Pediatric Nurse At The Local Emergency Department

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I. Background SL, a 4-month-old Caucasian male, accompanied by his 24-year-old mother presented to the ER nurse at the local emergency department. SL’s mother reported he has had a fever, runny nose, coughing, and often wheezing during the past 4 days. With a colicky infant, she noticed a blue color to the skin, and relatively high fever developed during the night prompted her to bring him to the emergency department. SL’s mother stated when he breathes, he sounds funny, which is also accompanied by a barking cough. She has not even given any other thought but that he had developed a simple cold, because he has been exposed to other sick children at his daycare. Once the ER nurse evaluated SL, he had received a referral to a pediatric nurse at Children’s Hospital a few blocks away for further and immediate evaluation in Newborn Intensive Care Unit (NICU). II. Physical and Laboratory Findings On examination, the pediatrician noted SL has an increased respiratory distressed. He observed high fever, widespread expiratory wheeze, and fine crackles. Chest X-rays were taken and inflammation of the bronchioles was confirmed. In addition to the chest X-ray, the pediatrician required three nasopharyngeal specimen collections for viral testing. For this nasopharyngeal collection, the technician inserted sterile cotton tipped swap in the nostril, rotates the swab of the anterior and posterior surface of nasopharynx, withdraws the swab from the collection site and
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