April 2006, Volume 36 Number 4 , p 88 - 88
CHIOCCA, ELLEN M. RN, C, APN, CPNP, MSN
FOUR-YEAR-OLD PEDRO CHAPA arrives in the pediatric outpatient clinic with his mother. Through an interpreter, Mrs. Chapa says that Pedro was fine until this morning when he developed a fever and sore throat. Now his throat is so sore that he can't swallow, so he's drooling into a tissue. When you ask him how he feels, he can't answer. Pale and anxious, he appears to be focused on breathing. His vital signs are: BP, 102/66; temperature, 103.2° F (39.5° C); pulse, 128; respirations, 32 and labored, SpO 2 , 92%. You notice suprasternal retractions and nasal flaring, but no cough.
Figure. LYNN FELLMAN What's the situation?
Mrs. Chapa says none of her other three children are ill. The family recently moved to the United States from rural Mexico, and the children haven't had any routine immunizations. Pedro has no significant medical history.
As Mrs. Chapa speaks to you, Pedro becomes agitated and begins to cry for her. His voice sounds muffled. ...