Question

your assessment includes the following findings , select the abnormal findings and state a possible rationale for each .

PART 2 PEDIATRIC, MATERNITY, AND WOMEN'S HEALTH CASES 1. Your assessment includes the following findings. Select the abnormal findings and state a possible rationale for each. If Abnormal, State Rationale Assessment and Vital Signs Weight Neurologic 4.5 kg Irritable, awake, and fussy; difficult to console FOC: 44 cm, "increased 2 cm from measurement yesterday" per mother Anterior fontanel slightly bulging Respiratory Unable to palpate posterior fontanel Pupils equal and reactive Bilateral breath sounds equal and clear Spo, 95% on room air Respiratory rate: 40 breaths/min Rectal temperature: 38.8°C Cardiovascular Gastrointestinal Heart rate (HR): 182 Blood pressure (BP): 111/70 Pulses 2+ and equal bilaterally Positive bowel sounds Emesis during examination Last feeding 6 hours ago Last urine output 2 hours ago Moves all extremities well Head lag noted Genitourinary Musculoskeletal Skin Diaper rash noted The doctors order a CT scan and lumbar puncture with a cell count, culture, Gra glucose, and protein run on the CSF. What is the rationale for each procedure?

Answer 1

Irritable, fussy and difficult to console are symptoms of low energy or other illness.

Anterior fontanel slightly bulging - may be due to fall or crying

Rectal Temperature 38.8 degree C - due to fever (cause may be diaper rash)

Heart rate and blood pressure are slightly high - due to crying (since age is unknown, difficult to assess)

Emesis - mostly due to difficult to console and indigestion (considering fever)

Head lag - If the patient's age is more than 4 months, it should be considered as abnormal. However, the amount of lag also should be considered.

Diaper rash - may be change in food or prolonged exposure from stool or urine