Catherine E. Burns - Pediatric Primary Care Case Studies

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Production Credits

Publisher: Kevin Sullivan

Acquisitions Editor: Emily Ekle

Acquisitions Editor: Amy Sibley

Associate Editor: Patricia Donnelly

Editorial Assistant: Rachel Shuster

Associate Production Editor: Lisa Cerrone

Marketing Manager: Rebecca Wasley

V.P., Manufacturing and Inventory Control: Therese Connell

Composition: Paw Print Media

Cover Design: Kristin E. Parker

Cover Images: BackgroundCrayon Image: Anikasalsera/Dreamstime.com; Handprint Image: Lori Martin/Dreamstime.com. Photos, clockwise from top Vadim Ponomarenko/Dreamstime.com; Courtesy of Catherine E. Burns; Anette Romanenko/Dreamstime.com; Courtesy of Catherine E. Burns. Printing and Binding: Malloy, Inc.

Cover Printing: Malloy, Inc.

Library of Congress Cataloging-in-Publication Data

Pediatric primary care case studies / [edited by] Catherine E. Burns, Beth Richardson, Margaret A. Brady.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-0-7637-6136-3 (pbk.)

1. PediatricsCase studies. I. Burns, Catherine E. II. Richardson, Beth, CPNP. III. Brady, Margaret A. [DNLM: 1. PediatricsProblems and Exercises. 2. Primary Health CareProblems and Exercises.

WS 18.2 P37015 2010]

RJ58.P45 2010

618.92dc22

2009011613

6048

Printed in the United States of America

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Diagnostic Reasoning:
A Complex Issue for Pediatric Primary Care
Catherine E. Burns

Elissa Jones-Hua

Brian T. Maurer

Ann Marie McCarthy
Sharon Yearous

Dawn Lee Garzon

Anna Marie Hefner

Margaret A. Brady

Pamela J. Hellings

Tamra D. Kehoe

Catherine G. Blosser

Lynne Henry

Larry W. Lynn

Beth Moore
Margaret A. Brady

Ann M. Guthery

Sheran M. Simo

Ritamarie John

Deborah A. Bohan

Arlene Smaldone

Veronica Kane

Ritamarie John

Michele Saysana

Kathleen M. Boyd

Patrick E. Killeen

Jennifer Newcombe

Ardys M. Dunn
Victoria Winter

Prashant Gagneja
John Peterson

Shelly J. King

Deborah Stiffler

Teral Gerlt

Donald W. Kennerley

Catherine E. Burns
Danielle J. Poulin

Jan Bazner-Chandler

Lori J. Silao

George Anadiotis

Pediatric Primary Care Case Studies was written by nurse practitioner, physician, and physician assistant clinicians and educators who believe that health care for children in primary care settings should be excellent, whatever the discipline of the provider. This book is designed to exemplify the critical thinking process and diagnostic reasoning skills that clinicians should use to assess and manage treatment of the infants, young children, and adolescents who present with common signs and symptoms of childhood illnesses or behavioral problems in providers practice settings.

These cases were developed to reflect common pediatric healthcare problems such as depression, obesity, autism, attention-deficit hyperactivity disorder, and environmental health concerns among many others. The chapter authors address key elements in the reasoning process that should be employed as the provider gathers data about a case from the initial presentation through the diagnostic decision and highlight the standards of treatment for the selected diagnosis. Additionally, the cases discuss concerns surrounding children from a variety of socioeconomic, cultural, familial, and developmental backgrounds.

We hope this book helps fill in gaps in the clinical knowledge of students who have completed didactic courses and guides their preparation for clinical work by taking an organized approach to symptom-driven presentations.

This book is divided into three sections, which follow an introductory chapter reviewing essential features of the diagnostic approach to pediatric primary care. Unit I covers developmental problems in children from infancy through adolescencemotor delays, language delays, learning problems in school, and sleeping too much. The cases in Unit II involve functional health problems, beginning with a case study illustrating principles of health maintenance. Subsequent cases include an obese child with unhealthy nutritional practices, a breastfeeding infant who is not gaining weight, a constipated child, a child needing a preparticipation sports examination, an infant not sleeping through the night, a child with attention and hyperactivity issues, a child who is abused, a child with possible depression, and a teen who thinks she might be gay. Finally, Unit III surveys common medical symptoms and related conditions which the provider will see and should not misswheezing, type 2 diabetes, anemia, headache, a red eye, recurrent ear infections, a heart murmur, cough, vomiting and diarrhea, dental trauma, urinary tract infection, a birth control request, sexually transmitted infection, an itchy rash, acne, a limp, preterm infant care, and a possible genetic syndrome.