hypoxia due to the blood cells' reduced ability to carry oxygen throughout the body, and the shortened lifespan of sickle cells can cause a shortage of blood cells in the body. Swelling in child's hands can be an alarming development caused by sickle cell anemia, and it should not be ignored. I would rule out Kawasaki disease, a common disease of 5-year old and younger and can be identified by ruling out other possible illnesses. The child would likely suffer from a persistent fever for five or more days, and the disease sometimes damages the heart and main arteries in your child's body. Swelling in the hands is sometimes a symptom, although it usually does not develop on its own. Juvenile arthritis is an autoimmune disease which need to be ruled out. In juvenile arthritis the immune system attacks the body instead of protecting and it developed with no known causes. Disorders causing swelling of hand and feet can be cardiovascular, hematologic, renal or hepatic origin. For Mia, an appropriate assessment and history collection and diagnostic tests will involve testing the functionality of the above systems. It is essential to include bilateral hand and feet X-ray to rule out fracture, liver function test to rule out liver problem, antinuclear antibody test to evaluate autoimmune disorders, RPR to rule out a syphilis infection, C-reactive protein to evaluate inflammation, peripheral blood smear to evaluate RBCs, hemoglobin electrophoresis to detect different types of hemoglobin, blood culture and sensitivity to rule out infection, reticulocyte count to test RBC synthesis, tuberculin skin test, erythrocyte sedimentation rate (ESR)- to evaluate RBC density, lactate dehydrogenase (LDH)- tissue damage test, complete blood count (CBC)- Blood test to evaluate blood count. Results of lab work are crucial in patient’s diagnostics. What physical exam findings and diagnostic results would be concerning to you and why? What would be three differentials in this case?
According to Christian (2015), child physical abuse is an important cause of pediatric morbidity and mortality and is associated with major physical and mental health problems that can extend into adulthood. Providers are on the first line to identify abused children with suspicious injuries who present
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