venous blood gases (VBG) Hirschsprung's disease lactic acid, serum comprehensive metabolic panel (CMP) venous blood gases (VBG) CT abdomen/pelvis with IV contrast PT/INR complete blood count (CBC) Henoch-Schonlein purpura
CT abdomen/pelvis with IV contrast comprehensive metabolic panel (CMP) venous blood gases (VBG) PT/INR urinalysis (UA) complete blood count (CBC) lactic acid, serum child abuse: acts of commission skeletal survey head CT urinalysis (UA) traumatic brain injury (TBI) head CT incarcerated hernia (NOS) PT/INR complete blood count (CBC) comprehensive metabolic panel (CMP) venous blood gases (VBG) CT abdomen/pelvis with IV contrast lactic acid, serum systemic inflammatory response syndrome (SI) comprehensive metabolic panel (CMP) venous blood gases (VBG) PT/INR lactic acid, serum complete blood count (CBC ASSESSMENT Following are the differential diagnosis for the patient: Blunt abdominal trauma S39.91 Because patient has abdominal pain that started after he had a minor fall from bed. Volvulus K56.2 Symptoms include abdominal pain and distension (Kapadia, 2017). Patient has abdominal pain and distention Hirchsprung’s disease Q43.1
Causes functional bowel obstruction and is associated with Down syndrome (Burns, Dunn, Brady, Starr, & Blosser, 2016). Child has Down syndrome and abdominal pain. Henoch-Schönlein purpura D69.0 Presents with acute abdominal pain and vomiting (Da Dalt, et al., 2016) Child abuse T76.22XA Traumatic brain injury S09.90XA Because child had an injury after falling from bed and signs of head injury often have delayed onset. Incarcerated hernia K40.3 This condition is associated with sudden onset of severe abdominal pain or groin pain (Nisly, Barnett, Herzing, & Aranda, 2018). Systemic inflammatory response syndrome (SIRS) R65.11 Causes of SIRS include infection, trauma, inflammation or combination. Signs include systolic blood pressure, increased heart rate, increased respiratory rate and fever of more than 100.4 F.’ Primary Diagnosis The correct diagnosis for the child is blunt abdominal trauma, child abuse and systemic inflammatory syndrome (SIRS). Child had an abdominal trauma after falling from bed as mentioned by her mother. However, his mother mentioned that he is clumsy and has been to the ED several times for clumsiness issues. Physical examination indicates child abuse and SIRS as he has systolic murmur and tachycardia. PLAN Initial resuscitation and stabilization assess airway, breathing and circulation place on cardiac monitory and monitor vital signs ensure child receive oxygen supplementation for hypoxia
Complete primary and secondary surveys Evaluation after primary survey Obtain a detail patient SAMPLE history Order additional diagnostic tests Obtain an emergency surgical consult Admit to the ICT for further management Contact child protective services Evaluation of patient encounter was helpful to understand how to care for children with Down syndrome. My strength was I was able to form differential diagnosis. My weakness was I was unable to recommend test of the patient.
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- Summer '17
- Bowel obstruction, Systemic inflammatory response syndrome, NSG6435 Week 7 Discussion