Data Collection Case Study
Data Collection Worksheet: Pediatric Case Study
Failure to thrive.
SSG Alsawalha, Musab
1. Client Demographics
a. Age: 11 months
b. Gender: Male
c. Marital Status/Significant others: Single,
d. Primary Language: English
e. Religion: Baptist
f. Barriers to care:
i. Noted in home life, past medical history, social history: Patient barriers to care all revolve around the parents neglect to medical treatments needed for the patient. ii. Developmental Stage: Trust vs Mistrust.
g. Other: Patient is under the care of child protective services currently.
2. Client History
a. Chief complaint: Hyponatremia, failure to thrive (FTT).
b. Admitting Diagnosis: Hyponatremia, failure to thrive.
3. Past Medical History/Hospitalization
a. Past Medical History: Patient admitted to UVA hospital in June/July 2016 for failure to thrive. Patient also has a history of eczema, food allergies, weight loss, chronic diarrhea, and gross motor delay.
b. Past Surgical History: None
c. Allergies: Adhesive tape, propofol, soy, all nuts, eggs, gluten, and milk-protein.
d. Family History: Patient is one of 9 children, father is active duty Navy captain, and mother has refused medical …show more content…
Review of Normal A&P: The lower GI tract consists of the small intestine, large intestine, rectum, and the anus. The small intestine is made up of three parts the duodenum, jejunum, and the ileum. The duodenum is where the digestive enzymes and bile mix together. The enzymes break down protein and bile. The jejunum is the midsection of the small intestines and it contains villi which increases the surface area of tissue available to absorb the nutrients. The ileums function is to absorb any products of the digestions proves that were not absorbed by the jejunum such as bile salts, and vitamin B12. Any material such as waste, water, and electrolytes left behind moves into the large intestines where the main function is to absorb vitamins, and water, and to convert the digested food in to
Failure to thrive.
SSG Alsawalha, Musab
1. Client Demographics
a. Age: 11 months
b. Gender: Male
c. Marital Status/Significant others: Single,
d. Primary Language: English
e. Religion: Baptist
f. Barriers to care:
i. Noted in home life, past medical history, social history: Patient barriers to care all revolve around the parents neglect to medical treatments needed for the patient. ii. Developmental Stage: Trust vs Mistrust.
g. Other: Patient is under the care of child protective services currently.
2. Client History
a. Chief complaint: Hyponatremia, failure to thrive (FTT).
b. Admitting Diagnosis: Hyponatremia, failure to thrive.
3. Past Medical History/Hospitalization
a. Past Medical History: Patient admitted to UVA hospital in June/July 2016 for failure to thrive. Patient also has a history of eczema, food allergies, weight loss, chronic diarrhea, and gross motor delay.
b. Past Surgical History: None
c. Allergies: Adhesive tape, propofol, soy, all nuts, eggs, gluten, and milk-protein.
d. Family History: Patient is one of 9 children, father is active duty Navy captain, and mother has refused medical …show more content…
Review of Normal A&P: The lower GI tract consists of the small intestine, large intestine, rectum, and the anus. The small intestine is made up of three parts the duodenum, jejunum, and the ileum. The duodenum is where the digestive enzymes and bile mix together. The enzymes break down protein and bile. The jejunum is the midsection of the small intestines and it contains villi which increases the surface area of tissue available to absorb the nutrients. The ileums function is to absorb any products of the digestions proves that were not absorbed by the jejunum such as bile salts, and vitamin B12. Any material such as waste, water, and electrolytes left behind moves into the large intestines where the main function is to absorb vitamins, and water, and to convert the digested food in to