SR Pedi Answers Updated 2021

Hayden Clark Room 305 Hayden Clark, 6-year-old male, weighing 44 lbs., comes to school looking disheveled, and not wearing a coat with the outside temperature in the low 40’s. You responded correctly to 6 out of 6 ev ...

Hayden Clark Room 305 Hayden Clark, 6-year-old male, weighing 44 lbs., comes to school looking disheveled, and not wearing a coat with the outside temperature in the low 40’s. You responded correctly to 6 out of 6 evaluations: Category Your response Explanation Educational Needs Increased acuity Education needed for child and parents relating to clothing, hygiene, and physiological needs. Health Increased acuity Status assessment reports patient not wearing coat in 40-degree weather. LOC Normal acuity Status assessment reports no indication of increased LOC acuity Pain Normal acuity Status assessment reports no indication of increased Pain acuity Psych Normal acuity Status assessment reports does not give clear indication to increased Psych acuity Safety Increased acuity Status assessment reports not wearing coat which places patient at risk for hypothermia Hannah Johnson Room 304 Hannah Johnson, 10-year-old female presented to the ED 45 minutes ago with dehydration, dysuria, and significant weight loss of 18 pounds over the last 2 months. Both parents are with the child, the father is insisting that he be notified of all interventions before they are initiated.  Initial assessment reveals: Skin dry and warm to touch, B/P 90/58, T 99.2 F, 37.3 C, HR 110, RR30. Child appears thin. Breathing is fast and deep. Noted fruity odor to breath. Initial labs: CBC WNL, K+ 2.89, BG 459, Urinalysis: Positive for ketones, glucose, and bacteria. Orders: IV 0.9% normal Saline at 150 ml/hour, Add 20 mEq K+ after first liter, Ampicillin 250 mg PO q 6 hours, finger stick blood glucose (FSBG) q 1 hour. You responded correctly to 4 out of 6 evaluations: Category Your response Explanation Educational Needs Increased acuity Status assessment reports abnormal and possible newly diagnosis of type 1 diabetes. Health Increased acuity Status assessment reports abnormal labs and weight loss. LOC Normal acuity Status assessment reports no indication of increased LOC Pain Increased acuity Status assessment reports dysuria. Psych Normal acuity Status assessment reports no indication of Psychiatric deficits Safety Increased acuity Status assessment reports IV's and High Blood Glucose.Amanda Blaire Room 301 Amanda Blaire, 14-year-old female, who was in an ATV accident and now has a fractured tibia and fibula. Her vital signs are Temperature 98.6 F, 37.0 C, HR 87, BP 111/72, RR 18, PaO2 97%. She is post-op day 1 with continuous traction and skeletal pins to immobilize leg. Category Your response Explanation Educational Needs Increased acuity Status Assessment reports fracture and surgery and rehabilitation needs Health Increased acuity Status Assessment reports fractures, major surgery, and rehabilitation ne LOC Normal acuity Status assessment reports no indication of increased LOC acuity Pain Increased acuity Status Assessment reports fractures, major surgery, and rehabilitation ne Psych Normal acuity Status assessment reports no indication of increased Psychiatric acuity Safety Increased acuity Status Assessment reports fractures, major surgery, and rehabilitation ne Baby Harris Room 302 Baby Harris, 4-hour-old newborn male, weight 6.6 lbs. with a length of 18” and approximate gestational age of 36 weeks. Late prenatal care. Mom has history of methamphetamine and heroin addiction. In addition, the mom admits to smoking 1 pack per day through pregnancy. Urine drug test on baby positive for heroin and methamphetamine. VS: T 98.1 F, 36.7 C, HR 178, R 70, PaO2 96%. Category Your response Explanation Educational Needs Increased acuity Mother needs to be taught to recognize signs of drug withdrawal. Health Increased acuity All body systems are affected by drug withdrawal. LOC Increased acuity Status assessment reports baby tested positive for drugs which affect L Pain Increased acuity Drug withdrawal increases irritability and pain.Category Your response Explanation Psych Increased acuity Drug withdrawal affects levels of well-being. Safety Increased acuity Increased probability of seizures. Paul Windsor Room 303 Paul Windsor, 4-year-old male admitted yesterday from the clinic with a diagnosis of Nephrotic Syndrome. Vital signs: Temperature 99.0 F, 37.2 C, HR 88, BP 104/76, RR 22, PaO2 95%. He presented yesterday with his parents reporting a gradual increase in pain and “swelling” around his eyes and ankles, and now his stomach is getting “bigger". Paul has little to no appetite. Current weight is 56 pounds compared to a usual weight of 43 pounds. Urinalysis: Thick, frothy appearance. Specific gravity: 1.025. Protein 3+. Blood 2+. Other labs: Triglycerides 180 mg/dl. Cholesterol 190 mg/dl. Group B strep culture negative in office. Category Your response Explanation Educational Needs Increased acuity Mother and patient need renal diet and fluid restriction education. Health Increased acuity Status assessment reports weight gain and recent abnormal labs. LOC Normal acuity Status assessment reports no indication of increased LOC acuity Pain Increased acuity Status assessment reports gradual increase pain and “swelling” around his eye Psych Normal acuity Status assessment reports no indication of increased Psychiatric acuity Safety Increased acuity Status assessment reports pain around ankle making patient a fall risk. Paula Smith Room 304 Paula Smith, 16-year-old female. She is a dancer who presents to the clinic for a yearly physical, and is found to have significant weight loss, loss of menstrual cycles, and depression. She is 5’7” and weighs 94 pounds.Category Your response Explanation Educational Needs Increased acuity Patient needs to recognize seriousness of significant weight loss Health Increased acuity Status assessment reports significant weight loss, loss of menstrual cycles, and LOC Normal acuity Status assessment reports no indication of increased LOC acuity Pain Normal acuity Status assessment reports no indication of increased Pain acuity Psych Increased acuity Status assessment reports depression Safety Increased acuity Status assessment reports depression Baby Strickland Room 305 Category Your response Explana Educational Needs Increased acuity Status assessment reports uncontrolled diabetes. Health Increased acuity Status assessment reports mother is dx with diabetes and patien LOC Normal acuity Status assessment reports no indication of abnormal LOC Pain Normal acuity Status assessment reports no indication of Pain Psych Normal acuity Status assessment reports no indication of Psychiatric deficits Safety Increased acuity Status assessment reports baby large for birth and at risk for vola Baby Strickland, 1-hour-old newborn female, 37-week gestational age born via C-section, weight 9.9 lbs. Mom has history of diabetes, not well controlled. Maria Hernandez Room 306