Practicum: Journal Entry ( 1 to 2 pages)
Patient is a 20 months old African American changeable who was brought to the pediatric office by her mother with a arch complaint of diarrhea and airsickness for 3 days. Mother declared that her stools as aqueous and abhorrent smelling, with no mucous, fungus or blood. Mother states that her babyish is clumsy to accumulate annihilation down, airsickness afterwards anniversary feeding, including water. Her babyish has had about 5 episodes of diarrhea and 4 episodes of airsickness a day. Mother letters that her babyish is not agriculture able-bodied and her action akin has decreased, she looks anemic and annoyed to her . And in the aftermost few hours, she has a decreased cardinal of wet diapers. Mother letters that her aftermost weight at 18 ages analysis up was 24 pounds .
Exam: VS T 37.0, P 110, RR 25, BP 100/75, weight 23 pound, HT 33.7 inches . She is alert, sitting on her mother’s lap , looks annoyed and cries sometimes during the exam. HEENT: antecedent fontanel closed, basal tears, aperture dry, close membranes tacky, no articulate lesions or erythema, TMs normal. Her close is supple. Heart assay reveals balmy tachycardia, no murmur. Lungs are clear. Abdomen is flat, soft, and non-tender with hyperactive bowel sounds. No wet diaper during the exam. Moves all Her extremities. No rashes present. Her capillary bushing time is beneath than 3 abnormal and her bark turgor is hardly diminished.
Possible Diagnosis: Gastroenteritis and Dehydration
Reflect on a this pediatric accommodating above who presented with gastrointestinal disorders during your Practicum analytic experience. Describe your acquaintance in assessing and managing the accommodating and his or her ancestors as their primary affliction practitioner. Include capacity of your “aha” moment in anecdotic the patient’s ataxia as relates to your chic account and references. Then, explain how the acquaintance affiliated your classroom studies to the real-world analytic setting.
Class Account /References
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary affliction (5th ed.). Philadelphia, PA: Elsevier.
◦Chapter 32, “Gastrointestinal Disorders” (pp. 739–788)
•Diagnosis, management, and blockage of rotavirus gastroenteritis in accouchement by Parashar, U.D., Nelson, E.A., Kang, G. in BMJ. 2013 Dec 30;347:f7204. doi: 10.1136/bmj.f7204. Copyright 2013 by BMJ Publishing Group. Reprinted by permission of BMJ Publishing Group via the Copyright Clearance Center.
•Blackmer, A. B., & Farrington, E. A. (2010). Constipation in the pediatric patient: An overview and pharmacologic considerations. Journal of Pediatric Health Care, 24(6), 385–399.
Centers for Disease Control and Prevention. (2003). Managing astute gastroenteritis amid children: Articulate rehydration, maintenance, and comestible therapy. Morbidity and Mortality Weekly Report, 52(RR-16), 1–20. Retrieved from http://www.cdc.gov/mmwr/PDF/RR/RR5216.pdf