Discussion 1
A 17-year-old African American female presents to the family nurse practitioner with symptoms of musculoskeletal pain, fatigue, and a facial rash. On physical exam, her vital signs are normal, she is thin but not underweight for her height, and malar skin changes are noted.
1. What further assessment would the nurse practitioner need?
2. What is the pediatric immunologic or rheumatologic diagnosis?
3. What are some differential diagnoses to consider?
4. What imaging and labs are indicated to confirm your diagnosis?
5. What are the non-pharmacological and pharmacological treatment plans?
6. What education and risk information will be beneficial for the patient and his parents?
7. What will be the follow up and possible referral options?
Discussion 2
A 4-year-old child presents to the primary care clinic with a history of several weeks of limping. The parents do not recall any specific injury or recent infections. They have noted swelling of the left knee, but it did not seem particularly painful. There is stiffness in the early morning hours that improves as the day progresses. There have not been any fevers, rashes, or other symptoms.
1. What further assessment would the nurse practitioner need?
2. What is the pediatric immunologic or rheumatologic diagnosis?
3. What are some differential diagnoses to consider?
4. What imaging and labs are indicated to confirm your diagnosis?
5. What are the non-pharmacological and pharmacological treatment plans?
6. What education and risk information will be beneficial for the patient and his parents?
7. What will be the follow up and possible referral options?
