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Tate is a 4-year-old male who is brought to the ER by his mother and father with concerns about coughing and labored breathing. A “barking” cough is noticed and stridor is auscultated when breathing in. The patient has tachypnea, an O2 sat of 90%, and an oral temperature of 102.4°F. The mother states that the patient is up to date on his vaccines. 1. What is your initial diagnosis? 1. List 2 possible differential diagnoses. (Keep the patient’s age in mind.) 1. What is stridor? Why are children more prone to this symptom? 1. When educating the mother before discharging the patient, what teaching should be provided to inform the mom on how to treat stridor at home if the patient develops this symptom again?

User Myaaoonn
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Initial diagnosis: Viral croup.

Differentials: Epiglottitis, foreign body aspiration.

Stridor is noisy breathing; children prone due to narrower airways.

Home treatment: Cool mist, fluids, upright position, seek medical help for worsening stridor.

Based on Tate's symptoms, the initial diagnosis is likely croup, specifically viral croup.

This is supported by the characteristic barking cough, stridor on inhalation, tachypnea, and the presence of fever.

Although the patient is up to date on vaccines, croup is often caused by viruses, such as parainfluenza virus, which may not be preventable through vaccination.

Two possible differential diagnoses to consider in a 4-year-old with cough and stridor include epiglottitis and foreign body aspiration.

Epiglottitis presents with a sudden onset of high fever, sore throat, and drooling, while foreign body aspiration may occur after the child inhales a small object.

Stridor is a high-pitched, noisy respiratory sound caused by turbulent airflow due to partial obstruction of the upper airway.

Children are more prone to stridor because their airways are narrower and more easily obstructed, and they can be particularly susceptible to swelling of the larynx and trachea, as seen in croup.

When educating Tate's mother, it is important to provide instructions on how to manage stridor at home.

She should be advised to use a cool mist humidifier to help soothe the airways, encourage fluid intake to prevent dehydration, and keep Tate in an upright position to ease breathing.

If stridor worsens or if there are signs of respiratory distress, such as retractions or increased work of breathing, immediate medical attention should be sought.

Additionally, reassuring the mother about the self-limiting nature of viral croup and the importance of seeking medical care if needed will be crucial for her understanding and confidence in managing Tate's symptoms at home.

User Vinaut
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