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Fever in child
HISTORY:
Fever for
days
Up to:
°
not measured
,
persistent
intermittent
Treatments tried:
none
acetaminophen
ibuprofen
,
effective
ineffective
cough
sputum
runny nose
sore throat
shortness of breath
Additional symptoms:
chest pain
headache
fatigue
irritability
rash
decrease in fluid intake
decrease in urine ouput
decrease in appetite
nausea
vomiting
diarrhea
abdominal pain
dysuria
frequency
foul-smelling urine
flank pain
Other elements:
daycare
similar symptoms in close contacts
recent travel
recent upper respiratory infection
recurrent ear infections
asthma
premature birth
recent antibiotics
Vaccination status:
up-to-date
incomplete
unvaccinated
EXAM:
General appearance:
well-appearing
Vital signs:
normal
,
BP
,
HR
,
RR
,
SpO2
%
,
Temp
°
Head:
fontanelles
soft
,
normocephalic
Eyes: -R:
normal
, -L:
normal
,
Ears: -R:
normal
, -L:
normal
Nose:
clear
,
nasal flaring
,
discharge
clear
,
Throat:
normal
Mouth:
normal
Neck:
normal
Heart:
RRR
,
normal S1 and S2
Lungs:
clear
,
retractions
Abdomen:
soft
,
non-tender
,
non-distended
,
Genital:
normal
,
testicles
normal
,
penis
normal
,
Tanner stage
Extremities:
normal
,
normal pulses
,
cap refill
< 3 sec
> 3 sec
Skin:
no rash
Musculoskeletal:
joints
normal
,
no limited ROM
ASSESSMENT:
Viral illness
likely
suspected
possible
DDx:
PLAN:
- Chest X-ray
- Covid test
- Throat swab
- Urine culture
- Blood work:
CBC
,
CRP
,
blood culture
-
Acetaminophen (Pediatric)
-
Ibuprofen (Pediatric)
- Encourage hydration
- Antibiotics
if bacterial infection suspected
- Follow-up in
hours
days
- Return if fever persists for more than 3 days, if new symptoms develop, or if condition worsens
- Referral to pediatrician if no improvement after 72 hours
- Go to ER if seizures, severe headache, stiff neck, or other signs of serious illness occur