Cases in Pediatric Acute Care Strengthening Clinical Decision Making

Cases in Pediatric Acute Care presents over 100 real-world pediatric acute care cases, each including a brief patient history, a detailed history of present illness, presenting signs and symptoms, vital signs, and physical examination findings. Ideal for developing a systematic approach to diagnosis, evaluation, and treatment, this resource provides students and advanced practitioners with the tools required to deliver comprehensive care to acute, chronic and critically ill children. The cases encompass a wide range of body systems, medical scenarios, professional issues and general pediatric concerns, and feature laboratory data, radiographic images and information on case study progression and resolution.

• Develops the essential skills necessary to provide the best possible pediatric acute care
• Discusses the most appropriate differential diagnoses, diagnostic evaluation, and management plans for each case
• Presents cases related to pulmonary, cardiac, neurologic, endocrine, metabolic, musculoskeletal, and other body systems
• Highlights key points in each case to quickly identify critical information

Cases in Pediatric Acute Care is an excellent resource for advanced practice provider students and pediatric healthcare providers managing acutely ill children.

ANDREA KLINE-TILFORD, PHD, CPNP-AC/PC, FCCM, FAAN is the Nurse Practitioner Manager at C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA.

CATHERINE M. HAUT, DNP, CPNP-AC/PC, FAANP, CCRN is the Coordinator of Research and Evidence-Based Practice at Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA; also practices in a Pediatric Intensive Care Unit, employed by Mednax Pediatrix Medical Group, Baltimore, MD, USA.

Preface xi

List of Contributors xiii

1 Complication of Pneumonia 1
Ji-Yeon Kim

2 Infant with Diaphoresis during Feedings 5
Kristen Brown and Kristen Nelson McMillan

3 Hypotension in the Operating Room 7
Ann Marie Felauer

4 Toddler with Vomiting and Diarrhea 11
Kimberly L. DiMaria

5 Infant with Fever and Cold Symptoms 15
Cheryl Bartke

6 Toddler with Pineoblastoma and Bone Marrow Transplant 19
Cathryn Freeman

7 A 5-Year-Old with Altered Mental Status 23
Yu-shan Tseng and Richard Garcia

8 An 8-Year-Old with Abdominal Trauma 29
Julie Resler

9 Child with Left Eye Swelling 33
Amy Graf

10 Billing and Coding 37
Dawn M. Silverman

11 Language Delay 47
Jolene Dickerson

12 A 6-Month-Old Infant with RSV and Respiratory Failure 51
Catherine M. Haut

13 Adolescent Abdominal Pain after Cardiac Surgery 55
Cathy Woodward

14 Young Infant with Vomiting 57
Sarah Martin

15 School-age Child with Bruising 61
Lisa Hovingh and Candie Ritsema

16 Infant with Shunted Hydrocephalus 65
Mark Weber

17 Newborn with Poor Oral Intake and Irritability 69
Elaine Geary

18 An 8-Week-Old Infant with a Cough 73
Sarah Jane Garraty

19 Desaturation in Postoperative Cardiac Surgery Infant 77
Lisa Kohr

20 Pre-school Child with Seizures 81
Heather Herrera and Rachel Luthen

21 Child with Blood in Stool 85
Brittany Cook and Darby Tozer

22 Osteomyelitis Case Study 89
Kim Steanson

23 A 2-Year-Old with Liver Transplant and Fever 93
Louise Flynn

24 Respiratory Decompensation in Trached Infant 97
Jennifer Helman

25 Neonatal Hypoglycemia 101
Janice L. Wilson

26 Chronic Otitis Media 105
Kimberly Young-Conner

27 Complex Patient with Recurrent Lower Respiratory Tract Infection 109
Ann Marie Ramsey

28 Child with Racing Heart 115
Bradley Goettl

29 Teen with Headache and Seizure 119
Valarie Eichler

30 A 4-Year-Old with Bloody Diarrhea 125
Tamara Hill

31 Child with Persistent Fever 129
Misty Ellis

32 Quality Improvement Case Study 133
Peggy Dorr

33 Newborn Immediately Post Delivery 139
Heather Schniepp

34 A 5-Year-Old with Poor Weight Gain and Dehydration 143
Kimberly Young-Conner

35 Toddler with Complex Chronic Condition 147
Jennifer Wright

36 Pre-adolescent with Knee Pain 151
Katelyn Hamann and Shannon Konieczki

37 Infant with Increased Fussiness and Decreased Oral Intake 155
Stephanie Haughey

38 Infant with Prolonged Jaundice 161
Aimee Bucci

39 Child with Rash and Drooling 165
Mark Weber

40 Child with Fever and Sore Throat 169
Stephanie Robell and Danielle Van Damme

41 Teenager with Sickle Cell Disease and Fever 173
Shannon Konieczki and Katelyn Hamann

42 Ethical Case Study 177
Jamie Tumulty

43 Infant with Neurologic Changes and Respiratory Failure 183
Blythe Pollack and Stacey Sears

44 Acute Hyperglycemia 191
Jeanne Little

45 Infant with Progressive Lethargy and Poor Feeding 195
Kathleen P. Thompson

46 Neonatal Tachypnea 199
Janet Dutcher

47 Diplopia and Esotropia 203
Lindsay Chapman

48 Acetaminophen Ingestion 207
Aaron Carpenter

49 A 3-Year-Old with Sudden Onset of Breathing Difficulty 211
Judy Verger

50 A 2-Month-Old with Acute Abdomen 215
Christyne Kyper

51 Henoch–Schönlein Purpura Nephritis 219
Tamara Hill

52 Toddler with Tachypnea and Cool Extremities 223
Cathy Woodward

53 Teen with Intractable Headache 227
Tara Pezzuto

54 Seizures in School-age Child 231
Ann Marie Felauer

55 An 18-Year-Old with Upper Respiratory Symptoms, Headache and Fever 235
Misty Evans

56 Testicular Torsion 239
Amanda Mandel

57 Teen with Fever and Rash 243
Christine Renke and Elizabeth Hoppe

58 Preterm Infant Unable to Wean from Mechanical Ventilation 247
Michelle Dokas

59 Toddler with Acute Respiratory Failure 251
Ahmed Aly and Bradley Tilford

60 Adolescent with Head Injury 255
Jennette Firlein

61 Newborn with Ambiguous Genitalia 261
Barbara Wise

62 Anemia in a Toddler 265
Dyane Bunnell

63 A 2-Year-Old with Fever and Cough 269
Jessica Strohm Farber

64 Research Review 273
Lauren R. Sorce

65 Toddler with Fever and Redness Behind Ear 277
Amanda Lewis Weir

66 A 5-Year-Old with Right-Sided Weakness 281
Suzette Meinke and Jessica Spruit

67 Postoperative Heart Block 285
Cathy Woodward

68 Recognizing Human Trafficking 287
Christine DiPaolo

69 A Toddler With Stridor 291
Mari Welch

70 Delirium in a 9-Year-Old Boy 295
Heather Herrera

71 Feeding Challenge in a Child with Spinal Muscular Atrophy 299
Nicole Fragale

72 A 5-Year-Old with Osteomyelitis, Electrolyte Disturbance and Headaches 303
Kimberly L. DiMaria

73 Child with Scald Burn Injury 307
Amarilis Martin and Bradley Tilford

74 Parvovirus Requiring Blood Transfusion 313
Ashley Thibodeau

75 A Teen With High Fever, Rash and Lethargy 317
Jessica Strohm Farber

76 A 9-Year-Old With Scoliosis 321
Alicia McCarthy

77 An Unresponsive Infant 325
Charlene Pringle

78 A Toddler With Abdominal Pain, Diarrhea and Lethargy 331
Jessica Pech

79 Sore Throat and Shortness of Breath 335
Amy Manion

80 Oral Presentation and Communication 339
Jill Siegrist Thomas

81 A 7-Year-Old with Migratory Joint Pain 345
Christin Diller

82 Adolescent with Murmur and Chest Flutter 349
Natalie Hecht

83 Outpatient Management of Asthma 353
Jolene Dickerson

84 A Newborn with Abnormal Movements 357
Maura Bernardo

85 Postoperative Infant with Tachycardia 361
Cathy Woodward

86 Brain Death 363
Maria C. Woosley

87 Postoperative Spinal Fusion with Complications 367
Jaime Panton and Melissa C. Varrone

88 Orthopnea in a 10-Year-Old 371
Max Pizzo

89 Complication of Traumatic Brain Injury 375
Christine Schindler

90 Newborn with Hypothermia 379
Marshay James

91 Back Pain in an Active Teenager 383
Alicia McCarthy

92 Teen with Fever and Abdominal Pain 387
Sarah Martin

93 Complication in a 6-Year-Old with a Kidney Transplant 391
Alison Hewitt Torres

94 Acute Hypertension and Seizures in a 17-Year-Old Male 395
Alison Hewitt Torres

95 Jittery 2-Week-Old Infant 399
Christopher D. Newman

96 Child with Leg and Back Pain 403
Jill Marks

97 Fussy, Tired Infant 407
Charlene Pringle

98 Tics and Something More 411
Judy Adelizzi-DeLany

99 Lightheaded Adolescent 415
Cathy Woodward

100 Infant with Hyponatremia 419
Sarah Pihl

101 Bone Marrow Transplant in Sickle Cell Disease 423
J. Paige Rieckhoff

102 Child with Respiratory Failure and Transaminitis 427
Kim Steanson

103 A Serious Football Injury 431
Julie Resler

104 Infant with Generalized Weakness 435
Blythe Pollack

105 A 3-Day-Old with Irritability 441
Christopher D. Newman

106 Child with Fever and Rash 445
Misty Evans

107 A Teen With Vomiting and Diarrhea 449
Christyne Kyper

108 Acute Jaundice in a 7-Year-Old Child 453
Roseann Hausmann

109 Idiopathic Nephrotic Syndrome 457
Tamara Hill

110 School-age Child with Hives and Lip Swelling 461
Jay M. Hunter

111 A 10-Year-Old with Asthma in the PICU 463
Catherine M. Haut

112 Skin Wound in Postoperative Neonate 467
Hayley Redmond

113 Provider Burnout and Resiliency 471
Jill Siegrist Thomas

114 Kidney Transplant Complication 475
Cathy C. McAdams

115 Infant with Influenza A and New Fever 479
Lauren Flagg

116 A 3-Year-Old with Fever and Painful Urination 483
Roseann Hausmann

Index 487

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