nurse caring for children in a rural clinic

Please read the following case study details. Then answer the questions below.

Setting

You are a nurse caring for children in a rural clinic. This clinic serves most of the area’s population and provides comprehensive pediatric healthcare. This includes things such as: primary and urgent care needs, vaccinations, and care for all ages of children.

Introduction

Sawyer is a 7-year-old male brought to the clinic by his mother Kristen. FOB not involved. Kristen states that Sawyer hasn’t been feeling well for the past few days and thought he just had a cold.

Chief Complaint

“My son started running a fever today and isn’t feeling well.”

Medical History

Vital Signs:

Weight: 60 lbs.

Length: 52 inches

Temperature: 102⁰F

Pulse: 80 bpm

Respiratory rate: 16

Blood pressure: 100/75 mmHg

Physical Exam:

Head- Symmetrical Features, patient complains of headache

Eyes- Glasses in place

Ears- Ear pain bilaterally

Nose- increased congestion

Mouth and Teeth- Visible dental caries noted, Tonsils 3+

Oropharynx- Complains of sore throat, redness noted

Neck/nodes- lymph nodes swollen bilaterally

Respiratory- Pt complains of cough and intermittent SOB on exertion. At rest breathing is even and unlabored. Labored with activity. Wheezing noted bilaterally.

Cardiovascular- No murmur noted on auscultation

Abdominal- Patient complains of nausea, denies pain.

Genitalia- Testes descended bilaterally

Musculoskeletal/hips- Full ROM bilaterally

Neurologic/reflexes- 2+ patellar reflexes

Skin- eczema noted to upper arms bilaterally

Other: Immunizations UTD

Questions

1. Based on the limited assessment provided, what areas are you most concerned about?
2. What additional assessment and diagnostics are a priority for this patient?

***Answer the first 2 questions prior to answering further questions.***

1. Sawyer’s SOB continues to get worse. Sawyer is now in a tripod position, drooling, and having difficulty swallowing.
2. What do these changes lead you to believe is going on? What is the likely cause of this?
3. What are the priorities of care for this patient? What should the nurse do and not do in this situation?
4. What is the immediate treatment for this issue that the nurse should prepare for?
5. How should the nurse approach communication and education with Kristen during this progressing situation?
6. Add a question: After you have analyzed the content from the discussion board, please add a question to the end of your initial post regarding the reading material for the week.

Please be sure to validate your opinions and ideas with citations and references in APA format.