Issy: Bronchiolitis (Airway and Breathing)IIssy is a 7 week old infant, who has been brought into the Emergency Department (ED) by her parents at 1000hrs.SIssy has a three dayhistory of rhinorrhoea and tachypnoea. Her parents have brought her in because they are concerned Issy is getting worse. Issy is breastfed and for the last 2 days has not been feeding as wellas usual -her mother reports she frequently‘pullsoff the breast’. BIssy was born at term and had no birth complications. Issy is normally well and has received her 6 week immunisations.
ATemp (axillary): 38.4degrees
C; heart rate: 165 beats per minute; blood pressure:90/50mmHg; respiratory rate: 55 breaths per minute; SpO2: 95% on room air.
R*Issy has been diagnosed with moderate respiratory distress caused by RSV bronchiolitis.
Max:
Gastroenteritis(Circulation)IMax is a three year oldboy who has been brought into the Emergency Department (ED) by his mother at 1600hrs.SMax has been camping with his family over the weekend.
He started vomiting at approximately 0500hrs today.
The family packed up and returned home –it was a fourhour drive from the camping site to their home. Max continued vomiting –he is thirsty, but every time he has a drink he vomits. He wears pullups and Sylvia reports he has not been wet since early this morning.BMax is normally well and is up to date with his immunisations.
ATemp (axillary): 37.0 degrees C;
heart rate: 140 beats per minute; blood pressure:100/65mmHg; respiratory rate: 35 breaths per minute; SpO2: 99% on room air.R*
Max has been diagnosed with moderate dehydration caused by viral gastroenteritis.*For the purposes of this assessment task, R represents the current diagnosis.
There are two main focus areas for the written report:
1) Describe in detail the assessment (‘airway and breathing’ or ‘circulation’) of an acutely unwell child. You must describe the assessment as indicated on the scenario;
2) Outline the likely findings from that assessment based on the information and images provided in the clinical scenario; and
2) Describe in detail the underlying pathophysiology related to the assessment findings.
The assessment of the unwell child should cover the type of assessments you would undertake, what you are likely to find based on the information provided in the clinical scenario, and how these findings differ from the normal findings for that child if they were not unwell. The assessment should be relevant and specific to the child’s condition and developmental stage.
The description of the underlying pathophysiology should directly relate to the assessment findings. For example, what is the underlying pathophysiology that is causing the breath sounds heard when auscultating the child or infant’s chest? The description of the pathophysiology should be relevant and specific to the child’s condition and developmental stage.
