Assignment: Infectious Diseases in Children -

Assignment: Infectious Diseases in Children

A Case Scenario of Infectious Diseases in Children

Case Study Overview

In this scenario, I will discuss the case of an 18-month old child who has a history of high fever ranging from 101-104.7F. Laboratory tests conducted included blood and urine culture, complete blood count and a comprehensive metabolic panel which were all negative. The vital signs include a temperature of 101.5F, HR of 120b/min, RR of 20b/min a BP of 90/40mmHg. On physical examination, the child had palmar redness, an injected conjunctiva, magenta-coloured lips and rashes on the diaper area.

Differential Diagnosis

Kawasaki Disease. The disease occurs in two phases with the first phase having a classic symptom of high fever for about five days. The fever does not respond to antibiotic therapy and may persist for up to three weeks if no treatment is provided (Sari, New burger, Burns & Takahashi, 2016). Besides, laboratory tests cannot detect the disease, and the diagnosis is concluded from the presenting symptoms while eliminating the presence of other conditions. Other presenting symptoms include erythema in the eyes, rash in the groin region, chest or the stomach, swollen and purple-red palms, red and cracked lips and a strawberry-like tongue (New burger, Takahashi & Burns, 2016). The second phase starts after two weeks of the onset of fever, and the skin begins to peel on the feet and hands (Sosa, Brower & Divanovic, 2019). In this case study, the child had a history of fever of 101-104.7⁰F for seven days, and currently has a body temperature of 101.5⁰ There is also palmar redness, inflamed conjunctiva, red-coloured lips and rashes in the diaper area.
Scarlett Fever. This is a condition that results from a Streptococcal bacterial infection and is characterized by a high fever of 101⁰F and a sore throat (Wessels, 2016). The disease responds to bacterial therapy; however, if not treated, it can affect major body organs. Scarlet fever presents with tachycardia, petechiae on the mucous membranes and small lesions on the soft palate (Wessels, 2016). A red rash also erupts on the neck, axilla region and chest, causing the affected part to have a rough and dry texture (Wessels, 2016). Skin folds of the groin region, armpits and neck also become erythematous. In this scenario, the baby had signs and symptoms of a high HR of 120beats/min, high fever and had a rash around the groin region.
Staphylococcal Scalded Skin Syndrome (SSSS). This syndrome is caused by Staphylococcus aureus and presents with a maculopapular rash (Staiman, Hsu & Silverberg, 2018). Symptoms include general body weakness, fever and irritability. Positive findings on physical examination include conjunctivitis, blisters on the infected site, and tender skin on palpation (Staiman, Hsu & Silverberg, 2018). The signs and physical findings in the case study that support this diagnosis include an injected conjunctiva, fever and an excoriating rash.

Most Concerning Differential Diagnosis

Kawasaki disease is the differential diagnosis that is of most concern in this scenario. The child’s signs and symptoms had typical characteristics of Kawasaki disease such as high fever lasting for seven days, rash, palmar redness, inflamed conjunctiva and red-coloured lips. Furthermore, the condition occurs as a result of inflamed blood vessels caused by an attack of the vessels by the immune system (Newburger, Takahashi & Burns, 2016). Besides, it is a risk of Coronary Artery Disease and consequently, sudden death if not appropriately managed. Untreated cases of Kawasaki disease can further lead to heart complications, inflammation of major blood vessels and arrhythmias.

Additional Diagnostic Tests

I will recommend other laboratory and imaging studies to facilitate narrowing down of the differential diagnosis to the most likely medical diagnosis for the patient. These will include:

Echocardiograph (ECG). An ECG will help to identify aneurysms in the coronary arteries and also evaluate for dilation and the presence of thrombi in the arteries (Sosa, Brower & Divanovic, 2019). Coronary artery aneurysm is a common complication of Kawasaki disease, and an ECG will help to rule out its presence and also manage if there are positive findings.
Liver Function Tests (LFTs). An LFT test will assist in evaluating the functioning of the liver and also the level of circulating liver proteins in the blood (Sosa, Brower & Divanovic, 2019). Besides, symptoms of the Liver disease are manifested in the eyes and skin. Low levels of Albumin protein is associated with severe Kawasaki disease.
A biopsy of the affected diaper area will help in identifying the causative factor of the excoriating rashes.

Caregiver Health Education

I will offer health education to the child’s primary caregiver to minimize the occurrence of potential complications and also

reduce anxiety. Education on adherence to medical treatment will be emphasized to ensure that the child does not have complications (Sosa, Brower & Divanovic, 2019). In addition, I will advise the caregiver to take the child for scheduled child-well clinic for observation and immunization. I will also teach the caregiver on the appropriate measures to take when the child has fever such as exposing the child, giving oral fluids and performing sponge births (Monsma, Richerson & Sloand, 2015). Furthermore, I will advise the caregiver to bring the child for follow-up for monitoring of complications. The hygiene of the child will be highlighted, especially of the diaper area by proper cleaning and drying to avoid spreading the rash to other body parts. Lastly, I will offer advice on avoidance of over-the-counter medications but to seek immediate medical attention when the baby presents with symptoms such as fever.

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Assignment: Infectious Diseases in Children References

Monsma, J., Richerson, J., & Sloand, E. (2015). Empowering parents for evidence‐based fever management: An integrative review. Journal of the American Association of Nurse Practitioners, 27(4), 222-229.

Newburger, J. W., Takahashi, M., & Burns, J. C. (2016). Kawasaki disease. Journal of the American College of Cardiology, 67(14), 1738-1749.

Saji, B. T., Newburger, J. W., Burns, J. C., & Takahashi, M. (Eds.). (2016). Kawasaki disease: current understanding of the mechanism and evidence-based treatment. Berlin, Germany: Springer.

Sosa, T., Brower, L., & Divanovic, A. (2019). Diagnosis and Management of Kawasaki Disease. JAMA paediatrics, 173(3), 278-279.

Staiman, A., Hsu, D. Y., & Silverberg, J. I. (2018). Epidemiology of staphylococcal scalded skin syndrome in US children. British Journal of Dermatology, 178(3), 704-708.

Wessels, M. R. (2016). Pharyngitis and scarlet fever. In Streptococcus pyogenes: Basic Biology to Clinical Manifestations. Oklahoma, OK: University of Oklahoma Health Sciences Center.

The discussion assignment provides a forum for discussing relevant topics for this week on the basis of the course competencies covered.

For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned.

To support your work, use your course and textbook readings and the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates\’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite sources in your responses to your classmates. Complete your participation for this assignment by the end of the week.

Using your course and textbook readings and the South University Online Library, perform research on the following:

Assessment, diagnostic testing, and management of infectious conditions in a pediatric patient
Differential diagnoses for presentation of symptoms involving infectious diseases in pediatric patients
After completing your research, consider this scenario:

An eighteen-month-old child, well-known to your practice, presents with a seven-day history of fever ranging from 101 to 104.7 degrees Fahrenheit. On the fourth day of the fever, the emergency department had performed the following tests:

A blood and urine culture
A complete blood count
A comprehensive metabolic panel
The culture reports were found to be negative.

Today, the vitals of the child are the following:

Temperature: 101.5 degrees Fahrenheit
Heart rate: 120 beats/minute
Respiratory rate: 20 breaths/minute
Blood pressure: 90/40
Physical examination of the child indicates the following positive findings:

Injected conjunctiva
Palmar redness
Magenta-colored lips
Red macula
Excoriating rashes in the diaper area
On the basis of the above information, respond to the following:

What will be your differential diagnoses for this patient?
What specific physical exam findings support these differential diagnoses?
Of the differential diagnoses you listed, which would be the most concerning?
What additional diagnostic tests will you recommend? Why?
What would be your focus for caregiver education?
Submission Details:

Post your initial response to the Discussion Area by Saturday. Respond to at least two posts by the end of the week, Wednesday. Week starts on Thursday and ends on the following Wednesday.
Your initial post is due on Saturday.
Your two peer responses are due no later than Wednesday. The expectation is that you reply to your peers on more than 2 days before Wednesday to receive full credit.
Please make sure you are using scholarly references and should not be older than 5 years. Your posts/references must be in APA format.
Please follow the discussion rubric to make sure you have addressed the discussion criteria.
Rubrics

As we begin this session, I would like to take this opportunity to clarify my expectations for this course:

Please note that GCU Online weeks run from Thursday (Day 1) through Wednesday (Day 7).

Course Room Etiquette:

It is my expectation that all learners will respect the thoughts and ideas presented in the discussions.
All postings should be presented in a respectful, professional manner. Remember – different points of view add richness and depth to the course!

Office Hours:

My office hours vary so feel free to shoot me an email at [email protected] or my office phone is 602.639.6517 and I will get back to you within one business day or as soon as possible.
Phone appointments can be scheduled as well. Send me an email and the best time to call you, along with your phone number to make an appointment.
I welcome all inquiries and questions as we spend this term together. My preference is that everyone utilizes the Questions to Instructor forum. In the event your question is of a personal nature, please feel free to post in the Individual Questions for Instructor forumI will respond to all posts or emails within 24 or sooner.

Late Policy and Grading Policy

Discussion questions:

I do not mark off for late DQ’s.
I would rather you take the time to read the materials and respond to the DQ’s in a scholarly way, demonstrating your understanding of the materials.
I will not accept any DQ submissions after day 7, 11:59 PM (AZ Time) of the week.
Individual written assignments – due by 11:59 PM AZ Time Zone on the due dates indicated for each class deliverable.

Assignments:

Assignments turned in after their specified due dates are subject to a late penalty of -10%, each day late, of the available credit. Please refer to the student academic handbook and GCU policy.
Any activity or assignment submitted after the due date will be subject to GCU’s late policy
Extenuating circumstances may justify exceptions, which are at my sole discretion. If an extenuating circumstance should arise, please contact me privately as soon as possible.
No assignments can be accepted for grading after midnight on the final day of class.
All assignments will be graded in accordance with the Assignment Grading Rubrics

Participation

Participation in each week’s Discussion Board forum accounts for a large percentage of your final grade in this course.
Please review the Course Syllabus for a comprehensive overview of course deliverables and the value associated with each.
It is my expectation that each of you will substantially contribute to the course discussion forums and respond to the posts of at least three other learners.
A substantive post should be at least 200 words. Responses such as “great posts” or “I agree” do notmeet the active engagement expectation.
Please feel free to draw on personal examples as you develop your responses to the Discussion Questions but you do need to demonstrate your understanding of the materials.
I do expect outside sources as well as class materials to formulate your post.
APA format is not necessary for DQ responses, but I do expect a proper citation for references.
Please use peer-related journals found through the GCU library and/or class materials to formulate your answers. Do not try to “Google” DQ’s as I am looking for class materials and examples from the weekly materials.
I will not accept responses that are from Wikipedia, Business com, or other popular business websites. You will not receive credit for generic web searches – this does not demonstrate graduate-level research.
Stay away from the use of personal pronouns when writing.As a graduate student, you are expected to write based on research and gathering of facts. Demonstrating your understanding of the materials is what you will be graded on. You will be marked down for lack of evidence to support your ideas.

Plagiarism

Plagiarism is the act of claiming credit for another’s work, accomplishments, or ideas without appropriate acknowledgment of the source of the information by including in-text citations and references.
This course requires the utilization of APA format for all course deliverables as noted in the course syllabus.
Whether this happens deliberately or inadvertently, whenever plagiarism has occurred, you have committed a Code of Conduct violation.
Please review your LopesWrite report prior to final submission.
Every act of plagiarism, no matter the severity, must be reported to the GCU administration (this includes your DQ’s, posts to your peers, and your papers).

Plagiarism includes:

Representing the ideas, expressions, or materials of another without due credit.
Paraphrasing or condensing ideas from another person’s work without proper citation and referencing.
Failing to document direct quotations without proper citation and referencing.
Depending upon the amount, severity, and frequency of the plagiarism that is committed, students may receive in-class penalties that range from coaching (for a minor omission), -20% grade penalties for resubmission, or zero credit for a specific assignment. University-level penalties may also occur, including suspension or even expulsion from the University.
If you are at all uncertain about what constitutes plagiarism, you should review the resources available in the Student Success Center. Also, please review the University’s policies about plagiarism which are covered in more detail in the GCU Catalog and the Student Handbook.
We will be utilizing the GCU APA Style Guide 7th edition located in the Student Success Center > The Writing Center for all course deliverables.

LopesWrite

All course assignments must be uploaded to the specific Module Assignment Drop Box, and also submitted to LopesWrite every week.
Please ensure that your assignment is uploaded to both locations under the Assignments DropBox. Detailed instructions for using LopesWrite are located in the Student Success Center.

Assignment Submissions

Please note that Microsoft Office is the software requirement at GCU.
I can open Word files or any file that is saved with a .rtf (Rich Text Format) extension. I am unable to open .wps files.
If you are using a “.wps” word processor, please save your files using the .rtf extension that is available from the drop-down box before uploading your files to the Assignment Drop Box.

Grade of Incomplete

The final grade of Incomplete is granted at the discretion of the instructor; however, students must meet certain specific criteria before this grade accommodation is even possible to consider.
The grade of Incomplete is reserved for times when students experience a serious extenuating circumstance or a crisis during the last week of class which prevents the completion of course requirements before the close of the grading period. Students also must pass the course at the time the request is made.
Please contact me personally if you are having difficulties in meeting course requirements or class deadlines during our time together. In addition, if you are experiencing personal challenges or difficulties, it is best to contact the Academic Counselor so that you can discuss the options that might be available to you, as well as each option’s academic and financial repercussions.

Grade Disputes

If you have any questions about a grade you have earned on an individual assignment or activity, please get in touch with mepersonally for further clarification.
While I have made every attempt to grade you fairly, on occasion a misunderstanding may occur, so please allow me the opportunity to learn your perspective if you believe this has occurred. Together, we should be able to resolve grading issues on individual assignments.
However, after we have discussed individual assignments’ point scores, if you still believe that the final grade you have earned at the end of the course is not commensurate with the quality of work you produced for this class, there is a formal Grade Grievance procedurewhich is outlined in the GCU Catalog and Student Handbook.