NU 665B Week 1 Discussion 1 Pediatric Health
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NU 665B Week 1 Discussion 1 Pediatric Health
Paper Instructions
Initial Post
Imagine you are a primary care provider in the middle of your busy Thursday. Your 11 30 a.m. appointment is as follows
HPI You are seeing a 12-month-old child accompanied by his mother for a well-child visit. The patient’s mother asks questions about immunizations because she is concerned the child will get too many “shots” by the time the vaccinations are complete. She also expresses concern that the immunizations may be unsafe for the 12-month-old boy. The mother consents to the scheduled immunizations after you discuss with her the patient’s need for the immunizations.
- PAST MEDICAL HISTORY Unremarkable.
- FAMILY HISTORY Noncontributory.
- ROS (completed by the medical assistant)
- CONSTITUTIONAL The mother denies fevers, chills, sweats, and weight changes.
- EYES The mother denies any visual symptoms.
- EARS, NOSE, AND THROAT No difficulties with hearing.
- CARDIOVASCULAR Mother denies chest pains, palpitations, orthopnea, and paroxysmal nocturnal dyspnea.
- RESPIRATORY No dyspnea on exertion, no wheezing or cough.
- GI No nausea, vomiting, diarrhea, constipation, abdominal pain, hematochezia, or melena.
- GU No urinary hesitancy or dribbling. No nocturia or urinary frequency. No abnormal urethral discharge.
- MUSCULOSKELETAL No myalgias or arthralgias.
- NEUROLOGIC No chronic headaches, no seizures. The mother and patient deny numbness, tingling, or weakness.
Complete the following
- Initial Post by Wednesday (Day 3) at 11 59 p.m.
List 10 to 20 additional pieces of subjective information you would need to elicit from the mother and patient to help formulate your differential diagnoses and plan.
You may not ask questions that were already addressed in the HPI/ROS. You will need two scholarly references for the questions you ask. See the rubric for more detail.
Initial Response Post by Friday (Day 5) 11 59 p.m. Choose a classmate’s questions to answer
Every peer post should only have one response post. Please do not reply to a peer if a response is already posted.
You are answering as the patient’s mother. Make it case appropria
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Sample Answer
Part Three
Milestones
One of the appropriate developmental milestones for the child at this time is social and emotional development. Social and emotional development regulates one’s behavior. The nurse assesses social and emotional development by playing with the child or observing her interacting with the mother.
The other milestone is language development as seen from calling parents by names such as mama or papa. The nurse observes and points to her mother to elicit her to call by names such as mama. Language development is important for expression. The other developmental milestone is cognitive development.
Cognitive development is important for processes such as decision-making. The nurse assesses cognitive development from behaviors such as putting something in a cup or container. The last one is movement or physical development. Physical development milestones are important to rule out developmental delays. The nurse assesses this milestone by determining if the child is able to stand or hold onto the furniture (CDC, 2023).
Plan of Care
The child wellness visit did not reveal any condition in the child. There are no indications for pharmacological treatments, interprofessional collaboration, or referrals. However, the mother was educated in several areas. They include the following:
- Educate the mother on promoting balanced nutrition for the child
- Educate the mother on safety precautions at home
- Educate the mother on the risks of over-the-counter medications
- Educate the mother on the importance of ensuring adequate play
- Educate the mother on danger signs that should be reported
- Educate the mother on the child’s developmental milestones
- Educate the mother on the normal side effects of vaccines
- Educate the mother on the management of the child’s reactions to vaccines
- Educate the mother on the importance of hygiene for disease prevention
- Follow-up care after a month
Health Maintenance Item
Balanced nutrition Balanced nutrition is important for the child’s health and well-being. Balanced nutrition improves the child’s immunity, hence, protection against infections. It also promotes normal development, which prevents delayed developmental milestones (Marshall et al., 2022).
Social Determinants of Health
Educational level is a potential social determinant of health in the case study. Educational level influences other health-related aspects such as awareness about health promotion interventions and access to high-quality care for the infant. Low education affects the utilization of health promotion services such as immunizations among the population (Johnson, 2020). I will address the obstacle by educating the mother about health promotion and disease prevention strategies.
Differential Diagnoses
Influenza Influenza is the child’s first differential diagnosis. The mother reports that the child occasionally has some nasal drainage. Influenza is a respiratory condition with similar symptoms such as nasal drainage (Duris, 2022). However, the child does not have other symptoms such as a sore throat or irritability.
Allergic rhinitis Allergic rhinitis is the other differential that should be considered based on the history of runny or stuffy nose (Duris, 2022). Additional information such as the presence or absence of fever, irritability, or poor feeding should be obtained to rule out allergic rhinitis.
Anatomic rhinitis Anatomic rhinitis is the other differential to be considered because of a history of nasal drainage (Duris, 2022). Anatomic rhinitis develops due to structural problems such as the deviation of the nasal septum.
Bacterial rhinitis Bacterial rhinitis is the last differential diagnosis that should be considered for the child. However, it is the least likely diagnosis because of the lack of fever.
References
- CDC. (2023, December 7). What developmental milestones is your 1-year-old reaching? Centers for Disease Control and Prevention. https //www.cdc.gov/ncbddd/actearly/milestones/milestones-1yr.html
Duris, A. (2022). Textbook of 2023 Medical-Surgical Nursing. Amazon Digital Services LLC – Kdp.
- Johnson, T. J. (2020). Intersection of Bias, Structural Racism, and Social Determinants With Health Care Inequities. Pediatrics, 146(2), e2020003657. https //doi.org/10.1542/peds.2020-003657
- Marshall, N. E., Abrams, B., Barbour, L. A., Catalano, P., Christian, P., Friedman, J. E., Hay, W. W., Hernandez, T. L., Krebs, N. F., Oken, E., Purnell, J. Q., Roberts, J. M., Soltani, H., Wallace, J., & Thornburg, K. L. (2022). The importance of nutrition in pregnancy and lactation Lifelong consequences. American Journal of Obstetrics and Gynecology, 226(5), 607–632. https //doi.org/10.1016/j.ajog.2021.12.035
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