Mother brings her 14 month old child to the clinic after suffering from a weekend of nausea, vomiting, and diarrhea. The child is slightly febrile, appears lethargic and is lying in her mother’s arms. She is attentive to noises and faces, but does not make an effort to move around the exam room. Her mother reports she has not vomited or had any loose stools since
the previous evening, but she still does not want to take her regular bottles. According to the history provided, she did not keep any food or liquids down for more than 48 hours.
Based on initial clinical observations and reported history, the clinician assumes that the child is suffering from dehydration and hypovolemia (decrease in plasma level).
6. As the nurse completes the physical assessment, pharyngeal erythema is noted. Patchy white exudate is visible on the bilateral tonsils. What bedside testing does the nurse anticipate will be ordered for this patient? (Other labs? Other tests?)
7. After a fluid bolus and a dose of Acetaminophen, the child is observed babbling and playing in her mother’s lap. She is taking sips of Pedialyte from her bottle. Amoxicillin in ordered for the patient to take
at home. What education
will the nurse provide this mother about the strep throat and it’s treatment? What education will the nurse provide about the continued management of the child’s dehydration? (best thoughts based upon
the pathophysiology of the disease process.)
Solution Preview
ANSWER 6) For the noted pharyngeal erythema and the patchy white exudate on the bilateral tonsils, infection with group A streptococcus is suspected causing tonsilitis. The immediate test performed at bedside are: Throat swab for culture. If throat s…
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