FNP_NR511_Week 2_SNAPPS_Oral Presentation ALL ANSWERS 100% CORRECT FALL-2021 SOLUTION AID GRADE A+

5-year-old female presents to the clinic complaining of a headache, runny nose, cough and congestion. Onset of symptoms 3 days ago and is now getting worse. The headache is constant. She describes the headache as throbbing mostly, but at times stabbing (mostly behind her eyes) and rates it at a 5/10 using the NPRS. Nose runs mostly at night, and has clear drainage. She states that during the day she is very stopped up, and that she has trouble breathing or smelling anything. Aggravating factor is laying down, alleviating factor is medication. Mom has given her Tylenol, and Motrin for pain which did help some, but doesn’t last all day. Associated symptoms include mild sore throat, discomfort felt in both ears and nasal area, a intermittent cough and low grade fever of 99-100 degrees F. past medical history includes getting tubes placed 1 yr ago due to frequent ear infections. General- febrile Head: forehead and maxillary sinuses are tender to touch Eyes: pink conjunctiva and white sclera Ears: pearly gray bilaterally Nose : nasal mucosa is pale an boggy, slight edema noted to bridge of nose and bilateral cheeks Throat: posterior pharynx has mild erythema, uvula is midline, tonsils 2 + bilaterally, tonsillar lymph nodes palpable, but fluctuate. neck- supple no palpable masses upon palpation Resp: lung sounds clear bilaterally throughout HEART: Stills murmur heard, 2/6 vibratory to the apex- new finding ABD- denies any abdominal symptoms upon examination Musculoskeletal- denies any back, muscle or joint pain Neuro- denies any bowel or bladder incontinence PE: Head: forehead and maxillary sinuses with tenderness to touch Nose : nasal mucosa is pale an boggy, slight edema noted to bridge of nose and bilateral cheeks Throat: posterior pharynx has mild erythema, uvula is midline, tonsils 2 + bilaterally, tonsillar lymph nodes palpable, but fluctuate.