iHuman Case of Emma Ryan, 2 year old with chief complaint of runny nose, cough, and fever.
Discussion Question 1
Based on your performance and the
... [Show More] expert feedback in your HISTORY collection, describe two
missed questions and your understanding of why they were important to collect for this case
history. Use specific references from your text to explain.
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During history collection, when going through patient’s symptoms with her mother, I failed to
further investigate an ear problem, because patient is a 2 year old, she was not able to
communicate and presented with discomfort during visit. I asked about ear pain or discomfort
such as the child tugging at her ear and mother replied that there were no signs of that, but I
failed to ask if there were any signs of discharge or bleeding of the ears. The collection of these
signs are clinically important because that could lead to a better understanding initially, prior to
physical exam, as bleeding discharge from the ears can indicate and external ear canal wound,
skull fracture, or traumatic perforation of the tympanic membrane (Goolsby, Jo, M., Grubbs,
Laurie., 2014, p. 127). Discharge of the purulent type can also be a sign of infection or a foreign
body in the ear (Goolsby, Jo, M., Grubbs, Laurie., 2014, p. 127). Another question that was
missed during history collection was if patient had a flu shot. I stopped at asking if when her last
immunizations were given and if they were up to date, but failed evaluate mother’s answers
further and ask about the flu vaccine. This is very important to assess and document because
children are a target population in receiving flu vaccine due to the benefits of reducing rates of
pneumonia in children and reducing the incidence of influenza in the community and should be
offered to all children older than 6 months that have no contraindications (Seasonal influenza
vaccine in children, n.d). NSG 6020 Emma Ryan iHuman Case study, 2 year old with chief
complaint of runny nose, cough, and fever [Show Less]