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Cardiovascular and Hematologic Disorders in Children Essay

How to evaluate and manage a pediatric patient with chest pains

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There are two steps involved in assessing a pediatric patient with chest pains. Whereas the first step includes the analysis of the history of the patient, the second step involves the carrying out of a physical examination. Concerning the interpretation of the history of the child, the medical officer will concentrate on the description of the chest pain with a focus on the duration and severity. Besides, the history of past medical conditions and treatments will be carried out, specifically looking out for cases of the cardiac disease, sickle cell disease, and other related medical conditions (Friedman et al, 2011). Also, it will also look at the past medical surgeries especially on the chest and the abdomen. Family history, genetic disorders and history of trauma will also be examined.

Concerning the physical examinations, the process will begin with an analysis of vital signs and the anthropometric measures. It should check out for fever and tachypnea which are intended at finding out the various body reactions that may be affecting the health of the child especially lung disorder. The medical personnel should also look at the facial abnormality and also the shape of the lens. Finally, there should be a visual inspection of the chest wall to look out for any abnormities

The recommended diagnostic studies for the patient

The suggested diagnosis for the patient is the probability diagnosis (Thull-Freedman, 2010). The main advantage of the diagnosis is that the severe disorders are not to be missed. Besides, it is a diagnosis that does not require much expertise to carry out. However, it has pitfalls since some conditions may be missed by the exercise.

Referring a patient to a specialist

It is important to submit the patient to a medical specialist in case the pains are persistent in spite of the efforts that have been put in place to control it.

The differential diagnostic for a pediatric patient with a murmur depending on the patient’s age

It is prudent to carry out different diagnostic procedures depending on the circumstances and the facts of each case. In a case where the patient in question has a murmur, it means that there is a lack of expression. That implies that the patient is not in a position to communicate the feelings. That would make it difficult for the examining officer to determine what is ailing the patient. For examples, if the chest is painful, it is necessary to identify which side is affected and the extent to which it hurts. In such circumstances, therefore, it is prudent to come up with a different diagnosis standard that will not involve the participation of the patient since they will not be able to express themselves.

The primary reason for developing a different diagnosis method is to ensure that the diagnosis is as accurate as possible and is in tandem with the prevailing conditions. However, if a single methodology would be used in all the age groups, then the results of the diagnosis may not be accurate, and this may lead to misdiagnosis. The result may be a loss of life or even further complication of the condition.

The definition of a pediatric patient with an abnormal bruising

Children may get bruised for some reasons. They may occur as a result of different reasons. It may be due to their playful nature or accidents at whichever place. However, bruises can be categorized as either normal or abnormal. An abnormal bruising can be defined as that type of bruising that leads to unusual blood loss or that which is out of proportion. A typical bruise should always result in minimal or reasonable bleeding, and that should always stop in a short while. However, it becomes abnormal when the flow continues in a prolonged manner and is not even proportional with the injury caused (Pierce et al, 2010). The primary cause of unusual bruising is the hemostatic disorders that have a bearing on the kind of diagnosis being applied to a particular case.

The diagnostic testing for abnormal injury among children

Some diagnostic testing procedures can be conducted. The testing being used should be in tandem with the nature of the injury as observed by the medical officer. However, among children, the most recommended test is the diagnosis of exclusion. The determination is made on the basis that the patient is well and lacks thrombocytopenia or lymphadenopathy. The bruise should present a normal blood clotting and coagulation screen (Nock et al, 2006). The investigations should include analysis of the bone marrow. Of more important, however, is the insistence on careful analysis of the blood film and parental blood counts.

The central reason for using this kind of testing is that it excludes some of the rare conditions that may also lead to that kind of abnormal bleeding. It is necessary that the process involved tries to uncover as many possible causes as possible. The exclusion diagnosis procedure is straightforward and able to identify some of the hidden causes of bleeding.

The physical exam findings and diagnostic results that would be of concern

The physical exam finding that would be of interest is the effect on the test screen. The display would indicate the kind of clot. Abnormal blood clotting in the display would form the foundation of all the other subsequent stages in the examination. Therefore, the first observations need to be reliable if the solutions are to be determined.

References: Cardiovascular and Hematologic Disorders in Children Essay

Friedman, K. G., Kane, D. A., Rathod, R. H., Renaud, A., Farias, M., Geggel, R., … & Saleeb, S. F. (2011). Management of pediatric chest pain using a standardized assessment and management plan. Pediatrics, 128(2), 239-245.

Nock, M. K., Joiner, T. E., Gordon, K. H., Lloyd-Richardson, E., & Prinstein, M. J. (2006). Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry research, 144(1), 65-72.

Pierce, M. C., Kaczor, K., Aldridge, S., O’Flynn, J., & Lorenz, D. J. (2010). Bruising characteristics discriminating physical child abuse from accidental trauma. Pediatrics, 125(1), 67-74.

Thull-Freedman, J. (2010). Evaluation of chest pain in the pediatric patient. Medical Clinics of North America, 94(2), 327-347.

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