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Differential diagnoses and pediatrics

Differential diagnoses and pediatrics

After reviewing the readings and overview, discuss the significance of understanding the following items in relation to clinical practice as an advanced practice nurse. Consider the following two situations in addressing your assigned roles:
Patient A: A 32-year-old Asian American construction worker visits his primary care physician with a 2-inch cut on the anterior aspect of his right hand. He lacerated his hand while fixing a barbed-wire fence 5 days ago. He told his wife that he did not have time to go to his primary care provider for such a small cut. The primary care provider noted the wound bed to be erythemic, swollen, and with a small amount of purulent greenish drainage on the Band-Aid the wife had placed on cut. The patient had an oral temperature of 100°F. The primary care provider cleaned the wound, applied a clean dressing, administered Tdap, and called in a prescription for 10 day-courses of an antibiotic.
Patient B: A 5-year old was playing on his family’s farm when he accidentally tripped over a fallen fence suffering a similar injury as the first patient. This child suffered a 2-inch cut to the anterior aspect of his right hand. His father cleaned the wound, covered the site, and made an appointment for the following week (about 3 days later) to see the pediatrician. The pediatrician examined the wound and noted the wound bed to be erythemic, swollen, and with a small amount of purulent drainage on the Band-Aid the father had placed on the cut. The patient had an oral temperature of 100°F. The primary care provider cleaned the wound, applied a clean dressing, administered dTAP, and called in a prescription for 10 day-course of an antibiotic.
In your post please answer these questions based on each of the patients above:
1. Identify some potential concerns based on the findings of the wounds for each patient and provide a rationale for the healthcare provider’s treatment choices. Include the mechanism of wounds healing in your discussion.
2. In addition, briefly discuss each individual’s risk for shock and what type of shock he is at most risk for based on the information presented.
Explain your rationale for your choices, citing resources from the literature.
3. What are further assessment findings that you would expect to find on inspection of each patient? Discuss the risk factors for the development of shock in this individual.
4. What are the corresponding potential differential diagnoses that you would prioritize based upon these findings? Explain your rationale for selecting differential diagnoses, using evidence from the literature.
5.Discuss the pathophysiology issues that must be addressed due to changes at the cellular level.
Discussion should be about 2 paragraphs for each question and ANSWER/address all the questions.

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