NR 511 Week 2 iHuman Virtual Patient Encounter Attempt 2619857 - Olive Chaney

History Notecard by Natasha Rollins on case Olive Chaney Use this worksheet to organize your thoughts before developing a differential diagnosis list. 1. Indicate key symptoms (Sx) you have identified from the history. Start with the patient's reason(s) for the encounter and add additional symptoms obtained from further questioning. 2. Characterize the attributes of each symptom using "OLDCARTS". Capture the details in the appropriate column and row. 3. Review your findings and consider possible diagnoses that may correlate with these symptoms. (Remember to consider the patient's age and risk factors.) Use your ideas to help guide your physical examination in the next section of the case. HPI rash cough runny fever SxSx nose = = Onset 3 days ago 3 3 3 days days days ago ago ago Location started on abdomen and spread to arms and legs Duration 2 days Characteristics Aggravating Relieving Timing / tylenol Treatments Severity Attempt: 2619857 Report generated on 1/21/2023, 12:32:19 PM America/Denver Management Plan by Natasha Rollins on case Olive Chaney ***Diagnostic Test*** N/ A (Tremblay & Bradey, 2023) ***Pharmacologic Care*** Continue using Tylenol for fevers and/or discomfort PRN. Oliva is currently 28 lbs (12.7kg). She can have 10-15mg/kg/dose every 4-6 hours. DO NOT exceed more than 75mg/kg/day. (Acetaminophen, n.d.)(Tremblay & Bradey, 2023) ***Supportive Care*** Tylenol for fevers or discomfort. Ensure Olivia continues drinking plenty of fluids and eating meals (Tremblay & Bradey, 2023) ***Patient Education*** Fever, cough, and runny nose that resolve and are followed by rash are considered to be indicative of roseola infantum. Rash usually appears 1-2 days after fever resolves. Rash is expected to start clearing up 2-5 days from initial appearance, but rash may come and go during this time. There is no treatment for roseola, as it is a viral infection. Treatment as mentioned previously can be used for symptomatic relief. Preventative Measures: practice proper hand hygiene and sanitization of frequently used surfaces and objects. (Tremblay & Bradey, 2023) ***Consult/Referral*** N/ A (Tremblay & Bradey, 2023) ***Follow-up/Disposition*** No follow-up is needed unless symptoms persist for more than 1 week or worsen. Please seek emergency care for fever that are over 103F >2-3 days or if child is difficult to awake, has difficulty breathing, notably less wet or increased stool diapers, or if child has nausea and vomiting that last more than 24 hours (possible dehydration). (Tremblay & Bradey, 2023) ***References: Acetaminophen. (n.d.). Up to Date. https://www.uptodate.com/contents/acetaminophen-paracetamol-drug-information? source=auto_suggest&selectedTitle=1~4---1~4---acetamin&search=acetaminophen#F129345 Tremblay, C., MD, & Bradey, M., MD. (2023, January 10). Roseola Infantum. Up to Date. https://www.uptodate.com/contents/roseola-infantum-exanthem-subitum? search=roseola %20infantum&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H14 Attempt: 2619857 Report generated on 1/21/2023, 12:32:19 PM America/Denver Review of Systems Category Data entered by Natasha Rollins General Integumentary / Breast rash over abdomen that spread to extremities x 1 day HEENT / Neck Cardiovascular Respiratory no trouble breathing; reports cough x3 days Gastrointestinal denies nausea and vomiting reports having 2 stools, no change Genitourinary reports 4-5 wet diapers, no change Musculoskeletal n/a Allergic / Immunologic no reported allergies Endocrine Hematologic / Lymphatic Neurologic Psychiatric Physical Exams Category Data entered by Natasha