CLINICAL GROUP C

REMEDIOS TRINIDAD ROMUALDEZ MEDICAL FOUNDATION

COLLEGE OF NURSING
TACLOBAN CITY

NCM 109-RLE
CASE SCENARIO RELATED TO CARE OF CHILD WITH INFECTIOUS DISEASE

CASE SCENARIO:

Vincent a 6 -year-old child develops a sizeable and painful swollen at the back of his neck. Based on his
mother, “the swollen site is painful and large enough that it causes him considerable discomfort when he
tries to put on or change clothing. A mild fever adds to the child’s discomfort, so his mother decided to
seek walk-in consult in the clinic for advice”.

Upon examination, Vincent’s vital signs are normal, except for increased body temperature (38.1ºC). The
swollen area on his neck is located at the hairline and measures 2.4 x 3.7 cm. The center of this area is
somewhat soft to the touch and appears to contain a substantial amount of pus. The overall appearance of
the swollen area is that of an unusually large pustule surrounded by a distinct rash.

Furthermore, the mother of child is asked about his medical history. She remembers that, several days
ago, she noticed some minor irritation surrounding the hair follicles in the area that is now swollen.
Except for occasional appearances of boils on his skin over the past few years, other than that the child
has enjoyed very good health.

The doctor prescribed mupirocin ointment to treat the affected site and mefenamic acid syrup 250mg/5ml
5 mL or 1tsp prn for pain. The child then advised for CBC and Urinalysis for further evaluation.

The following LABORORATORY RESULTS:

COMPLETE BLOOD COUNT (CBC) URINALYSIS

Result Results
WBC 15,000/ul Appearance clear
RBC 4.7 million/ul Color yellow
Hgb 12 g/dl Odor aromatic
Hct 38% pH 6.0
WBC Differential: Protein negative
Neutrophils 60% Specific Gravity 1.005
Lymphocytes 30% Glucose negative
Monocytes 5.2% Casts none
Eosinophils 3% Pus cells few
Basophils 1% WBC 0-1
Platelet Count 320,000/mm3 RBC 0-1

QUESTIONS:

1. Based on the given scenario, identify the priority signs and symptoms.
a. Elevated temperature (38.1 degrees Celsius)
b. Large pustule that measures 2.4 x 3.7 cm surrounded by distinct rash
c. Painful swollen at the back of the neck

2. What is the medical diagnosis/differential diagnosis based on the presented signs and symptoms
of the patient?
- Furuncle (boil)

3. Interpret the laboratory and diagnostics results with clinical significance.

4. Using a concept map, explain the pathophysiology of the specific condition correlating the
diagnostic/laboratory results and pharmacological management. (Note: Submit also a narrative
pathophysiology explaining the concept map).
5. Based on the treatment modalities prescribed by the physician, make a pharmacological study of
the specific medications.
CLINICAL GROUP C

6. Based on the priority problems presented in the case scenario, Formulate 3 priority nursing care
plan.