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What are 5 questions you would ask the mother next?

1. How high was the temperature and how was it taken (eg, rectal, temporal, axillary, or not taken at all, just by touch)?

2. Any home meds given for fever or is the patient taking any medication OTC or prescribed?

3. How much is the patient feeding and wetting diapers daily?

4. Any recent exposure to anyone sick or does patient attend daycare?

5. How many times did the patient have diarrhea in a day and describe stool for any blood and color?

What additional signs/symptoms would alert you that this infant may need to be transferred to the ER?

-Dehydration

– Failure to Thrive

-Continuous vomiting and labs as indicated

-Any child with fever and petechiae and who appears very ill.

According to Burns ,Dunn, Brady, Starr, Blosser, & Garzon (2017) symptoms that would prompt emergency care include: a change in or new rash, duskiness, cyanosis, or mottling of the skin. Coolness of the extremities, poor feeding or vomiting, irritability, cries with positional changes, difficulty in comforting or arousing, seizure activity and bulging anterior fontanelle.

What are your top 3 differential diagnoses

1. Rotavirus

2. Acute Gastroenteritis

3. Bacterial Gastroenteritis

Rotavirus has an acute onset of fever, vomiting and watery diarrhea occur 2 to 4 day later in children <5 years old, especially those between 3 to 24 months old (Burns et al., 2017).

Reference

Burns, C. E., Burns, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (2017). Pediatric primary care(6th ed.). St. Louis, MO: Elsevier.

Week 2 Discussion Question

Contains unread posts

Shana Henderson posted Mar 12, 2019 3:06 PMSubscribe

A 6 month old male patient presents to your clinic with his mother. The mother’s chief complaint is that the baby has had a fever and diarrhea for several days and is not nursing as much as usual. The infant is quiet and warm, lung sounds are clear, heart sounds normal. No medical history, born healthy at 39 weeks 5 days via uncomplicated vaginal delivery, he is exclusively breast fed and is up-to-date on his vaccinations.

5 questions to you would ask the mother?

1. How high was the temperature and what have you been giving to treat the temperature?

2. Anyone else in the family sick?

3. Does the child attend daycare?

4. How many episodes of diarrhea does the child have per day? Is there any blood in the diarrhea?

5. How many wet diapers per day are you changing?

What additional signs/symptoms would alert you that this infant may need to be transferred to the ED?

Additional signs and symptoms that would alert me that the infant may need to be transferred to the ED would include a high fever >39C, the infant is lethargic or difficult to arouse, the infant is not producing any tears/dry mucus membranes, persistent vomiting, tachycardia, increased or decreased respirations, decreased urine output, poor muscle tone, delayed capillary refill, pale cool skin, irritability, sunken eyes and sunken fontanels.

Top 3 differential diagnosis:

1. Viral gastroenteritis

2. Bacterial gastroenteritis

3. Parasitic gastroenteritis

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