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see attachment PICK ONE SCENARIO **files (2)** – ## Week4DiscussionPartI.pdf – ## week4DS.pdf **## Week4DiscussionPartI.pdf** Week 4 Discussion Part I Table 1 Innocent versus Pathologic Murmur Table 2 Pediatric Cardiac Conditions Auscultatory Findings- Innocent versus Pathologic Murmur Innocent Murm…

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see attachment

PICK ONE SCENARIO

**files (2)**

– ## Week4DiscussionPartI.pdf

– ## week4DS.pdf

**## Week4DiscussionPartI.pdf**

Week 4 Discussion Part I

Table 1
Innocent versus Pathologic Murmur

Table 2
Pediatric Cardiac Conditions

Auscultatory Findings- Innocent versus Pathologic Murmur

Innocent Murmur – list 4 and describe the
auscultatory findings

Pathologic Murmur – list 4 and describe
the auscultatory findings

Complete the table.

Cardiac Condition Description Clinical Findings Treatment/
Management

Atrial Septal Defect

Ventricular Septal
Defect

Tetralogy of Fallot

Coarctation of the Aorta

Transposition of the
Great Arteries

Table 3
Differential Diagnoses for vomiting

Table 4
Do Not Miss GI Conditions

Fill in the table with 5 common differential diagnoses for a chief complaint of vomiting.

Differential Description Clinical Findings/
Presentation

Management

1.

2.

3.

4.

Fill in the following

Condition Description Clinical Features/
Presentation

Management

Foreign Body Ingestion

Appendicitis

Intussusception

Hirschsprung Disease

Pyloric Stenosis

Table 5
Enuresis

Table 6

GU Anomalies

List 4 differential diagnoses for enuresis.

Differentials Description Clinical Findings/
Presentation

Management

1.

2.

3.

4.

Complete the requested information related to Common Genitourinary Anomalies

Brief
Pathyphysiolog
y

Description Clinical
Features

Management

Hypospadias

Epispadias

Hydrocele

Cryptorchidis
m
Testicular
Torsion

Table 7
Respiratory Conditions in Children

Table 8

Differential Diagnoses for Pediatric Cough

Complete the information.

Condition Causative Agents Clinical Findings Treatment/
Management

URI "common cold"

Allergic rhinitis

Rhinosinusitis

Bronchiolitis

RSV

Pneumonia

Asthma

List the top 3 differential diagnoses for cc: “cough” in pediatric patients

Differentials Description Clinical Findings Treatment/
Management

1.

2.

3.

Table 9
National Asthma Education and Prevention Program Expert Panel Report (EPR3)

Complete the information below.

Asthma Classification
and Step Before
Treatment

Symptoms Nighttime
Symptoms

Lung Function

Step 1: Intermittent

Step 2: Mild Persistent

Step 3: Moderate
Persistent
Step 4: Severe
Persistent

**## week4DS.pdf**

Case Scenario 1: Keisha has come in for her annual well-child visit. Keisha enjoys
preschool, she has been a healthy child, and she is at the 50% for height and weight. On
exam, you note a Grade III/VI, mid-systolic murmur, heard best in the left sternal border.

• What additional information should the APRN know about Keisha?
• What tests should the APRN order?
• What should the APRN specifically include in the cardiac physical examination?
• How should the APRN approach referrals?

Case Scenario 2: Mr. Jones has brought in his 3-year-old daughter Clara to be seen for
vomiting and diarrhea for 2 days. He states that last night she vomited 3 times. She
weighs 15kg. This morning she vomited her breakfast of pancakes and sausage.

• What more does the APRN need to know about Clara’s symptoms?
• What should the APRN look for in the physical examination?
• What are the signs and symptoms of dehydration?
• What are 3 differentials the APRN should consider?
• What is the calculation for pediatric volume replacement?
• What type of anticipatory guidance should the APRN give Clara’s father?

Case Scenario 3: Mark is a 5-year-old male who was brought into the clinic today for a
well-child exam. His mother reports that she is concerned that Mark wets his bed at
night 3 to 4 times per week. She is at her wit’s end and does not know what to do.

• What does the APRN need to know about Mark’s condition?
• What are some of the possible causes for Mark’s condition?
• What strategies should the APRN share with Mark’s mother to help him stay dry at

night?

Case Scenario 4: Lindsey is an 8-year-old female brought into the clinic today for an
evaluation of a “bad cough” for 2 weeks. She was diagnosed with a URI a week ago. Her
vital signs are the following: Temperature 98.6° F, HR: 80, RR: 24, BP 110/50, Pulse Ox:
95%. She is alert and does not appear to be in distress. On exam, you note that she has
inspiratory and expiratory wheezes and mild tracheal retractions.

• What more does the APRN need to know about this child?
• What treatment(s) should the APRN provide in clinic today and why?
• What diagnostic tests should the APRN order today and why?

• What education should the APRN provide Lindsey and her family?

Case Scenario 5: Wendy is a 13-year-old female who comes into your clinic with a
complain of a sore throat, pain with swallowing, fevers of 102 F, headache, and body
aches x 3 days. She weighs 110 pounds and has NKA. On exam you note erythema on
the tonsils and pharynx, tender cervical lymphadenopathy, and no exudates.

• What is the standardized Brodsky tonsils grading scale?
• What is the Centor Criteria?
• What diagnostic studies should the APRN consider?
• How should the APRN manage her symptoms? Be specific about treatment and

rationale. If prescribing, include dosages, precautions, and follow-up
• How would you manage Wendy’s treatment plan if she were allergic to penicillin? If

prescribing, include dosages, precautions, and follow-up.
• When can Wendy return to school?

Case Scenario 6: Luis is a 12-year-old male who lives in a dilapidated, older apartment
complex. He has had a chronic cough since moving into that apartment building 8 weeks
ago. His asthma has worsened despite using his albuterol inhaler more than usual (3
times a day or more) and steroid inhaler, complains of shortness of breath, wheezing, and
chest tightness, and a dry cough at night and early morning hours (waking him up 2-3
times a week). Luis has had to miss school and is too tired to play with his friends.

• What diagnostic tests might you perform and why?
• What is the gold standard for diagnosing asthma?
• How would you manage his asthma symptoms?
• What type of education should you give parents and Luis?
• What is the proper way to use a metered dose inhaler?

**## week4DS.pdf**

Case Scenario 1: Keisha has come in for her annual well-child visit. Keisha enjoys
preschool, she has been a healthy child, and she is at the 50% for height and weight. On
exam, you note a Grade III/VI, mid-systolic murmur, heard best in the left sternal border.

• What additional information should the APRN know about Keisha?
• What tests should the APRN order?
• What should the APRN specifically include in the cardiac physical examination?
• How should the APRN approach referrals?

Case Scenario 2: Mr. Jones has brought in his 3-year-old daughter Clara to be seen for
vomiting and diarrhea for 2 days. He states that last night she vomited 3 times. She
weighs 15kg. This morning she vomited her breakfast of pancakes and sausage.

• What more does the APRN need to know about Clara’s symptoms?
• What should the APRN look for in the physical examination?
• What are the signs and symptoms of dehydration?
• What are 3 differentials the APRN should consider?
• What is the calculation for pediatric volume replacement?
• What type of anticipatory guidance should the APRN give Clara’s father?

Case Scenario 3: Mark is a 5-year-old male who was brought into the clinic today for a
well-child exam. His mother reports that she is concerned that Mark wets his bed at
night 3 to 4 times per week. She is at her wit’s end and does not know what to do.

• What does the APRN need to know about Mark’s condition?
• What are some of the possible causes for Mark’s condition?
• What strategies should the APRN share with Mark’s mother to help him stay dry at

night?

Case Scenario 4: Lindsey is an 8-year-old female brought into the clinic today for an
evaluation of a “bad cough” for 2 weeks. She was diagnosed with a URI a week ago. Her
vital signs are the following: Temperature 98.6° F, HR: 80, RR: 24, BP 110/50, Pulse Ox:
95%. She is alert and does not appear to be in distress. On exam, you note that she has
inspiratory and expiratory wheezes and mild tracheal retractions.

• What more does the APRN need to know about this child?
• What treatment(s) should the APRN provide in clinic today and why?
• What diagnostic tests should the APRN order today and why?

• What education should the APRN provide Lindsey and her family?

Case Scenario 5: Wendy is a 13-year-old female who comes into your clinic with a
complain of a sore throat, pain with swallowing, fevers of 102 F, headache, and body
aches x 3 days. She weighs 110 pounds and has NKA. On exam you note erythema on
the tonsils and pharynx, tender cervical lymphadenopathy, and no exudates.

• What is the standardized Brodsky tonsils grading scale?
• What is the Centor Criteria?
• What diagnostic studies should the APRN consider?
• How should the APRN manage her symptoms? Be specific about treatment and

rationale. If prescribing, include dosages, precautions, and follow-up
• How would you manage Wendy’s treatment plan if she were allergic to penicillin? If

prescribing, include dosages, precautions, and follow-up.
• When can Wendy return to school?

Case Scenario 6: Luis is a 12-year-old male who lives in a dilapidated, older apartment
complex. He has had a chronic cough since moving into that apartment building 8 weeks
ago. His asthma has worsened despite using his albuterol inhaler more than usual (3
times a day or more) and steroid inhaler, complains of shortness of breath, wheezing, and
chest tightness, and a dry cough at night and early morning hours (waking him up 2-3
times a week). Luis has had to miss school and is too tired to play with his friends.

• What diagnostic tests might you perform and why?
• What is the gold standard for diagnosing asthma?
• How would you manage his asthma symptoms?
• What type of education should you give parents and Luis?
• What is the proper way to use a metered dose inhaler?

**## Week4DiscussionPartI.pdf**

Week 4 Discussion Part I

Table 1
Innocent versus Pathologic Murmur

Table 2
Pediatric Cardiac Conditions

Auscultatory Findings- Innocent versus Pathologic Murmur

Innocent Murmur – list 4 and describe the
auscultatory findings

Pathologic Murmur – list 4 and describe
the auscultatory findings

Complete the table.

Cardiac Condition Description Clinical Findings Treatment/
Management

Atrial Septal Defect

Ventricular Septal
Defect

Tetralogy of Fallot

Coarctation of the Aorta

Transposition of the
Great Arteries

Table 3
Differential Diagnoses for vomiting

Table 4
Do Not Miss GI Conditions

Fill in the table with 5 common differential diagnoses for a chief complaint of vomiting.

Differential Description Clinical Findings/
Presentation

Management

1.

2.

3.

4.

Fill in the following

Condition Description Clinical Features/
Presentation

Management

Foreign Body Ingestion

Appendicitis

Intussusception

Hirschsprung Disease

Pyloric Stenosis

Table 5
Enuresis

Table 6

GU Anomalies

List 4 differential diagnoses for enuresis.

Differentials Description Clinical Findings/
Presentation

Management

1.

2.

3.

4.

Complete the requested information related to Common Genitourinary Anomalies

Brief
Pathyphysiolog
y

Description Clinical
Features

Management

Hypospadias

Epispadias

Hydrocele

Cryptorchidis
m
Testicular
Torsion

Table 7
Respiratory Conditions in Children

Table 8

Differential Diagnoses for Pediatric Cough

Complete the information.

Condition Causative Agents Clinical Findings Treatment/
Management

URI "common cold"

Allergic rhinitis

Rhinosinusitis

Bronchiolitis

RSV

Pneumonia

Asthma

List the top 3 differential diagnoses for cc: “cough” in pediatric patients

Differentials Description Clinical Findings Treatment/
Management

1.

2.

3.

Table 9
National Asthma Education and Prevention Program Expert Panel Report (EPR3)

Complete the information below.

Asthma Classification
and Step Before
Treatment

Symptoms Nighttime
Symptoms

Lung Function

Step 1: Intermittent

Step 2: Mild Persistent

Step 3: Moderate
Persistent
Step 4: Severe
Persistent

**## week4DS.pdf**

Case Scenario 1: Keisha has come in for her annual well-child visit. Keisha enjoys
preschool, she has been a healthy child, and she is at the 50% for height and weight. On
exam, you note a Grade III/VI, mid-systolic murmur, heard best in the left sternal border.

• What additional information should the APRN know about Keisha?
• What tests should the APRN order?
• What should the APRN specifically include in the cardiac physical examination?
• How should the APRN approach referrals?

Case Scenario 2: Mr. Jones has brought in his 3-year-old daughter Clara to be seen for
vomiting and diarrhea for 2 days. He states that last night she vomited 3 times. She
weighs 15kg. This morning she vomited her breakfast of pancakes and sausage.

• What more does the APRN need to know about Clara’s symptoms?
• What should the APRN look for in the physical examination?
• What are the signs and symptoms of dehydration?
• What are 3 differentials the APRN should consider?
• What is the calculation for pediatric volume replacement?
• What type of anticipatory guidance should the APRN give Clara’s father?

Case Scenario 3: Mark is a 5-year-old male who was brought into the clinic today for a
well-child exam. His mother reports that she is concerned that Mark wets his bed at
night 3 to 4 times per week. She is at her wit’s end and does not know what to do.

• What does the APRN need to know about Mark’s condition?
• What are some of the possible causes for Mark’s condition?
• What strategies should the APRN share with Mark’s mother to help him stay dry at

night?

Case Scenario 4: Lindsey is an 8-year-old female brought into the clinic today for an
evaluation of a “bad cough” for 2 weeks. She was diagnosed with a URI a week ago. Her
vital signs are the following: Temperature 98.6° F, HR: 80, RR: 24, BP 110/50, Pulse Ox:
95%. She is alert and does not appear to be in distress. On exam, you note that she has
inspiratory and expiratory wheezes and mild tracheal retractions.

• What more does the APRN need to know about this child?
• What treatment(s) should the APRN provide in clinic today and why?
• What diagnostic tests should the APRN order today and why?

• What education should the APRN provide Lindsey and her family?

Case Scenario 5: Wendy is a 13-year-old female who comes into your clinic with a
complain of a sore throat, pain with swallowing, fevers of 102 F, headache, and body
aches x 3 days. She weighs 110 pounds and has NKA. On exam you note erythema on
the tonsils and pharynx, tender cervical lymphadenopathy, and no exudates.

• What is the standardized Brodsky tonsils grading scale?
• What is the Centor Criteria?
• What diagnostic studies should the APRN consider?
• How should the APRN manage her symptoms? Be specific about treatment and

rationale. If prescribing, include dosages, precautions, and follow-up
• How would you manage Wendy’s treatment plan if she were allergic to penicillin? If

prescribing, include dosages, precautions, and follow-up.
• When can Wendy return to school?

Case Scenario 6: Luis is a 12-year-old male who lives in a dilapidated, older apartment
complex. He has had a chronic cough since moving into that apartment building 8 weeks
ago. His asthma has worsened despite using his albuterol inhaler more than usual (3
times a day or more) and steroid inhaler, complains of shortness of breath, wheezing, and
chest tightness, and a dry cough at night and early morning hours (waking him up 2-3
times a week). Luis has had to miss school and is too tired to play with his friends.

• What diagnostic tests might you perform and why?
• What is the gold standard for diagnosing asthma?
• How would you manage his asthma symptoms?
• What type of education should you give parents and Luis?
• What is the proper way to use a metered dose inhaler?

**## Week4DiscussionPartI.pdf**

Week 4 Discussion Part I

Table 1
Innocent versus Pathologic Murmur

Table 2
Pediatric Cardiac Conditions

Auscultatory Findings- Innocent versus Pathologic Murmur

Innocent Murmur – list 4 and describe the
auscultatory findings

Pathologic Murmur – list 4 and describe
the auscultatory findings

Complete the table.

Cardiac Condition Description Clinical Findings Treatment/
Management

Atrial Septal Defect

Ventricular Septal
Defect

Tetralogy of Fallot

Coarctation of the Aorta

Transposition of the
Great Arteries

Table 3
Differential Diagnoses for vomiting

Table 4
Do Not Miss GI Conditions

Fill in the table with 5 common differential diagnoses for a chief complaint of vomiting.

Differential Description Clinical Findings/
Presentation

Management

1.

2.

3.

4.

Fill in the following

Condition Description Clinical Features/
Presentation

Management

Foreign Body Ingestion

Appendicitis

Intussusception

Hirschsprung Disease

Pyloric Stenosis

Table 5
Enuresis

Table 6

GU Anomalies

List 4 differential diagnoses for enuresis.

Differentials Description Clinical Findings/
Presentation

Management

1.

2.

3.

4.

Complete the requested information related to Common Genitourinary Anomalies

Brief
Pathyphysiolog
y

Description Clinical
Features

Management

Hypospadias

Epispadias

Hydrocele

Cryptorchidis
m
Testicular
Torsion

Table 7
Respiratory Conditions in Children

Table 8

Differential Diagnoses for Pediatric Cough

Complete the information.

Condition Causative Agents Clinical Findings Treatment/
Management

URI "common cold"

Allergic rhinitis

Rhinosinusitis

Bronchiolitis

RSV

Pneumonia

Asthma

List the top 3 differential diagnoses for cc: “cough” in pediatric patients

Differentials Description Clinical Findings Treatment/
Management

1.

2.

3.

Table 9
National Asthma Education and Prevention Program Expert Panel Report (EPR3)

Complete the information below.

Asthma Classification
and Step Before
Treatment

Symptoms Nighttime
Symptoms

Lung Function

Step 1: Intermittent

Step 2: Mild Persistent

Step 3: Moderate
Persistent
Step 4: Severe
Persistent

**## week4DS.pdf**

Case Scenario 1: Keisha has come in for her annual well-child visit. Keisha enjoys
preschool, she has been a healthy child, and she is at the 50% for height and weight. On
exam, you note a Grade III/VI, mid-systolic murmur, heard best in the left sternal border.

• What additional information should the APRN know about Keisha?
• What tests should the APRN order?
• What should the APRN specifically include in the cardiac physical examination?
• How should the APRN approach referrals?

Case Scenario 2: Mr. Jones has brought in his 3-year-old daughter Clara to be seen for
vomiting and diarrhea for 2 days. He states that last night she vomited 3 times. She
weighs 15kg. This morning she vomited her breakfast of pancakes and sausage.

• What more does the APRN need to know about Clara’s symptoms?
• What should the APRN look for in the physical examination?
• What are the signs and symptoms of dehydration?
• What are 3 differentials the APRN should consider?
• What is the calculation for pediatric volume replacement?
• What type of anticipatory guidance should the APRN give Clara’s father?

Case Scenario 3: Mark is a 5-year-old male who was brought into the clinic today for a
well-child exam. His mother reports that she is concerned that Mark wets his bed at
night 3 to 4 times per week. She is at her wit’s end and does not know what to do.

• What does the APRN need to know about Mark’s condition?
• What are some of the possible causes for Mark’s condition?
• What strategies should the APRN share with Mark’s mother to help him stay dry at

night?

Case Scenario 4: Lindsey is an 8-year-old female brought into the clinic today for an
evaluation of a “bad cough” for 2 weeks. She was diagnosed with a URI a week ago. Her
vital signs are the following: Temperature 98.6° F, HR: 80, RR: 24, BP 110/50, Pulse Ox:
95%. She is alert and does not appear to be in distress. On exam, you note that she has
inspiratory and expiratory wheezes and mild tracheal retractions.

• What more does the APRN need to know about this child?
• What treatment(s) should the APRN provide in clinic today and why?
• What diagnostic tests should the APRN order today and why?

• What education should the APRN provide Lindsey and her family?

Case Scenario 5: Wendy is a 13-year-old female who comes into your clinic with a
complain of a sore throat, pain with swallowing, fevers of 102 F, headache, and body
aches x 3 days. She weighs 110 pounds and has NKA. On exam you note erythema on
the tonsils and pharynx, tender cervical lymphadenopathy, and no exudates.

• What is the standardized Brodsky tonsils grading scale?
• What is the Centor Criteria?
• What diagnostic studies should the APRN consider?
• How should the APRN manage her symptoms? Be specific about treatment and

rationale. If prescribing, include dosages, precautions, and follow-up
• How would you manage Wendy’s treatment plan if she were allergic to penicillin? If

prescribing, include dosages, precautions, and follow-up.
• When can Wendy return to school?

Case Scenario 6: Luis is a 12-year-old male who lives in a dilapidated, older apartment
complex. He has had a chronic cough since moving into that apartment building 8 weeks
ago. His asthma has worsened despite using his albuterol inhaler more than usual (3
times a day or more) and steroid inhaler, complains of shortness of breath, wheezing, and
chest tightness, and a dry cough at night and early morning hours (waking him up 2-3
times a week). Luis has had to miss school and is too tired to play with his friends.

• What diagnostic tests might you perform and why?
• What is the gold standard for diagnosing asthma?
• How would you manage his asthma symptoms?
• What type of education should you give parents and Luis?
• What is the proper way to use a metered dose inhaler?

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