NR 602 Week 6 iHuman Virtual Patient Encounter - Tommy Acker

  • NR 602 Week 6 iHuman Virtual Patient Encounter -  Tommy Acker
  • $25.00


Institution Chamberlain
Contributor Christie

Week 6 – Tommy Acker 26 m/o M CC: Tummy ache

Problem Statement

TA is a 26-month-old M with Downs syndrome who presents with his mother with c/o abdominal pain after “falling out of bed” two days ago, one episode of emesis, and lethargy. PMH includes s/p ASD surgical repair with CHF. The mother also reports TA has been breathing more rapidly, sweating, has a poor appetite, and has diminished urine output with a dark color and strong odor. PE reveals pallor, listlessness, hypotension, tachycardia, tachypnea, grossly distended abdomen with epigastric bruising, firm to palpation with guarding, and rebound tenderness. A reducible 2cm umbilical hernia, diaper rash, and faint circumferential macular discolorations present at wrists consistent with aging ligature marks are also present on examination. A single mother raises TA with occasional help from her boyfriend and neighbors. TA is exposed to secondhand smoke. The birth father is not involved.

 

 

Instituition / Term
Term Spring Session
Institution Chamberlain
Contributor Christie
 

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