Olive Chaney ihuman Case Study

Olive Chaney ihuman Case Study

Reason for encounter

Rash

History Questions

1. How can I help her today?
2. Does she have any other symptoms or concerns or concerns we should discuss?
3. Has she been having fevers?
4. How is her appetite? Any recent change?
5. Did she have any other problems two to four days before the rash started?
6. When did her fever start?
7. On what part of her body did the rash start and where did it spread?
8. Is her rash painful or itchy?
9. Is she coughing up any sputum?
10. What treatments has she had for her cough?
11. What treatments has she had for her rash?
12. How high is her fever?
13. How many wet diapers does your child make per day?
14. How many stool diapers does your child make per day?
15. Is she taking any over-the-counter or herbal medications?
16. Does she have any allergies?

History or Present illness (HPI)

Olive Chaney, a 2-year old female is brought to the clinic by her mother for evaluation of a rash that begun after a cold she had 1 week ago. The rash begun today in the morning. It started on her abdomen and has spread gradually to her arms and legs. Mother describes the rash as non-tender and non-itchy. She denies any treatments. Mother also informs of runny nose, fever, and cough. She describes the cough as non-productive, the fevers begun 3 days ago. The highest recorded was 103 but have since resolved since yesterday in the evening. She is uptodate with immunizations and has met all developmental milestones. She denies allergies, changes in appetite, or chills.

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Problem Statement 

Olive Chaney is a 2-year old female who is brought by her mother for evaluation of an itchy rash that begun today morning on the abdomen spreading to the extremities. She also acknowledges a non-productive cough and runny nose for the last three days and a 3-day fever that resolved yesterday. Mother denies changes in appetite. She stools and urinates normally

Management Plan

Diagnostic test and labs

• None

Medications (RX and OTC)

OTC Tylenol oral suspension for fevers (Mullins & Krishnamurthy, 2023).

• SIG: take 5ml 6 hourly by mouth
• Do not exceed 25ml in 24 hours.

Patient education

• Your child has been diagnosed with roseola. This is a mild common viral infection resolves spontaneously on its own.
• Since this is a viral self-limiting illness, the rash will resolve on its own within 24-72 hours (Mullins & Krishnamurthy, 2023).
• Allow the child to rest and ensure that she is adequately hydrated to promote her recovery. Give her small frequent sips of fluid.
• Other than the Tylenol prescribed for fevers, consider exposing her to a cooler environment, dress her in light breathable clothes and avoid heavy layers and blankets.
• Maintain good hand hygiene to prevent spread within the household (Mullins & Krishnamurthy, 2023).

Referrals (if none- state that)

• None

Follow Up:

• If the fevers remain non-responsive, seek emergency medical care immediately.

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References

Mullins, T. B., & Krishnamurthy, K. (2023). Roseola infantum. In StatPearls [Internet]. StatPearls Publishing

Reflection

If Olive Chaney wouldn’t be uptodate on her vaccinations, the management would include the administration of all the subsequent immunizations based on the recommendations of the Centers for Disease Control and Prevention (CDC) immunization schedule (Lewandowska et al., 2020). The opportunities for education would include; evaluating the reasons for not being uptodate with immunizations, identifying and addressing gaps in knowledge about immunizations, evaluating the caregiver’s beliefs, myths and misconceptions about vaccines and sharing more knowledge. The feedback provided by the patient would determine the appropriateness of the education strategies to consider such as encouraging the parent to setup reminders, knowledge sharing, or community outreach (Damnjanović et al., 2018). It would also be important to educate the mother about the side effects of each of the vaccines that would be administered and the actions to take to lessen the severity or promote the child’s comfort until the side effects disappear.

References

Damnjanović, K., Graeber, J., Ilić, S., Lam, W. Y., Lep, Ž., Morales, S., … & Vingerhoets, L. (2018). Parental decision-making on childhood vaccination. Frontiers in psychology, 9, 735. doi: 10.3389/fpsyg.2018.00735.

Lewandowska, A., Lewandowski, T., Rudzki, G., Rudzki, S., & Laskowska, B. (2020). Opinions and knowledge of parents regarding preventive vaccinations of children and causes of reluctance toward preventive vaccinations. International journal of environmental research and public health, 17(10), 3694.  doi: 10.3390/ijerph17103694

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