Question

2. Emma Helm, 18 months old, has been brought to the clinic by her parents because she has had a "cold" for about a month and just doesn't seem to get any better. Emma has not seen a physician since she was 6 months old because her parents cannot afford to pay doctor bills and have no health insurance According to Emma's parents, she is a very irritable child and a picky eater, and she tires casily. The mother reports that Emma does not take any multivitamins. Further investigation reveals that Emma's mother was anemic during pregnancy, that Emma was placed on cow's milk at age 9 months, and that Emma drinks about 6 cups of milk each day. Emma's birthweight was 2.73 kg and her length was 48.6 cm. Today, Emma weighs 11.36 kg and is 30 in tall. Emma appears pale and listless. Her temperature is 37.5°C, heart rate 150 beats per minute, and blood pressure 102/58, and her skin is warm and dry to touch. (Learning Objectives 1, 2, 7, 8, and 11) A. On physical examination, what would the nurse pay particular attention to? B. What laboratory tests would the nurse expect to be ordered for this child? C. What dietary interventions might the nurse provide for Emma and her family?

Answer 1

According to history - Emma is a picky eater and drink cow milk

Cow milk altered absorption of iron from intestine - so due to less intake of food and use cow milk - patient develop pallor due to most probably iron deficiency

So due to severe anemia - sign and symptoms of heart faliure appears

Tachycardia, low systolic and diastolic no , skin is warm and dry these are sign and symptoms of heart faliure

Investigation do - check heamoglobin level , serum iron , serum ferritin,

Ecg , echocardiography ,

Treatment- blood transfusion if severe anemia present

Treat heart faliure , do iron supplements