Skin dry and warm to touch, B/P 90/58, T 99.2, HR 110, RR 30. Child ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
appears thin. Breathing is fast and deep. Noted fruity odor to breath. Initial labs: CBC WNL,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
K+ 2.89, BG 459, Urinalysis: Positive for ketones, glucose, and bacteria. Orders: IV 0.9%
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
normal Saline at 150 ml/hour, Add 20 mEq K+ after first liter, Ampicillin 250 mg PO q 6
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hours, finger stick blood glucose (FSBG) q 1 hour. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Decreased effectiveness of breathing pattern ||//\\|| ||//\\|| ||//\\|| ||//\\||
Dehydration
Infection
Knowledge deficit ||//\\||
Potential for injury ||//\\|| ||//\\||
Growth and development ||//\\|| ||//\\||
Higher number acuities are at most risk. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Bridgett Allen, Acuity 3, Room 301 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
6-year-old girl with Down syndrome. Her mother brings her to the community clinic for an ill ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
visit. The mother states "Bridgett just isn't acting like herself these days. She is tired all the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
time and is short of breath just after climbing the stairs. She doesn't keep up with her older
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
brothers at all. She's usually always moving. She just wants to sit and watch television." The
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
nurse notes that Bridgett is demonstrating increased work of breathing and an oxygen
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
saturation of 91% with the pulse correlating with her heart rate of 138 beats/minute. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Bridgett's other vital signs include: 30 breaths/minute, 98/60 mmHg, 37.4o C./99.3o F. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Bridgett's capillary refill is 2 seconds, her fingers and toes are warm and dry. The nurse notes ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
a murmur during auscultation of heart sounds. Bridget is found to be 26.4 kg which is
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
approximately 3 kg greater than Bridgett's weight one month ago. During that visit, Bridgett ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
answers
Terms in this set (40) ||//\\|| ||//\\|| ||//\\|| ||//\\||
Original
Bridgett Allen - Room 301 ||//\\|| ||//\\|| ||//\\|| ||//\\||
Patient Overview: ||//\\||
6-year-old girl with Down syndrome. Her mother brings her to the community clinic for an ill ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
visit. The mother states "Bridgett just isn't acting like herself these days. She is tired all the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
time and is short of breath just after climbing the stairs. She doesn't keep up with her older
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
brothers at all. She's usually always moving. She just wants to sit and watch television." The ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
nurse notes that Bridgett is demonstrating increased work of breathing and an oxygen
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
saturation of 91% with the pulse correlating with her heart rate of 138 beats/minute. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Bridgett's other vital signs include: 30 breaths/minute, 98/60 mmHg, 37.4o C./99.3o F. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Bridgett's capillary refill is 2 seconds, her fingers and toes are warm and dry. The nurse notes ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
a murmur during auscultation of heart sounds. Bridget is found to be 26.4 kg which is
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
approximately 3 kg greater than Bridgett's weight one month ago. During that visit, Bridgett ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
was treated for an otitis media. Bridgett has frequent ear infections requiring antibiotic
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
therapy. Bridgett is referred to the local children's hospital. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Educational
Health
Safety
Hannah Johnson - Room 302 ||//\\|| ||//\\|| ||//\\|| ||//\\||
Patient Overview ||//\\||
10-year-old female presented to the ED 45 minutes ago with dehydration, dysuria, and ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
significant weight loss of 18 pounds over the last 2 months. Both parents are with the child, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
the father is insisting that he be notified of all interventions before they are initiated. Initial
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
assessment reveals: Skin dry and warm to touch, B/P 90/58, T 99.2, HR 110, RR 30. Child ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
appears thin. Breathing is fast and deep. Noted fruity odor to breath. Initial labs: CBC WNL,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
K+ 2.89, BG 459, Urinalysis: Positive for ketones, glucose, and bacteria. Orders: IV 0.9%
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
normal Saline at 150 ml/hour, Add 20 mEq K+ after first liter, Ampicillin 250 mg PO q 6
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hours, finger stick blood glucose (FSBG) q 1 hour. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, Educational Needs ||//\\||
Health
Pain
Safety
Higher numbered acuities are at most risk. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Hannah Johnson, acuity 3, room 302 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
10-year-old female presented to the ED 45 minutes ago with dehydration, dysuria, and ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
significant weight loss of 18 pounds over the last 2 months. Both parents are with the child, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
the father is insisting that he be notified of all interventions before they are initiated. Initial
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
assessment reveals: Skin dry and warm to touch, B/P 90/58, T 99.2, HR 110, RR 30. Child ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
appears thin. Breathing is fast and deep. Noted fruity odor to breath. Initial labs: CBC WNL,
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
K+ 2.89, BG 459, Urinalysis: Positive for ketones, glucose, and bacteria. Orders: IV 0.9%
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
normal Saline at 150 ml/hour, Add 20 mEq K+ after first liter, Ampicillin 250 mg PO q 6
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
hours, finger stick blood glucose (FSBG) q 1 hour. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Decreased effectiveness of breathing pattern ||//\\|| ||//\\|| ||//\\|| ||//\\||
Dehydration
Infection
Knowledge deficit ||//\\||
Potential for injury ||//\\|| ||//\\||
Growth and development ||//\\|| ||//\\||
Higher number acuities are at most risk. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Bridgett Allen, Acuity 3, Room 301 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
6-year-old girl with Down syndrome. Her mother brings her to the community clinic for an ill ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
visit. The mother states "Bridgett just isn't acting like herself these days. She is tired all the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
time and is short of breath just after climbing the stairs. She doesn't keep up with her older
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
brothers at all. She's usually always moving. She just wants to sit and watch television." The
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
nurse notes that Bridgett is demonstrating increased work of breathing and an oxygen
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
saturation of 91% with the pulse correlating with her heart rate of 138 beats/minute. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Bridgett's other vital signs include: 30 breaths/minute, 98/60 mmHg, 37.4o C./99.3o F. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Bridgett's capillary refill is 2 seconds, her fingers and toes are warm and dry. The nurse notes ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
a murmur during auscultation of heart sounds. Bridget is found to be 26.4 kg which is
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
approximately 3 kg greater than Bridgett's weight one month ago. During that visit, Bridgett ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
