Case Study A nurse is caring for a 6-year-old male child bei…
Case Study A nurse is caring for a 6-year-old male child being seen in the emergency room for lethargy, abdominal pain, and nausea. Nurses Note: 1440 A 6-year-old male has been brought to the Emergency Department by his parents. The parents state “our child has not been well since he had a virus about three weeks ago. He is so tired and sleeps all the time. He has not been eating a lot lately but has been very thirsty and is drinking a lot of fluids. He has been to the pediatrician’s twice and they say it just a virus and he should get better. Today he has been sleeping most of the day and then he started having abdominal pain. The last two nights he has wet the bed, and he has not done that in years.” The patient is otherwise a healthy child and has no medical history other than having virus three weeks ago. Immunizations are up to date. The child is lethargic, laying with eyes closed, he can open eyes and answers questions appropriately when spoken to. He is requesting some water, “I am so thirsty.” He states he has abdominal pain with a 2/10 on Wong-Baker FACES pain scale. Skin is flushed and dry with decreased skin turgor. Apical regular at 122 beats/min. Blood pressure 84/41 mm Hg. His lungs are clear to auscultation, breathing is unlabored at 20 breaths/min, oxygen saturation 97% on room air. Fruity breath odor present. Bowel sounds present. Peripheral pulses are palpable but thready. Capillary refill less than 3 seconds. Temperature 98.9F. Blood glucose fingerstick 285 g/dl (15.67 mmol/l). For each symptom below, choose “1” for signs and symptoms of hypoglycemia, choose “2” for signs and symptoms of hyperglycemia.
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