Case Presentation- Kim Phan Kim Pham is

Case Presentation- Kim Phan Kim Pham is a five-year-old female who was brought to the ED by her mother who is Vietnamese and speaks little English. The mother reports, through hand motions and the aid of a hospital maintenance man, that the child has been having diarrhea for the past two days. The mother has left the hospital to take the younger siblings home and to wait for family members to return so they can babysit the children. She said she would return with her husband as soon as possible. The mother left a phone number for contact. Admission orders have been written. The mother reports that the child has had eight to 10 diarrhea stools each day for the past two days. She has been eating poorly and doesn’t appear to have any energy. The mother has been giving her a traditional liquid medication, but it hasn’t helped. The child is lethargic and irritable. There is no significant medical history and no known allergies. Social/Family History: Family is Vietnamese and speaks little English. She lives with her mother and father who have a total of three children. Her two siblings, one aged two years and the other aged three months, accompanied the mother and patient to the hospital. She attends pre-school 3 days per week when she is well. Weight: Unknown Height: Unknown Vital signs: HR 132, BP 108/68, RR 28, deep and rapid, SpO2 has been 95% on room air, Temp 37.20 C General Appearance: Lethargic child who appears dehydrated. Cardiovascular: Sinus Tachycardia, capillary refill is 5 seconds Respiratory: Clear GI: Hyperactive BS, foul-smelling diarrhea GU: Unable to void, refusing fluids Extremities: Warm, poor turgor and movements are adequate Skin: Warm, dry to touch, dry lips; eyes appear sunken, no tears; skin turgor is poor Neurological: Awake, pupils equal, round, reactive to light. After reading the case presentation above, answer the following questions and bring with you to Sim. This is your ticket in the door. How will you modify your typical approach based on the child’s age & developmental level with regards to… Communication? Assessment? Interventions? What additional background/history information do you want to collect? List 5 orders do you expect the provider to give for this patient. What potential complications are you on alert for? What are your top 3 priority interventions will you expect to perform for this child? What lab panels/diagnostics would you expect to perform/collect for this child? What abnormal lab values are you on alert for in a child with dehydration due to diarrhea?

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