Scenario 1

Question

You are employed in a pediatrician’s office. A young, first-time mother calls the office crying
because her toddler is complaining of a sore throat and headache and has nasal drainage with
a cough that worsens at night. She is afraid he is going to quit breathing and die. She wants to
know what to do.
1. What should you ask the mother before responding?
2. Is this child going to need to be seen?
3. What should you advise the mother?
Scenario 2
An older patient calls to complain of a high fever, muscle aches, a headache, and chills. They
think they are getting the flu. They stated they had a flu shot about nine months ago, even
though they did not want it, and they are not supposed to get sick.
1. Should you take their self-appraisal of their condition without further question?
.
2. How would you explain to them the nature of the flu vaccine and its effectiveness?

Answer 1

Scenario 1

1. What should you ask the mother before responding?

   • I would ask the mother several questions to gather more information, including:
     • How old is your toddler?
     • When did the symptoms first appear?
     • Is the toddler having any difficulty breathing or wheezing?
     • Is there a fever, and if so, what is the temperature?
     • Has the child been eating and drinking normally?
     • Are there any other symptoms (e.g., rash, vomiting, ear pain)?
     • Has the child been exposed to anyone with a similar illness recently?

2. Is this child going to need to be seen?

   • Given the symptoms of sore throat, headache, nasal drainage, and a worsening cough at night, combined with the mother’s anxiety about breathing difficulties, it would be prudent to recommend that the child be evaluated by a healthcare professional. If there are signs of respiratory distress or worsening symptoms, a same-day visit or an urgent evaluation may be essential.

3. What should you advise the mother?

   • I would advise the mother to:
     • Monitor her child's symptoms closely.
     • Keep the child hydrated and comfortable, providing clear fluids as tolerated.
     • Use a humidifier in the child’s room to help with cough and nasal drainage.
     • Use age-appropriate over-the-counter medication (with pediatrician approval) to relieve discomfort like fever or headache.
     • If the child shows difficulty breathing, has a high fever that does not respond to medication, appears very lethargic, or has worsening symptoms, she should seek urgent medical attention.

Scenario 2

1. Should you take their self-appraisal of their condition without further question?

   • No, I would not take their self-appraisal at face value. It is important to ask additional questions to better understand their symptoms, medical history, and any potential complications. Inquire about:
     • How high is their fever?
     • When did the symptoms start, and how severe are they?
     • Have they experienced nausea, vomiting, or other symptoms?
     • Do they have any chronic health issues or take any medications that might affect their immune system?
     • Are they experiencing any difficulty breathing or chest pain?

2. How would you explain to them the nature of the flu vaccine and its effectiveness?

   • I would explain that the flu vaccine is designed to reduce the risk of contracting the flu virus and can help lessen the severity of illness if they do get infected. However, it is not 100% effective, and immunity generally wanes over time, which is why it’s recommended to get vaccinated annually. Additionally, while the vaccine can protect against certain strains of the virus, there may be circulating strains that are not covered by the vaccine, which could lead to illness. It's also important for everyone to practice good hygiene, like washing hands frequently and staying away from sick individuals, to further reduce the risk of illness. If the patient is feeling very unwell, they should consult a healthcare professional for a formal assessment and guidance on managing their symptoms.