Reference no: EM133444252

Prompt:

AM. is a 3-year-old female, in daycare AM was in her normal state of health until 3 days ago when she came home from daycare with a mild runny nose. Her mother notes that over the past 3 days the nasal drainage has increased, she has developed a cough, and sore throat, her voice has changed, and last night she had a low-grade fever (tactile) when she came home from day care. During the night she woke with up crying and hot, mom noted that her temperature was 103.1 (taken under her arm) and she gave her Motrin (7 ml), and she was restless but went back to sleep. This morning the child woke up later than normal, has not had her normal energy, has had about 2 ounces of milk, no food intake today, she is irritable and just wants to be held. Nasal drainage stated as clear but today was yellow and thick, she is needing help blowing her nose, her nose is red and irritated, and when mom tried to wipe her nose the child deflects and runs to the chair in the clinic.

Mom called the clinic this morning for a sick visit. The temperature came down some after the Motrin, but the child feels hot again at time of visit. No vomiting or diarrhea with these symptoms. No rash.

AM has been in daycare since she was 6 months, but in the past month had to move to a new day care (one that will eventually take all 3 children in the family), since the day care move mom has noted regression, more baby talk, she bit someone recently at school.

AM has is up to date per the mom on her immunizations (for her age), has never been hospitalized, no surgeries, does not take medications routinely, and has no allergies. AM was seen in clinic 2 months ago for her 3-year-old well child and has had routine well exams since birth in this clinic and intermittent sick concerns, mainly respiratory in nature, and one visit for a fall.