Question

Mom has described her child's symptoms as fever for 3 days, and vomiting for the last 24 hours. She states the child has been very sleepy for the last 2-3 hours. What subtle symptom alerts the nurse that this child needs to be seen as soon as possible?

1) 3 days of fever
2) 3 days of fever, 1 day of vomiting
3) 1 day of vomiting
4) very sleepy for 2-3 hours with fever for 3 days

Answer 1

The most concerning symptom requiring immediate medical attention is the child being very sleepy for 2-3 hours combined with a 3-day fever, suggesting a risk of serious conditions like dehydration or central nervous system issues.

The subtle symptom that suggests this child needs to be seen as soon as possible is being very sleepy for 2-3 hours with a fever for 3 days. This could indicate a serious condition such as dehydration, electrolyte imbalance, or even central nervous system involvement requiring immediate medical attention.

The presence of vomiting further exacerbates the risk of dehydration. Combined with the fever duration, this could signal a more serious infection or illness that is potentially life-threatening if not treated promptly.

So, the combination of prolonged fever, recent onset of vomiting, and the child being unusually lethargic or sleepy, necessitates urgent medical evaluation to rule out severe illnesses such as meningitis or encephalitis, and to provide appropriate care.