Cases in Pediatric Acute Care

ANDREA KLINE-TILFORD, PHD, CPNP-AC/PC, FCCM, FAAN is the Nurse Practitioner Manager at C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA.

CATHERINE M. HAUT, DNP, CPNP-AC/PC, FAANP, CCRN is the Coordinator of Research and Evidence-Based Practice at Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA; also practices in a Pediatric Intensive Care Unit, employed by Mednax Pediatrix Medical Group, Baltimore, MD, USA.

Preface xi


List of Contributors xiii


1 Complication of Pneumonia 1
Ji-Yeon Kim


2 Infant with Diaphoresis during Feedings 5
Kristen Brown and Kristen Nelson McMillan


3 Hypotension in the Operating Room 7
Ann Marie Felauer


4 Toddler with Vomiting and Diarrhea 11
Kimberly L. DiMaria


5 Infant with Fever and Cold Symptoms 15
Cheryl Bartke


6 Toddler with Pineoblastoma and Bone Marrow Transplant 19
Cathryn Freeman


7 A 5-Year-Old with Altered Mental Status 23
Yu-shan Tseng and Richard Garcia


8 An 8-Year-Old with Abdominal Trauma 29
Julie Resler


9 Child with Left Eye Swelling 33
Amy Graf


10 Billing and Coding 37
Dawn M. Silverman


11 Language Delay 47
Jolene Dickerson


12 A 6-Month-Old Infant with RSV and Respiratory Failure 51
Catherine M. Haut


13 Adolescent Abdominal Pain after Cardiac Surgery 55
Cathy Woodward


14 Young Infant with Vomiting 57
Sarah Martin


15 School-age Child with Bruising 61
Lisa Hovingh and Candie Ritsema


16 Infant with Shunted Hydrocephalus 65
Mark Weber


17 Newborn with Poor Oral Intake and Irritability 69
Elaine Geary


18 An 8-Week-Old Infant with a Cough 73
Sarah Jane Garraty


19 Desaturation in Postoperative Cardiac Surgery Infant 77
Lisa Kohr


20 Pre-school Child with Seizures 81
Heather Herrera and Rachel Luthen


21 Child with Blood in Stool 85
Brittany Cook and Darby Tozer


22 Osteomyelitis Case Study 89
Kim Steanson


23 A 2-Year-Old with Liver Transplant and Fever 93
Louise Flynn


24 Respiratory Decompensation in Trached Infant 97
Jennifer Helman


25 Neonatal Hypoglycemia 101
Janice L. Wilson


26 Chronic Otitis Media 105
Kimberly Young-Conner


27 Complex Patient with Recurrent Lower Respiratory Tract Infection 109
Ann Marie Ramsey


28 Child with Racing Heart 115
Bradley Goettl


29 Teen with Headache and Seizure 119
Valarie Eichler


30 A 4-Year-Old with Bloody Diarrhea 125
Tamara Hill


31 Child with Persistent Fever 129
Misty Ellis


32 Quality Improvement Case Study 133
Peggy Dorr


33 Newborn Immediately Post Delivery 139
Heather Schniepp


34 A 5-Year-Old with Poor Weight Gain and Dehydration 143
Kimberly Young-Conner


35 Toddler with Complex Chronic Condition 147
Jennifer Wright


36 Pre-adolescent with Knee Pain 151
Katelyn Hamann and Shannon Konieczki


37 Infant with Increased Fussiness and Decreased Oral Intake 155
Stephanie Haughey


38 Infant with Prolonged Jaundice 161
Aimee Bucci


39 Child with Rash and Drooling 165
Mark Weber


40 Child with Fever and Sore Throat 169
Stephanie Robell and Danielle Van Damme


41 Teenager with Sickle Cell Disease and Fever 173
Shannon Konieczki and Katelyn Hamann


42 Ethical Case Study 177
Jamie Tumulty


43 Infant with Neurologic Changes and Respiratory Failure 183
Blythe Pollack and Stacey Sears


44 Acute Hyperglycemia 191
Jeanne Little


45 Infant with Progressive Lethargy and Poor Feeding 195
Kathleen P. Thompson


46 Neonatal Tachypnea 199
Janet Dutcher


47 Diplopia and Esotropia 203
Lindsay Chapman


48 Acetaminophen Ingestion 207
Aaron Carpenter


49 A 3-Year-Old with Sudden Onset of Breathing Difficulty 211
Judy Verger


50 A 2-Month-Old with Acute Abdomen 215
Christyne Kyper


51 Henoch-Schoenlein Purpura Nephritis 219
Tamara Hill


52 Toddler with Tachypnea and Cool Extremities 223
Cathy Woodward


53 Teen with Intractable Headache 227
Tara Pezzuto


54 Seizures in School-age Child 231
Ann Marie Felauer


55 An 18-Year-Old with Upper Respiratory Symptoms, Headache and Fever 235
Misty Evans


56 Testicular Torsion 239
Amanda Mandel


57 Teen with Fever and Rash 243
Christine Renke and Elizabeth Hoppe


58 Preterm Infant Unable to Wean from Mechanical Ventilation 247
Michelle Dokas


59 Toddler with Acute Respiratory Failure 251
Ahmed Aly and Bradley Tilford


60 Adolescent with Head Injury 255
Jennette Firlein


61 Newborn with Ambiguous Genitalia 261
Barbara Wise


62 Anemia in a Toddler 265
Dyane Bunnell


63 A 2-Year-Old with Fever and Cough 269
Jessica Strohm Farber


64 Research Review 273
Lauren R. Sorce


65 Toddler with Fever and Redness Behind Ear 277
Amanda Lewis Weir


66 A 5-Year-Old with Right-Sided Weakness 281
Suzette Meinke and Jessica Spruit


67 Postoperative Heart Block 285
Cathy Woodward


68 Recognizing Human Trafficking 287
Christine DiPaolo


69 A Toddler With Stridor 291
Mari Welch


70 Delirium in a 9-Year-Old Boy 295
Heather Herrera


71 Feeding Challenge in a Child with Spinal Muscular Atrophy 299
Nicole Fragale


72 A 5-Year-Old with Osteomyelitis, Electrolyte Disturbance and Headaches 303
Kimberly L. DiMaria


73 Child with Scald Burn Injury 307
Amarilis Martin and Bradley Tilford


74 Parvovirus Requiring Blood Transfusion 313
Ashley Thibodeau


75 A Teen With High Fever, Rash and Lethargy 317
Jessica Strohm Farber


76 A 9-Year-Old With Scoliosis 321
Alicia McCarthy


77 An Unresponsive Infant 325
Charlene Pringle


78 A Toddler With Abdominal Pain, Diarrhea and Lethargy 331
Jessica Pech


79 Sore Throat and Shortness of Breath 335
Amy Manion


80 Oral Presentation and Communication 339
Jill Siegrist Thomas


81 A 7-Year-Old with Migratory Joint Pain 345
Christin Diller


82 Adolescent with Murmur and Chest Flutter 349
Natalie Hecht


83 Outpatient Management of Asthma 353
Jolene Dickerson


84 A Newborn with Abnormal Movements 357
Maura Bernardo


85 Postoperative Infant with Tachycardia 361
Cathy Woodward


86 Brain Death 363
Maria C. Woosley


87 Postoperative Spinal Fusion with Complications 367
Jaime Panton and Melissa C. Varrone


88 Orthopnea in a 10-Year-Old 371
Max Pizzo


89 Complication of Traumatic Brain Injury 375
Christine Schindler


90 Newborn with Hypothermia 379
Marshay James


91 Back Pain in an Active Teenager 383
Alicia McCarthy


92 Teen with Fever and Abdominal Pain 387
Sarah Martin


93 Complication in a 6-Year-Old with a Kidney Transplant 391
Alison Hewitt Torres


94 Acute Hypertension and Seizures in a 17-Year-Old Male 395
Alison Hewitt Torres


95 Jittery 2-Week-Old Infant 399
Christopher D. Newman


96 Child with Leg and Back Pain 403
Jill Marks


97 Fussy, Tired Infant 407
Charlene Pringle


98 Tics and Something More 411
Judy Adelizzi-DeLany


99 Lightheaded Adolescent 415
Cathy Woodward


100 Infant with Hyponatremia 419
Sarah Pihl


101 Bone Marrow Transplant in Sickle Cell Disease 423
J. Paige Rieckhoff


102 Child with Respiratory Failure and Transaminitis 427
Kim Steanson


103 A Serious Football Injury 431
Julie Resler


104 Infant with Generalized Weakness 435
Blythe Pollack


105 A 3-Day-Old with Irritability 441
Christopher D. Newman


106 Child with Fever and Rash 445
Misty Evans


107 A Teen With Vomiting and Diarrhea 449
Christyne Kyper


108 Acute Jaundice in a 7-Year-Old Child 453
Roseann Hausmann


109 Idiopathic Nephrotic Syndrome 457
Tamara Hill


110 School-age Child with Hives and Lip Swelling 461
Jay M. Hunter


111 A 10-Year-Old with Asthma in the PICU 463
Catherine M. Haut


112 Skin Wound in Postoperative Neonate 467
Hayley Redmond


113 Provider Burnout and Resiliency 471
Jill Siegrist Thomas


114 Kidney Transplant Complication 475
Cathy C. McAdams


115 Infant with Influenza A and New Fever 479
Lauren Flagg


116 A 3-Year-Old with Fever and Painful Urination 483
Roseann Hausmann


Index 487