Hello Students,
When writing your discussion post, do not write soap notes. This should be done in paragraph form and avoid + and – signs in your post as it can get very confusing and review your rubric. The main point of this discussion post is to explore differential diagnoses and how they can be ruled in and ruled out.
PART I
All students are required to complete Tables 1-5 Download Tables 1-5as a component of the discussion. Completing these exercises will assist you in preparing for the discussion, weekly quiz, and the Competency Exam. The Burns Text should be the predominant resource used to complete the tables.
PART II
Select one of the following four case scenarios. Identify the prompt in the subject line of your post, for example, Case Scenario 1 – Russell.
Complete all Part II elements of the discussion:
Each prompt has additional key questions to address in the body of your response to ensure an understanding of learning objectives.
Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.
In your peer replies, please reply to at least two peers who chose a different case scenario – other than the one you selected. For example, if you selected Case Scenario 1, then reply to one peer who selected Case Scenario 2 and another peer who selected Case Scenario 3 or 4.
Be prepared to answer additional questions relating to a secondary diagnosis or consideration posed by faculty.
Case Scenario 1: Russell is a 7-year-old boy who weighs 50 pounds. He is frequently teased at school because he soils his pants and is called the “stinky kid” by his peers. His mother states that this has been occurring for the past 8 months. She brought him into the clinic because she thinks he might have an intestinal infection. She also reports that once a ,week he has very large bowel movements that completely clog the toilet.
What more does the APRN need to know about Russell’s bowel problems?
What type of diagnostic testing should the APRN order?
What treatment plan should the APRN prescribe and what is the rationale for this treatment? Include dosages and administration instructions if appropriate.
Case Scenario 2: Mr. and Mrs. Escandar have brought in their 4-day-old infant boy for a newborn exam. The mother and father are concerned that their baby seems to be crying excessively and appears to be “hungry all the time.” The mother reports that she exclusively breastfeeds her infant. The infant is measured and weighed; you estimate that he has lost 5% of his birth weight. On exam, you notice caput succedaneum and jaundice.
What should the APRN tell the parents about the baby’s 5% weight loss and crying?
How many wet and soiled diapers should the baby have at 4 days old?
How would you manage this baby’s jaundice?
What more should the APRN know about the baby–mother dyad breastfeeding experience?
What anticipatory guidance would the APRN provide Mr. and Mrs. Corrigan?
Case Scenario 3: Marcie is a 5-month-old baby who was brought into the clinic by her mother. She has had a fever for 3 days, up to 102.5°F. So far today, Maria has not had a fever, but she now has a rash all over her body. She is taking her bottle well and has a slightly runny nose. Her weight today is 18 pounds.
What else does the APRN need to know about baby Marcie’s symptoms and current rash?
What labs might the APRN order?
What type of anticipatory guidance should the APRN provide?
What dosage of Tylenol or Motrin should the baby be receiving?
Case Scenario 4: Ms. Lee presents with her 12-month-old daughter because she has had a runny nose for 2 days and has a “fever” of 99° F. After reviewing her immunization records, you note that she has not received any immunizations since her 4-month well-infant exam.
Are there contraindications for vaccinating this toddler today?
What vaccinations should the APRN order for this toddler today per CDC guidelines?
What type of anticipatory guidance should the APRN provide for Ms. Lee regarding vaccine schedule?
What are some strategies the APRN can use to overcome vaccine hesitancy?
CDC Immunization Schedules – https://www.cdc.gov/vaccines/schedules/index.html
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