Question

1-12 please practice

PATIENT CASE Mother's Chief Complaints "Our daughter has been vomiting and has had diarrhea for three days. She also has had a fever, but I've been giving her acetaminophen every six hours. The clear liquids and Pedialyte that she has been drinking don't seem to be helping much and she looks so sickly." HPI J.L. is a 4%-month-old Asian American female infant who was taken to the emergency room of a local hospital because her parents were concerned about vomiting, diarrhea, fever, and irritability. The patient was in good health until four days prior to presentation when she felt warm to her mother. The patient attends daycare, and other children at the daycare center have had similar symptoms recently. During the first day of her illness, she continued to take normal feedings of Similac with iron formula (approximately 6 ounces every six hours) and an occasional feeding of rice cereal. However, by the second day, her appetite had decreased significantly and she began to have frequent, loose, and watery stools (i.e., 6-8/day). During the 12 hours prior to pres- entation, J.L. had eight watery stools. The stools did not appear to contain blood. Early on the morning of the second day of illness, the patient vomited shortly after feeding. The vom- itus was non-bloody. She continued to vomit after each feeding for the next two meals and became increasingly more irritable. The mother called her pediatrician, who recommended 12 hours of clear liquids, including weak tea with sugar, Pedialyte, and warm 7-Up. Except for one episode in the past 48 hours, vomiting improved but diarrhea continued despite these measures. Over the following two days, fever was intermittent and the child became more lethargic. The parents continued the clear liquids that the doctor had ordered. On the day of presentation at the hospital, the mother stated that her daughter had a temperature of 101.5 F, was sleepy but very irritable when awake, and had fewer wet diapers than normal. She also noted that her daughter's skin was cool to the touch, her lips were dry and cracked, and her eyes appeared sunken with dark circles around them. At a doctor's appointment 10 days prior to presentation, the patient's weight was 14.5 lbs. Patient Case Ouestion 1. Is this patient's diarrhea considered acute or chrome?

Answer 1

ANS;

1.The patient diarrhea considered accute becaucause it is caused by virus{viral gastro enteritis}

2.8 signs and symptoms of viral gastro enteris;

-fever

-vomiting

-nausea

-greenish or watery stool in diaper

-dehydration-eyes appears sunken

-fatigue

-lethargic and sleepy

-weght loss

3. 15 signs and symptoms of dehydration

-a dry or sticky mouth

-few or no tears when crying

-eyes that look sunken

-in babies,the soft spot [fontenelle] on the top of head looks sunken.

-peeing less or fewer wet diapers than usual

-dry skin

-cool skin

-irritability

-drowsiness

-dizziness

-less activity than usual

-high grade fever

-weight loss

-lethargy

-sleepy appearance

4.5 signs and symptoms of metabolic acidosis

-nausea

-vomiting

-lethargy

-hyperpnea

-diarrhoea

5.the patient diarrhea is less than 10times per day so it is mild diarrhoea.

6.it is inflammatory

7.the infants normally have very high rate of water turnover when compared withoider children and adults.

8.both a and b

9.a.intracellular

10.e.three of the above

12.a.osmotic gap is an mesuarement of the difference in solute types between serum and feces, used to distinguish among difference causes of diarrhoea.

b.No the patient have chronic osmotic diarrhoea.