Diagnosis and Management of Hematologic and Metabolic Disorders.

Diagnosis and Management of Hematologic and Metabolic Disorders

Case Study 2:
Jimmy is a 3-year-old “picky” eater according to his mother. He refuses to eat anything but waffles for breakfast and macaroni and cheese or chicken nuggets for lunch and dinner. He will eat apples and bananas but refuses all vegetables except corn. After a normal physical examination, you obtained blood testing that revealed the hemoglobin is 11.4 mg/dl and his hematocrit is 30% (both obtained by venipuncture). The CBC revealed microcytic hypochromic RBCs.
To prepare:
• Review “Endocrine and Metabolic Disorders” and “Hematologic Disorders” in the Burns et al. text.
• Review and select one of the three provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.
Please address the following in bold topics referring to the above case study
an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why.
Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis.
Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments.
Finally, explain strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

Readings
• Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care(5th ed.). Philadelphia, PA: Elsevier.
o Chapter 25, “Endocrine and Metabolic Disorders” (pp. 529–556)

This chapter examines components of the endocrine system and metabolic function. It also explores the pathophysiology, assessment, and management of endocrine and metabolic disorders in children.
o Chapter 26, “Hematologic Disorders” (pp. 557–584)

This chapter explores the formation of blood including its cellular and fluid components: erythrocytes, leukocytes, and plasma. It also examines assessment and management strategies for treating hematologic disorders resulting from erythrocyte, platelet and coagulation, and leukocyte abnormalities.
• American Academy of Pediatrics, Subcommittee on Hyperbilirubinemia. (2004). Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics, 114(1), 297–316. Retrieved http://pediatrics.aappublications.org/content/114/1/297.full?sid=cc35023c-502d-474a-9856-bfb5e38eed54

This article provides guidelines for the prevention and management of hyperbilirubinemia in newborn infants of 35 or more weeks of gestation. It describes the health care provider’s role in promoting successful breastfeeding, performing a systematic assessment, following up with patients at risk, and providing appropriate treatment to patients diagnosed with the condition.