6435 W7 D9.docx - TA is a 26 month old male who presented with his mother who complains of him feeling listless lethargic pale skin cool clammy skin

6435 W7 D9.docx - TA is a 26 month old male who presented...

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TA is a 26 month old male who presented with his mother who complains of him feeling listless, lethargic, pale skin, cool, clammy skin; decreased appetite, whining, vomiting last night (milky), dark colored urine with foul odor, decreased urine output, and abdominal pain for two days. She states this started after he fell out of bed after a nap while her boyfriend was babysitting him. She states he has a history of Downs’ Syndrome and was born with a congenital heart defect (Atrial Septal Defect, a hole in his heart). His hole in his heart was corrected by ASD surgery. Developmentally, she states he is behind due to his Downs’ Syndrome. He says small words like “mama” and “dada” at times, but is not able to talk or pick up on things. She states he is very clumsy and always bumping into things, tripping, and falling. She states that after his fall, she noticed a bruise on his abdomen, along with all of his other associated symptoms. She works full-time as a cashier at a retail store and has her neighbors and current boyfriend (who is not the patient’s father) watch her children during work hours.
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  • Summer '17
  • TA, rib fracture, abdominal trauma, NSG6435 Week 7 Discussion

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