PBL
Case Discussion: Issues in Growth and Behavior Part One (graded)
Today
you note that Kayla is back with Jo for behavioral issues.
HPI:
Kayla (mom) is back to visit with Jo, the 5 & 8/12 year-old female child.
She is here for complaints of behavioral difficulties and poor performance in
school. Mother reports since moving back in with her parents that Jo has
started throwing tantrums and refusing to obey. The mother reports that she has
always been active with frequent changes in activity and difficulty in staying
seated or minding her own business. However, since the move and starting
kindergarten, others have commented on difficulties in behavior, including
Kayla’s own parents and Jo’s teacher. She is doing poorly in school and
has had many behavioral issues there and been sent to the principal’s office on
three occasions. She has not yet been to see the opthamologist as you
suggested.
PMH:
No change in diet; no fever; no communicable disease symptoms; continues
children’s chewable multivitamin with iron daily; sleep includes going to bed
around 10:30 p.m. at night and being awakened at 6 a.m. for school. She
continues to be difficult to get in bed with frequently getting up in the first
hour of bedtime.
Discussion Questions Part One
What
additional OLDCART and ROS information would you like? Why?
Differential
diagnoses with rationale?
Further
history and ROS needed to more fully develop your differential diagnoses?
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