28 Mar H. is a 2-week-old infant brought to the emergen
CASE STUDY 1
H. is a 2-week-old infant brought to the emergency department (ED) by his mother, who speaks little English. Her husband is at work. She is young and appears frightened and anxious. Through a translator, Mrs. H reports that J.H. has not been eating, sleeps all the time, and is “not normal.”
- What should your assessment include?
- What are some of the obstacles you need to consider, recognizing that Mrs. H does not speak or understand English well?
The ED physician orders the following lab work: CBC with differential, blood culture, complete metabolic panel (CMP), urinalysis (UA), and cerebrospinal fluid (CSF) for culture, glucose, protein, cell count (following a lumbar puncture). J.H. is admitted to the medical unit with a diagnosis of rule our (R/O) sepsis and meningitis.
- What lab values would you anticipate being above normal and why?
CASE STUDY 2
A 4-year-old female is brought to the pediatrician by her mother who states the child has been running a fever to 102.0 F, has “pink eye”, and that her tongue looks very bright red and swollen. The mother states the fever has been present for 5 days, noticed the child had developed a rash and that the child’s legs look “puffy”. No other symptoms noted. Past medical history noncontributory. All immunizations up to date.
1: What is the differential diagnosis?
2: What is the pathophysiology of the diagnosis?
3: The child is now transferred and admitted to the pediatric unit. The parents are really concerned and anxious for they’ve never seen this before with their other children. How would you reassure the parents?
4: What diagnostic and laboratory tests will the Pediatrician order? Why?
5: What is the treatment plan?
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