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Chamberlain College of Nursing I Human Case Study: Grady
Turner(18-Month-Old with Cough)Complete SOAP Notes,
History Questions ,Physical Exam & Management Plan 2026
| Updated Questions & Academic Use Only Premium
Section 1: Case Overview & Problem Statement
Case Problem Statement
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Grady Turner is an 18-month-old male who presents to an outpatient clinic with his caregiver for
evaluation of a cough. The clinician must conduct a thorough pediatric history and physical
examination, synthesize clinical findings, formulate an accurate differential diagnosis, and
develop an evidence-based management plan appropriate for a toddler-age patient with a
respiratory complaint.
This i-Human Basic DDx Case Play is set in Test Mode — no feedback is provided after
submitting each section. One attempt is permitted. The learner is expected to apply
developmental knowledge, recognize common pediatric respiratory presentations, and
distinguish between benign and serious etiologies of cough in the toddler age group.
Case Context
Parameter Details
Patient Grady Turner
Age 18 months
Sex Male
Height 2'10" (86 cm)
Weight 28.0 lb (12.7 kg)
Chief Complaint Cough
Setting Outpatient clinic with laboratory capabilities
Case Mode Test Mode — 1 attempt, no feedback after sections
Case Type i-Human Graduate Premium — Basic DDx Case Play
Institution Chamberlain College of Nursing
Learning Objectives
• Conduct a comprehensive pediatric history using age-appropriate and caregiver-directed
interview techniques
• Distinguish common pediatric respiratory conditions: viral URI, croup, bronchiolitis,
reactive airway disease, foreign body aspiration, and pertussis
• Perform a systematic pediatric physical examination with emphasis on respiratory
assessment
• Apply clinical reasoning to formulate a prioritized differential diagnosis in a toddler with
cough
• Develop an evidence-based, age-appropriate management plan with appropriate follow-
up
• Compose a complete SOAP note for a pediatric respiratory encounter
Section 2: Patient Demographics & Vitals
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Parameter Value Clinical Note
Age 18 months Toddler — key developmental stage for foreign
body aspiration risk
Sex Male Males have slightly higher risk for RSV
bronchiolitis and croup
Height 2'10" (86 cm) Assess on growth chart — normal range for 18-
month-old male
Weight 28.0 lb (12.7 kg) Monitor for failure-to-thrive; weight loss with
chronic cough
Temperature To assess Fever suggests infectious etiology
(viral/bacterial)
Heart Rate To assess Tachycardia may indicate respiratory distress or
fever
Respiratory Rate To assess Tachypnea (>40/min in toddlers) = respiratory
distress
SpO2 To assess SpO2 <94% indicates hypoxemia requiring
immediate intervention
Blood Pressure To assess Less critical; assess for hemodynamic stability
Developmental Context — 18-Month-Old
• Motor: Walking independently, beginning to run, climbing stairs with support
• Language: 10-25 words expected; points to objects; follows 2-step commands
• Behavior: Separation anxiety common — caregiver present during exam is essential
• Foreign body risk: PEAK age for aspiration of small objects, food, and toys — always
consider
• Immunization status: Should have received DTaP series (pertussis protection), MMR,
Hib, PCV — verify
Section 3: Chief Complaint & History of Present Illness
Chief Complaint
"Cough" — as reported by caregiver of 18-month-old Grady Turner.
HPI — OLDCARTS Framework
Element Key Questions to Ask Caregiver
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