A 4 week old male is brought to the Emergency Department wit…

A 4 week old male is brought to the Emergency Department with a recent history of several projectile non-bilious non-bloody emesis during the last few days. You obtained some labwork and image studies. The lab results show the following: Na =139 mmol/L, K = 3.4 mmol/L, Cl = 94 mmol/L, CO2 = 34 mmol/L. The most likely diagnosis is:

A 12-month-old non-ambulating toddler presents to the ED wit…

A 12-month-old non-ambulating toddler presents to the ED with a spiral fracture of their left tibia/fibula and a bruise on their right cheek. After completion of the primary assessment, appropriate interventions and stabilization, the next diagnostic evaluation should include:

A 10 year old female underwent a laparoscopic appendectomy f…

A 10 year old female underwent a laparoscopic appendectomy for perforated appendicitis with extensive peritonitis. He is currently postoperative day # 2, drinking clear liquids, and taking oxycodone and acetaminophen as needed for pain control. On morning rounds, it is noted that her abdomen is distended and seems more uncomfortable than past exams. The bedside nurse reports that he had one emesis this AM.  What is the most likely finding based on history and physical examination?

You are a PNP in a busy tertiary PICU caring for an 8 year o…

You are a PNP in a busy tertiary PICU caring for an 8 year old admitted for dehydration secondary to feeding intolerance. History includes birth at 24 weeks gestation, cerebral palsy, profound developmental delay and GT dependence. The GI service was consulted and recommended strict NPO for 7-10 days. To provide adequate caloric and nutritional intake, you decide your patient requires total parenteral nutrition (TPN), and subsequently undergoes PICC line placement. The following statements are true regarding this clinical scenario except:

A 3 week old presents to the ED with a 2 day history of poor…

A 3 week old presents to the ED with a 2 day history of poor feeding, decreased urine output, and lethargy. On exam, it is noted that he has a bulging fontanelle. The child was born via spontaneous vaginal delivery and was discharged to home with mom on day 2 of life. In the ED, he was found to have a body temperature of 39.0 C (102.2 F). Before you prepare for a lumbar puncture, you are considering obtaining a CT scan of the head first. Why would this be indicated?