Lipschutz Ulcers in an Adolescent After Sars-CoV-2 Infection.

This case report describes a 15-year-old female who presented with acute onset of painful genital ulcers. She denied being sexually active and tested positive for severe acute respiratory coronavirus 2 five days prior. Associated symptoms on days 1 to 3 included fatigue, nausea, headaches, and fever. Lipschutz ulcers (LUs), also known as aphthous ulcers, acute genital ulcers, and acquired genital ulcerations; are an uncommon, self-limiting, nonsexually transmitted condition characterized by the rapid onset of painful, necrotic ulcerations of the vulva or lower vagina. The pathogenesis of LUs is unclear, and the diagnosis is one of exclusion.

Necrotizing Enterocolitis in a Term Newborn: A Case Report.

This case report describes a 5-day-old term infant with necrotizing enterocolitis (NEC). The clinical presentation, diagnostic reasoning, current literature, hospital course, and follow-up are discussed. Necrotizing enterocolitis is a gastrointestinal emergency characterized by severe inflammation and ischemic necrosis of the intestinal mucosa. Usually a condition of prematurity, NEC primarily occurs in very low birth weight premature infants. Necrotizing enterocolitis can be managed medically or surgically, depending on the severity. Although the etiology of NEC is unknown, the clinical presentation includes abdominal distention and tenderness, feeding intolerance, grossly bloody stools, and severe hypotension and acidosis.

Button Battery Ingestion: A Case Report.

This case report describes a 17-month-old child with ingestion of a button battery. The clinical presentation, diagnostic reasoning, national guidelines, hospital course, and follow-up are discussed. Between 1995 and 2015, an estimated 759,074 children aged < 6 years were seen in emergency departments for suspected or confirmed foreign body ingestions, representing a 93.3% increase in cases . The most common objects ingested were coins, toys, jewelry, and batteries. The most common battery ingested was a button battery. Although 80% to 90% of ingested foreign objects pass without intervention, a button battery positioned in the esophagus is an emergency requiring immediate removal.

Unintentional Cocaine Exposure and Brugada Syndrome: A Case Report.

This case report describes a 16-month-old child with an accidental ingestion of cocaine. The clinical presentation, diagnostic reasoning, hospital course, and subsequent follow-up are discussed in this report. In 2018, there were 2.1 million human poison exposure calls to U.S. Poison Control Centers, with the highest incidence of calls for children aged 1-2 years. The substances with the largest number of deaths across all age groups included sedatives, sleeping medications, stimulants, street drugs, opioids, and alcohol. The child in this case report is a male who presented to the emergency department with altered mental status. When his urine drug screen resulted positive for cocaine, a social service consult was initiated, and the child was admitted to the intensive care unit for monitoring and supportive care. His electrocardiogram showed a Brugada rhythm. This case report highlights the incidence of accidental drug ingestions by children and a rare but potentially fatal cardiac arrhythmia.

Identifying the Preferred Method to Educate Low Income Caregivers About Common Childhood Illnesses: A Step Toward Health Literacy Through a Focus Group Study.

PURPOSE: The purpose of this focus group was to identify the preferred method of education for low-income caregivers to learn about common childhood illnesses in an effort to meet their health literacy needs. METHODS: Focus group participants were recruited from two sources; caregivers who qualified for Women, Infants, and Children (WIC) Food and Nutrition Services and those attending a monthly prenatal health education program for low-income pregnant women. Participants were asked to rank in order of preference five educational options. The five options included a commonly used diagnosis-specific handout, a booklet of the most common childhood illnesses and symptoms, a comprehensive book of common childhood illness and symptoms, a 24-hour nurse call line, and a mobile application developed by the American Academy of Pediatrics. All options provided accurate information from professional sources. RESULTS: The ranking of the five educational options identified the mobile application developed by the American Academy of Pediatrics, KidsDoc, to be the preferred method with the commonly used diagnosis-specific handout as the least favorite option. CONCLUSION/PRACTICE IMPLICATIONS: The United States Department of Health and Human Services (USDHHS) has identified a need to change the way health information is designed and delivered. Identifying that materials should be redesigned using best practices to reduce health literacy demands and match consumer preferences, the USDHHS calls for periodic testing of materials with the intended consumers. This focus group provides valuable information and a step toward future research to address health literacy using materials identified by low-income consumers.

Nonurgent Use of the Emergency Department by Pediatric Patients: A Theory-Guided Approach for Primary and Acute Care Pediatric Nurse Practitioners.

Providing quality, cost-effective care to children and their families in the appropriate setting is the goal of nurse practitioners in primary and acute care. However, increased utilization of the emergency department (ED) for nonurgent care threatens cost-effective quality care, interrupts continuity of care, and contributes to ED overcrowding. To date, descriptive research has identified demographics of those using the ED for nonurgent care, the chief complaints of children seeking nonurgent care, the cost to the health care system of pediatric nonurgent care, and characteristics of associated primary care settings. Using Donabedian's Model of Quality of Healthcare and a Theory of Dependent Care by Taylor and colleagues, acute and primary care pediatric nurse practitioners can incorporate interventions that will channel care to the appropriate setting and educate caregivers regarding common childhood illnesses and the value of continuity of care. By using a theoretical framework as a guide, this article will help both acute and primary care pediatric nurse practitioners understand why parents seek nonurgent care for their children in the ED and actions they can take to ensure that care is provided in an optimal setting.