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
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.
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.
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
BP 68/42 mmHg (59 MAP)
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
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