Case 6 week old 2023/2024
GRADED A+.
, Hector Jimenez-Walker, 6-week-old infant who presented to the ED with acute
dehydration and a history of projectile vomiting, irritability, and low urine
output. Hector’s mother, who is an adult orthopedic surgeon, and father
bring Hector to the ED. Hector’s father, Paul Walker, is the primary caregiver
and said he visited their pediatrician one week ago due to concerns over
frequent vomiting after feeds. Hector’s mother, Helena Jimenez, is
breastfeeding and went back to work last week. Hector takes the pumped
milk in a bottle well and the pediatrician recommended frequent burping,
keeping upright after feeds, and return to the doctor in one week if no
improvement. Despite following these instructions, the vomiting became
more projectile and larger volumes over the weekend, causing the parents to
seek out ED care. Hector’s last wet diaper was 6 hours ago, he has no tears,
and his mucus membranes are pale and dry. Hector’s vital signs are: Heart
rate 164 beats/minute, 35 breaths/minute, 88/48 mmHg, 38o C./100.4o F.
Hector is somewhat lethargic, crying and whimpering with intervention and
Hector has a weak cry. The parents state this is their first child.
You responded correctly to 5 out of 6 evaluations:
Category Your response Explanation
Educational Increased Hector’s parents admit this is their first child and they are worried about his
acuity care.
Health Increased Hector demonstrates a change in health status including vomiting and dehy
acuity
LOC Increased Hector appears dehydrated and has a weak cry. This indicates a change in L
acuity dehydration.
Pain level Increased Hector is irritable and crying, indicating some level of pain.
acuity
Psychological Increased There is no evidence of increased psychological needs in this case.
Needs acuity