Pediatric Final- 10 Case Studies Exam
With Complete Solutions
2-week-old infant with fever- Assessment - ANSWER • High or low
temperature
• Length and onset of fever
• Birth history (maternal infection, meconium stain amniotic fluid)
• Siblings (ages)
• Feeding pattern: is the infant staying hydrated and getting enough nutrient
• CBC- check for UTI
• Vomiting
• Diarrhea
• Vital signs (increased heart rate and respiration)
• Any home management, medication
• Clothing-too much? (1 adult layer-2 baby layer)
• Assess parent education
• Lethargic, irritability, stiff neck
• Bulging fontanel (meningitis)
• Joint stiffness (myelitis)
• Sunken fontanel (dehydration)
• Lactic acid (checking for sepsis)
• Family history of travel
FLACC score- check for pain - When in pain, RR, HR, and BP will increase
, 2-week-old infant with fever- Nursing management - ANSWER • Culture
(blood stool, urine)- send home after 48 hours if negative
• Antibiotics
• Hydration- fluid
• I and O - 6-8 wet, 1-2 dirty in 24 hours
• Educate parents
• Daily weight
• Tylenol, not more than 5 days
• No Motrin under 6 months, no ibuprofen before 6 month
• Aseptic workup
• Lumbar puncture
• S/s adverse drug effects
Don't give cough suppressant because they can get asthma later - cough
suppression is not recommended for baby
4-month-old infant with RSV bronchiolitis- Assessment - ANSWER • Vital
signs (will see increased respiratory rate-normal is 30-60, and increase HR)
• Auscultate lungs and cough (crackles, rhonchi, wheezing)
• O2 sat, ABGs-
• Nutritional status-poor feeding
• Capillary refill
• Wheezing
• Birth history-preterm?
• Skin color
• Home environment-around someone sick, smoke exposure, head
bobbing, labored resp., retraction, nasal flaring
• Labs- CBC ( WBC -viral, WBC -bacterial)
• Hydration status- tears, mucous membranes
• Respiration viral panel- nasal swab
• Chest X-ray
• RSV vaccine (synergis- 28 weeks preterm-chronic heart diseases, very
expensive)
• Persistent coughing
• Tachypnea
• Tachycardia
• Nasal swab to test
4-month-old infant with RSV bronchiolitis- management - ANSWER •
Oxygen- check pulse ox
• Suction- bulb syringe- nose breathers
With Complete Solutions
2-week-old infant with fever- Assessment - ANSWER • High or low
temperature
• Length and onset of fever
• Birth history (maternal infection, meconium stain amniotic fluid)
• Siblings (ages)
• Feeding pattern: is the infant staying hydrated and getting enough nutrient
• CBC- check for UTI
• Vomiting
• Diarrhea
• Vital signs (increased heart rate and respiration)
• Any home management, medication
• Clothing-too much? (1 adult layer-2 baby layer)
• Assess parent education
• Lethargic, irritability, stiff neck
• Bulging fontanel (meningitis)
• Joint stiffness (myelitis)
• Sunken fontanel (dehydration)
• Lactic acid (checking for sepsis)
• Family history of travel
FLACC score- check for pain - When in pain, RR, HR, and BP will increase
, 2-week-old infant with fever- Nursing management - ANSWER • Culture
(blood stool, urine)- send home after 48 hours if negative
• Antibiotics
• Hydration- fluid
• I and O - 6-8 wet, 1-2 dirty in 24 hours
• Educate parents
• Daily weight
• Tylenol, not more than 5 days
• No Motrin under 6 months, no ibuprofen before 6 month
• Aseptic workup
• Lumbar puncture
• S/s adverse drug effects
Don't give cough suppressant because they can get asthma later - cough
suppression is not recommended for baby
4-month-old infant with RSV bronchiolitis- Assessment - ANSWER • Vital
signs (will see increased respiratory rate-normal is 30-60, and increase HR)
• Auscultate lungs and cough (crackles, rhonchi, wheezing)
• O2 sat, ABGs-
• Nutritional status-poor feeding
• Capillary refill
• Wheezing
• Birth history-preterm?
• Skin color
• Home environment-around someone sick, smoke exposure, head
bobbing, labored resp., retraction, nasal flaring
• Labs- CBC ( WBC -viral, WBC -bacterial)
• Hydration status- tears, mucous membranes
• Respiration viral panel- nasal swab
• Chest X-ray
• RSV vaccine (synergis- 28 weeks preterm-chronic heart diseases, very
expensive)
• Persistent coughing
• Tachypnea
• Tachycardia
• Nasal swab to test
4-month-old infant with RSV bronchiolitis- management - ANSWER •
Oxygen- check pulse ox
• Suction- bulb syringe- nose breathers
