This week, you are discussing pediatric conditions affecting cardiac, atopic, rheumatic, immunodeficiency, and respiratory system disorders. An important question for NPs is when should you refer? The answer is more about clinical judgment than what the practice guidelines say, although always follow practice guidelines on when to refer as with all else. Remember, even cardiologists have difficulty with things such as distinguishing certain murmurs. You need to be very careful about interpreting tests such as EKGs, echocardiograms, chest films, MRIs, CT scans, etc. Unless you have received formal education in these areas, it is best to refer. Always keep in mind “scope of practice.” Exceptions would be previously diagnosed conditions that are now stable with current treatment.
You are expected to present your initial topic, including, but not limited to, the following items:
- Pathophysiology
- Physical exam findings
- Differential diagnoses and rationale
- Management plan to focus on pharmacotherapy agents based upon evidence-based practice guidelines
Topics:
- Murmurs (innocent and pathologic)
- Asthma
- Infective endocarditis, pericarditis
- Myocarditis
- Cardiomyopathy
- Cardiac dysrhythmias
- Upper respiratory disorders (common cold, rhinosinusitis)
- Pharyngitis, tonsillitis
- Diphtheria, pertussis
- Croup, epiglottitis
- Nonbacterial and bacterial pneumonia
- Cystic fibrosis
- Pectus deformity
- Rashes
- Rheumatic fever
- Systemic erythematosus lupus (SLE)
Any thoughts? Should the NP order any tests or labs before or while waiting for the referral? If so, what are some of these?
Minimum 3 references , please follow all instructions.
