What Should the Nurse Do?
Maria, a six-year-old female, has been brought to the pediatric clinic by her parents. Maria’s parents express concerns about her social interactions and repetitive behaviors. Maria presents with limited eye contact, challenges in verbal communication, and resistance to changes in routine. Her medical history indicates that Maria was born full-term without complications. Vital signs are heart rate of 90 beats per minute, respiratory rate of 24 breaths per minute, blood pressure of 90/60 mmHg, and oral temperature of 98.6°F (37°C). Maria’s parents report that they have been feeling overwhelmed and are seeking guidance on how to best support their daughter.
1
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What behavioral cues or observations in Maria’s interactions and routines might indicate potential challenges related to autism spectrum disorder?
2
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What specific steps should a nurse take to collaborate with Maria’s family in addressing their concerns and providing support for Maria’s potential diagnosis of autism spectrum disorder?
Aaron, an eight-year-old male, is brought to the pediatric clinic by his parents. They express concerns about his behavior, noting that he struggles to stay focused in school, is easily distracted, and has difficulty completing tasks. Aaron’s teacher has also reported impulsive behavior and challenges with peer interactions. His medical history reveals no significant issues, and vital signs are within normal limits (heart rate of 90 bpm, respiratory rate of 20 breaths per minute, blood pressure of 110/70 mmHg, and temperature of 98.6°F).
3
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How should a nurse distinguish between ADHD-related symptoms and potential underlying issues, such as anxiety or learning disabilities, during the analysis of ’Aaron’s cues?
4
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What steps should a nurse take to collaborate with Aaron’s parents and teachers to implement the family plan, and how would a nurse ensure its integration into both home and school settings?
Layla, a ten-year-old female, is brought to the pediatric clinic by her parents for her annual checkup. They express concerns about Layla’s academic performance, noting persistent difficulties in reading and writing. Layla exhibits frustration and avoidance behaviors when confronted with school-related tasks. Her medical history indicates no significant health issues, and vital signs are within normal limits at the visit: heart rate of 85 bpm, respiratory rate of 18 breaths per minute, blood pressure of 110/70 mmHg, and temperature of 98.7°F.
5
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What specific behaviors and expressions of frustration exhibited by Layla may be indicative of a potential specific learning disorder, and how do these cues differ from age-appropriate academic challenges?
6
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Considering Layla’s symptoms, what are the primary hypotheses for her academic challenges, and how would you prioritize them to guide further assessment and intervention?
Andrew is an eight-year-old male whose parents contacted the pediatrician to express concern about his unusual behaviors. The primary symptoms that Andrew is experiencing are repetitive, sudden, involuntary movements and sounds. These symptoms have been happening for about a year. There is no family history of any neuropsychiatric conditions. Andrew is an only child who does well in school. Recently, the tics have begun to affect his concentration and classroom participation.
7
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What additional information would the pediatrician need to know in order to confirm a diagnosis?
8
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What might Andrew’s teacher suggest to implement at school to support his education?
9
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What information could a nurse provide to Andrew’s parents to help them manage Andrew’s condition?