Case Study: Lateefah Marcos
Scenario:
A mother of a 2-month-old infant named Lateefah reports to the urgent care center.
Lateefah’s mother reports that Lateefah has been crying since she picked her up from day care
over 1 hour ago.
The nurse reviews Lateefah’s past medical history. Lateefah was a term vaginal delivery.
Her birth weight was 7 pounds (3.18 kg). Lateefah had a hepatitis B vaccination (HBV) in the
nursery and is scheduled for her 2-month well checkup next week. Lateefah’s weight today is 10 pounds (4.54 kg). Her rectal temperature is 99.3°F (37.4°C), respirations are 30 per minute, and heart rate is 120 beats per minute.
The nurse notes that Lateefah’s anterior fontanel is flat and pulsatile. Both pupils have a
bright red flex. Her nares are patent bilaterally and oral pharynx is moist and clear. Lateefah’s
neck is supple without lymphadenopathy.
Her heart rate is regular without murmur and her lungs are clear anteriorly and
posteriorly. Lateefah’s abdomen is nontender with active bowel sounds in all four quadrants.
There is no hepatosplenomegaly noted on physical exam.
One extra thigh fold is noted in Lateefah’s left lower extremity. Lax hip joints are also
noted. Lateefah cries when the nurse moves her lower extremities.
Lateefah’s skin is clear without bruising or swelling. Her last bowel movement was this
morning and it was soft and formed. Lateefah’s mother reports that Lateefah is urinating
regularly with a wet diaper reported with each bottle. Lateefah’s formula is a commercially
prepared formula with iron and she takes approximately 4 ounces every 3 to 4 hours while awake and during the night.
At the urgent care center, the physician orders a full skeletal x-ray. The results of the xray
reveal a healed fracture of a rib and the right ulna. In addition, Lateefah’s left femur is
fractured. A plaster of Paris cast is applied to Lateefah’s left leg. The physician suspects
osteogenesis imperfecta and will admit Lateefah to the hospital for further testing.
Critical Thinking Questions
1. Why is it important for the nurse to assess Lateefah’s sclera? Answers should be 3-4
sentences or no less than 150 words.
2. What laboratory test will the physician order to confirm a diagnosis of osteogenesis
imperfecta? Answers should be 3-4 sentences or no less than 150 words.
3. What are the priority nursing diagnoses at this time? Give at least 5.
4. What are the expected nursing outcomes related to this scenario? Give at least 5.
5. Discuss the nursing interventions related to this scenario.
a) Pain Management – state at least 3 interventions and 3 rationales
b) Cast Care Maintenance – state at least 5 interventions and 5 rationales.
c) Teaching: Disease Process and Infant Safety – state at least 5 interventions and 5
rationales.
6. Discuss the importance of multidisciplinary care in at least,200 words.
PLEASE USE THIS BOOK;
PRINCIPLES OF PEDIATRICS NURSING BY JANE BALL, RUTH BINDLER, KAY COWEN and any other source
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