Case 1
M.S. is a 26-year-old woman who is pregnant with her first child. Her husband accompanied her to all her prenatal visits. An ultrasound during a routine visit at 34 weeks’ gestation revealed that the baby had hydrocephalus and a myelomeningocele. The parents were initially devastated but remained very excited about the birth of their first child. M.S. was scheduled for a cesarean section at 38 weeks’ gestation, and the couple was anxious about their child’s condition and care following birth.
M.S. delivered a baby boy by cesarean section; he was transferred to the pediatric intensive care unit. On admission to the nursery, the baby’s vital signs and weight were within normal limits, but his head circumference was large. He had bulging fontanelles and a high-pitched cry. The nurse noted a saclike projection in the lumbar region of his spine.
Provide responses
Discuss the rationale for delivering the infant by cesarean section.
Discuss the significance of the infant’s clinical manifestations.
Discuss the acute and long-term treatment strategies for the infant.
Discuss the complications associated with myelomeningocele.
M.S. is a 26-year-old woman who is pregnant with her first child. Her husband accompanied her to all her prenatal visits. An ultrasound during a routine visit at 34 weeks’ gestation revealed that the baby had hydrocephalus and a myelomeningocele. The parents were initially devastated but remained very excited about the birth of their first child. M.S. was scheduled for a cesarean section at 38 weeks’ gestation, and the couple was anxious about their child’s condition and care following birth.
M.S. delivered a baby boy by cesarean section; he was transferred to the pediatric intensive care unit. On admission to the nursery, the baby’s vital signs and weight were within normal limits, but his head circumference was large. He had bulging fontanelles and a high-pitched cry. The nurse noted a saclike projection in the lumbar region of his spine.
Provide responses to the below based on Part 1.
Discuss the rationale for delivering the infant by cesarean section.
Discuss the significance of the infant’s clinical manifestations.
Discuss the acute and long-term treatment strategies for the infant.
Discuss the complications associated with myelomeningocele.
Case 2
A 13-year-old male is complaining of mild recurrent bilateral anterior knee pain without fever, joint swelling, erythema, or limitation of ambulation for the past 3 months. He is accompanied by his mother.
Prenatal and birth history: unremarkable.
Developmental history: mother reports normal development.
Past medical/surgical history: no major medical illnesses; no surgical history; no previous hospitalizations.
Social history: actively involved on his school’s soccer team for 2 years.
Family and environmental risks: none.
Immunization history: up to date.
Medications: none.
Allergies: no known drug allergies.
Vital signs: temperature 98.7°F; pulse 72 beats per minute; respirations 18 per minute; blood pressure 120/70 mmHg; pulse oximeter 100%.
Physical examination revealed a well-nourished adolescent male without any acute distress. Significant bilateral tenderness was noted when palpating the tibial tubercles, and extending his knees against resistance reproduced pain. The remainder of the musculoskeletal examination was unremarkable (e.g., deep tendon reflexes, strength, and sensation). Other systems examinations were unremarkable (e.g., heart, lungs, etc.).
Answer the following questions based on Case 2.
What is the most likely diagnosis for this patient?
What is the pathogenesis of this disorder?
What additional information assists in making the diagnosis?
What are treatment strategies for this patient?
What education would the provided to the patient and mother?
A 13-year-old male is complaining of mild recurrent bilateral anterior knee pain without fever, joint swelling, erythema, or limitation of ambulation for the past 3 months. He is accompanied by his mother.
Prenatal and birth history: unremarkable.
Developmental history: mother reports normal development.
Past medical/surgical history: no major medical illnesses; no surgical history; no previous hospitalizations.
Social history: actively involved on his school’s soccer team for 2 years.
Family and environmental risks: none.
Immunization history: up to date.
Medications: none.
Allergies: no known drug allergies.
Vital signs: temperature 98.7°F; pulse 72 beats per minute; respirations 18 per minute; blood pressure 120/70 mmHg; pulse oximeter 100%.
Physical examination revealed a well-nourished adolescent male without any acute distress. Significant bilateral tenderness was noted when palpating the tibial tubercles, and extending his knees against resistance reproduced pain. The remainder of the musculoskeletal examination was unremarkable (e.g., deep tendon reflexes, strength, and sensation). Other systems examinations were unremarkable (e.g., heart, lungs, etc.).
Answer the following questions based on Case 2.
What is the most likely diagnosis for this patient?
What is the pathogenesis of this disorder?
What additional information assists in making the diagnosis?
What are treatment strategies for this patient?
What education would the provided to the patient and mother?
REMOVE SCENARIOS TO REDUCE TURNIT IN SCORE. ANSWER QUESTIONS WHILE USING OWN WORDS AND REFERENCING FROM THE TEXT BOOK TO BACK UP ANSWERS. ONLY USE TEXT: Dlugasch, L. & Story, L. (2019). Applied pathophysiology for the advanced practice nurse (1sed.). Jones & Bartlett.
