Question

While completing your Nursing degree, you moonlight as an EMT. One night, you are called to a home of a 15-week-old girl, Nancy, who is listless and beginning to show signs of difficulty breathing. Upon arrival, you check the airways for any foreign objects, but find none. Talking with the parents, they explain how she is normally a happy, smiling girl, but hasn’t smiled in the past day or so. When pressed, they can’t remember her making any facial expressions in the last few days. You perform a routine physical examination on the child and note that her eyes are open but not focusing, she failed to grasp an offered finger, and the child had not moved any of their limbs in the 10 minutes you have been there. The parents also mentioned that the child has not had a bowel movement in three to four days. 1)What is your tentative diagnosis, based on the symptoms presented? 2)Assuming you are correct, do you start treatment at Nancy’s house, or transport them to the hospital? 3)What should be administered to Nancy as soon as possible? 4)How do babies acquire this condition? 5)Although diagnosis should be confirmed with laboratory tests, the hospital lab should not attempt to do this. Explain why.

Answer 1

1. The tentative diagnosis may be Seizure or epilepsy based on the symptoms presented.

Seizure:

Seizure is Abnormal , uncontrolled and altered electrical activity in the brain.

2. If tentative diagnosis is correct I would transport them to hospital for emergency care. During transport the care is taken by the nurse by clearing the obstacle nearby nancy and keeping pillow or soft material under the neck.

3. Buccal mizadolam or diazepam can be administered as soon as possible. Because it reduces the anxiety and calms the abnormal activity of brain.

4. Premature babies acquire this condition due to lack of blood flow to the brain and babies with low sugar level, infection like meningitis may acquire this condition.

5. This is an emergency situation. So emergency care should be taken otherwise it will harm the patient.The treatment shouldn't be delayed due to the diagnosis confirmation with laboratory tests. Primarily the symptoms are reduced by the emergency care and then laboratory tests need to be taken.