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. Based on the symptoms suggests that the child have Dissociative conversion disorder or hysteria. Here the patient presence of multiple vague somatic symptoms such as breathing difficulty, she failed to focus eye and grasp an offered fingers
2. Treatment started at the hospital however physical examination and investigation do not reveals the diagnosis. A complete mental status examination essential.
3. It occur as a result of stress or inner conflict. It can be corrected by

• Strong suggestion for return ti normalcy.
• Aversion therapy (liquor ammonia, pressure just above eye ball or tragus of ear.
• Psychotherapy
• Drug therapy has limited role may be given benzodiazipines to relieve anxiety.

4.It occur as a result of stress or conflict

5.lab test do not reveal diagnosis