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iHuman Aaron Preston
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I-HUMAN Case Study- Aaron Preston Case Pt is Aaron Preston male, age 7. Pt was brought into ER at 1700 by mother due to difficulty breathing. He has a history of asthma. Mother states that difficult... y breathing started today after school while playing outside. Mother also stated that there is smoke in their area due to wildfires. Neb treatment given at home with little effect. Mother is providing the history. BACKGROUND- PMH: Asthma. Current medications: Albuterol and neb treatment prn. SH: Pt lives with mother and father and older sister. Pet and smoke free home. Activities: Pt is in scouts and swimming. ASSESSMENT: Vitals: BP: 108/60 RR:32 HR:108 SpO2: 94% PAIN: 4/10 TEMP: 98.6 degrees F IV SITE: right forearm SKIN:Clean, dry and intact. Pale colored skin. Circumoral cyanosis noted. HEENT: Head: No visible or palpable masses, depressions or scaring. EYES: Pupils reactive to light. Conjunctivae pink, sclerae white. EARS: External auditory clear and hearing intact. NOSE: No external or internal lesions, or polyps. THROAT: Trachea midline. Mouth: Mucous membranes moist, and without lesions. Lips are bluish colored. RESPIRATORY: Labored breathing. Inspiratory and expiratory wheezing. Intercostal retractions. [Show More]
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Sep 14, 2022
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