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Mom & Dad bring their 5-week-old male child to your urgent care. They report him to be eating poorly, having trouble breathing and seems very tired & sleepy. They report he had been fine until a couple weeks ago when he developed a fever, cough, runny nose, and vomiting. They report his breathing continues to get worse and a much faster rate and his sleepiness is increasing as well. They also report he sweats on his forehead when feeding. Medical history: He was a full term, uncomplicated pregnancy. G3P2. Delivery was unremarkable except for meconium-stained fluid. He did well at delivery and in the nursery. His pediatric follow-up has been poor. Medications: noneAllergies: NKA Physical Examination T: 98.2 F, Resp: 74, Heart Rate: 160, BP: 92/68, O2 Sat: 99% (room air). Appearance: Mildly cachectic, acyanotic infant who is pale, lethargic, and tachypneic, mild to moderate subcostal and intercostal retractions. A chest x-ray was done showing moderate cardiomegaly with a moderate degree of pulmonary edema. There are no pleural effusions. Please answer the following questions: 1. Identify four (4) differential diagnoses for this patient 2. What would the primary diagnosis be for this patient – explain your rationale – findings that lead you to this diagnosis. 3. What lab and diagnostic tests would you anticipate? Give rationale for each. 4. How would you address the parents’ concerns? 5. Identify what the non-pharmacologic and pharmacologic treatment plan would consist of for this patient. 6. What is your plan for this treatment?

Image transcription text
Mom & Dad bring their 5-week-old male child to your urgent care. They report
him to be eating poorly, having trouble breathing and seems very tired & sleepy.
They report he had been fine until a couple weeks ago when he develop… Show more

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