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Fever Case Study (Pediatric) (30 min)

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A 3-month-old child presents to the emergency room with her mother. The mother reports that the baby is not acting like herself and she is having a hard time arousing the baby. Upon inspection the baby is wrapped in blankets in her car seat sleeping. The nurse unwraps the baby and feels heat radiating off the child. 

The vital signs are as follows:

Temp 104°F Rectally

HR 150 bpm

RR 32 bpm

SpO2 99%

BP 66/32 mmHg (54 MAP)

 

The child is not opening their eyes or crying. The nurse notices the fontanelle is sunken in and the baby’s skin is hot but dry.

Critical Thinking Check
Bloom's Taxonomy: Application

What questions should the nurse ask the mother?

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Critical Thinking Check
Bloom's Taxonomy: Analysis

What are priority nursing actions at this time?

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Baby is 5.9 kg and the nurse initiates a peripheral IV for the baby. The provider orders rectal Tylenol at the appropriate weight-based dose.

Critical Thinking Check
Bloom's Taxonomy: Analysis

How much fluids should the baby receive and which vital signs is the most concerning at this time?

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The baby has received the fluid bolus and rectal Tylenol. The nurse checks another set of vitals and gets the following:

Temp 101 F Rectally

HR 141

RR 30

SpO2 99%

BP 68/42 mmHg (59 MAP)

Critical Thinking Check
Bloom's Taxonomy: Application

What should the nurse do next?

View Answer

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