This educational guide provides a much-needed subspeciality-specific learning resource for pediatric hospital medicine. Featuring 50 of the most commonly presenting topics encountered by pediatric hospitalists, this book brings readers into the morning meeting and walks them through patient presentation, diagnosis, treatment, and resolution, providing realistic examples in an engaging case-based format. Available for purchase at https://shop.aap.org/pediatric-hospital-medicine-a-case-based-educational-guide-paperback/
Case 44: Lucy, a 16-Year-Old Girl with Altered Mental Status
"Lucy, a 16-Year-Old Girl with Altered Mental Status", Pediatric Hospital Medicine: A Case-Based Educational Guide, American Academy of Pediatrics, Melissa G. Cossey, MD, FAAP, Lauren K. Gambill, MD, MPA, FAAP
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Lucy is a 16-year-old girl who is being seen in the emergency department (ED) for confusion and vomiting. In the ED, her noncontrast computed tomography (CT) scan of the head is negative for intracranial hemorrhage, the result of a finger-stick blood glucose test is normal, and she is given an intravenous (IV) fluid bolus of normal saline (0.9%) at 20 mL/kg and a dose of IV ondansetron. Multiple serum and urine studies are collected and are pending. The ED physician reports that Lucy has a Glasgow Coma Scale score of 13. Because of Lucy’s altered mental status, the ED physician calls you to discuss hospitalization for close monitoring and further diagnostic evaluation, if needed. After speaking to the physician caring for her in the ED, you begin your evaluation.