Kayla brings Riley, now 17 months, in for complaint of fever and rash. The fever began “a couple of days ago” and is of normal levels in the morning then gets as high as 103 to 104 degrees in the afternoons. Riley has also had clear rhinorrhea and in the last 24 hours he has developed a red, diffuse rash to the torso and abdomen that does not itch and a dry cough in the last day. Mother reports he is drinking, but not as well as usual. He did have a good wet diaper this morning, but is not really eating much and is not playing.
Medications: Mother is giving OTC Robitussin cough and cold at 1 tsp last night and this morning. Liquid Tylenol ½ a tsp last night and this morning.
She is very concerned about the level of the fever and the fact that after 3 days he is not improving.
Discussion Questions Part One
We will begin by focusing on gathering history in an ill child.
What ‘red flags’ did you note in the historical data?
What data is most important to include in this particular case and which historical data that might be gathered on a well-child exam can be left out of this ill visit?
What are your differential diagnoses?
What parts of the physical exam will you focus on today to rule in or out your differentials?
Discussion Part Two (graded)
Physical Examination Riley:
V/S: Height: 81 cm (31.89 in), Weight: 13 kg (28.66 lbs), B/P: 94/60, T: 100.6, HR: 114 BMP/reg., Resp: 28, reg, non-labored, SpO2: 97%
17 months old, Height 51st percentile, Weight 87th percentile (CDC, 2016)
General: somewhat lethargic and cries some throughout exam. SKIN: Diffuse erythemamtous rash in fine popular patches across the torso and very erythematous to the cheeks. HEENT: Head normocephalic atraumiatic. Conjuctiva clear, non-icteric, but mildly injected PERRL. Unable to complete fundoscopic exam. Tympanic membranes intact with scant clear fluid posteriorly bill and mild injection. EAC unremarkable. Pinna/tragus w/o tenderness. Nares patent, mucosa mildly injected with sl. edema to the inferior and medial turbinates bill, moderate clear rhinorrhea. Pharynx with mild slight erythema, tonsils 2/4 bill. Oral exam unremarkable. Neck supple w/mild anterior cervical lymphadenopathy bill. Thyroid small, firm, equal bill. CARDIOPULMONARY: Heart RRR w/o murmur. Lungs with mild expiratory wheeze in posterior bases. Respirations even and unlabored. Abdomen rounded normative bowel sounds throughout, soft, non-tender, no masses or organomegaly.
NR 602 Week 3 PBL Case Study Discussion Assessment of a Child
Grading Rubric Guidelines
Performance Category
10
9
8
4
0
Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic decisions.
Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
Evaluates literature resources to develop a comprehensive analysis or synthesis.
Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
Evaluates information from source(s) to develop a coherent analysis or synthesis.
Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
Demonstrates little or no understanding of the topic.
Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
Information is taken from source(s) without any interpretation/evaluation.
The posting uses information that is not valid, relevant, or reliable
No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
Information is not valid, relevant, or reliable
Performance Category
10
9
8
4
0
Application of Course Knowledge –
Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations
Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
Applies concepts to personal experience in the professional setting and or relevant application to real life.
Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
Applies concepts to personal experience in their professional setting and or relevant application to real life
Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
Posts are superficial and do not reflect an understanding of the lesson content
Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category
5
4
3
2
0
Interactive Dialogue
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days.
(5 points possible per graded thread)
Exceeds minimum post requirements
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
Replies to a post posed by faculty and to a peer
Summarizes what was learned from the lesson, readings, and other student posts for the week.
Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days
Replies to a question posed by a peer
Summarizes what was learned from the lesson, readings, and other student posts for the week.
Meets expectations of 2 posts on 2 different days.
The main post is not made by the Wednesday deadline
Does not reply to a question posed by a peer or faculty
Has only one post for the week
Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
Does not post to the thread
No connections are made to the topic
Minus 1 Point
Minus 2 Point
Minus 3 Point
Minus 4 Point
Minus 5 Point
Grammar, Syntax, APA
Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted.
Points deducted for improper grammar, syntax and APA style of writing.
The source of information is the APA Manual 6th Edition
2-3 errors in APA format.
Written responses have 2-3 grammatical, spelling, and punctuation errors.
Writing style is generally clear, focused, and facilitates communication.
4-5 errors in APA format.
Writing responses have 4-5 grammatical, spelling and punctuation errors.
Writing style is somewhat focused.
6-7 errors in APA format.
Writing responses have 6-7 grammatical, spelling and punctuation errors.
Writing style is slightly focused making discussion difficult to understand.
8-10 errors in APA format.
Writing responses have 8-10 grammatical, spelling and punctuation errors.
Writing style is not focused, making discussion difficult to understand.
Post contains greater than 10 errors in APA format.
Written responses have more than 10 grammatical, spelling and punctuation errors.
Writing style does not facilitate communication.
The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
0 points lost
-5 points lost
Total Participation Requirements
per discussion thread
The student answers the threaded discussion question or topic on one day and posts a second response on another day.
The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement
per discussion thread
The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.
The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.
