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The story…
Tasha, a 17 year old irresponsible mother of a five month old baby named Jamie. Tasha has had symptoms of a common cold for about a week and a half.
Two and a half weeks later….
Patient - Jamie Brown
Tasha Brown reported her five month old baby Jamie Browns symptoms of
– Runny nose– Slight fever– Diarrhea
To the in-nurse at Jamie’s day care center at The Women’s League.
Exam at the Women's League
Jamie has not been given any medicine to calm her coldPhysical examMedical history shows no results of any complications Patient has no allergiesMothers’ history shows complications during birth and recently had the flu.Patient meds- none
Results
The nurse informed Tasha that her baby has a common cold and not to worry.
She also informed her that Jamie should be given 2.5 mL of Tylenol orally every 6-8 hours
Pediatrician
P.E.D
Study medicine and biochemistry and anatomy.
3-8 years of internships and residence working in hospitals or clinics.
Primary care is to care for infants and children until the age of 18.
ExamVital signs
Height: 21’’Wt: 16 lbs. 5 oz. T:37.9°C PR:120 to170
Palpitation is normal
Reflexes in bilateral in upper and lower extremities and muscle strength is normal.
Lungs sound is a bit abnormal because of the mucus.
DX: Common cold
Rx: Motrin for the next week to treat the fever. Return in two weeks for check-up.
Patients in Crisis
After 6 days the mother notice that her child's fever was getting worse and her breathing and coughing became heavier and had a distinct sound to it.
Tasha’s mother rushed Tasha and Jamie to the hospital.
Patient is admitted to the hospital
Questioning by hospital staff included concerns about the mothers health history, daily routines, and Jamie’s health and where-about.Tasha recalls having a severe common cold about a month ago but never went to the doctor/hospital.Recommended to a more experienced physician
Attending Hospital Physician
Doctor of medicine – M.D
Doctor of Osteopathy – D.O
Associate degree in respiratory therapy
Patient is stabilized
Thorough physical exam
Throat and nose mucus samples shows a great number of mucus
Blood test shows high white blood cell count
A chest x-ray was ordered – results show presence of inflammation and fluid in the lungs
Bacterial Infection
Bordetella pertussis
http://microblog.me.uk/wp-content/uploads/bordetella_pertussis_r.1.jpg
Pertussis
Symptoms:Catarrhal Stage (lasts 1-2 weeks)
Runny nose, sneezing, low fever, mild cough
Paroxysmal Stage (after 2 more weeks, lasts 1-10 weeks)
Bursts of coughing, sometimes rapid, followed by a long, deep, high pitched respiration
Ill appearance
Vomiting
Convalescent Stage (recovery stage)Gradual recovery
Complication
Can cause pneumonia and convulsions
Extreme leukocytosis in fatal cases (high number of WBCs)
http://www.safehealthmedicine.net/images/pneumonia%20image.jpg
Final TreatmentBaby will be hospitalized until signs of progression
Given antibiotics for next two weeks
Suctioned of thick respiratory secretions.
Breathing will be monitored and oxygen will be given
Given IV for dehydration due to poor oral intake
Tylenol and Motrin given to treat fever
PrognosisNeither Tasha nor Jamie were vaccinated
1 in 100 affected infants die
Unfortunately, Jamie succumbed to pneumonia while under hospital care and died Semptember 19, 2011
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Sources"Whooping Cough (Pertussis) Treatment, Prognosis - Whooping Cough (Pertussis) - HealthCommunities.com." Health Information and Tools - HealthCommunities.com. N.p., n.d. Web. 4 June 2012. <http://www.healthcommunities.com/whooping-cough-pertussis/children/whooping-cough-treatment-prognosis.shtml>.
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