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Discussion 7 – Oral Examinations.

Discussion 7 – Oral Examinations.

Sample Answer 

Discussion 7 – Oral Examinations

Oral Examinations

The parents report that their five-year-old daughter is sleeping more after school, which indicates that she might be having too much activity during the day, which makes her so exhausted. Additionally, the terrors reported in the night might be taking too much of her sleep time, which makes her very tired and sleep longer. On the other hand, it could be argued that she is not enjoying restorative sleep, which reduces the level of disease-fighting antibodies, thereby resulting in gum disease. Besides, the erythema noted to gingivae to the left lower tooth line and right upper posterior gum line also indicates that there could be an increased blood flow (hyperemia) in superficial capillaries (Ibsen, 2016).

According to social history, HPI, and PMH, it is essential to seek information about the 5 y.o. Concerning disorders related to too much sleep, such as diabetes and high blood pressure. Additionally, since the patient reports poor oral health, which might have resulted from sleeping longer hours, I could recommend medication for the erythema alongside trying natural stress-busting therapies, including meditation, muscle relaxation, and breathing exercises (Haaramo, Alapulli, Aine, Tuokkola, Saarnisto, Roine, and Kolho, 2019). These would help the patient to relax and get sufficient sleep. The mediation would be critical in managing the night terrors.

Finally, the parents should try and help the child with social issues such as her interactions with her mates in school, among others. This would help reduce the episodes that reoccur in her memory at night, thereby leading to the night terrors. For proper development, the child requires sufficient sleep time, which also requires a significant balance in her daytime activities with the time to relax.

References

Ibsen, O. A. (2016). Oral Pathology for the Dental Hygienist-E-Book. Elsevier Health Sciences.

Haaramo, A., Alapulli, H., Aine, L., Tuokkola, J., Saarnisto, U., Roine, R. P., … & Kolho, K. L. (2019). Oral and Otorhinolaryngological Findings in Adults Who Were Diagnosed with Pediatric Onset Crohn’s Disease. Journal of clinical gastroenterology53(7), e269-e275.

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Question 


Discussion 7 – Oral Examinations

Discussion Prompt: (250 – 300 words)

  • Evaluate the subjective and objective information provided to you in the file below.
  • First identify all pertinent positive and negative information.
  • Is there any other information you would want to obtain? 
  • Create a differential diagnosis list with at least 3 possibly actual diagnosis based on your findings. 
  • Next, create a plan utilizing clinical practice guidelines for the priority diagnosis, as well as expected health promotion and expected developmental milestones. 
  • Be sure to include APA in-text 2 scholarly citations and provide full reference citation at the end of the discussion

    Discussion 7 – Oral Examinations

    Discussion 7 – Oral Examinations

***File Below:

 NU632 Unit 7 Discussion Case

C.C. tooth pain

HPI: M.M. is a 5 y.o. F who present to HU clinic with her mother.  Recently, M.M had presented for her5 y.o. Well-child visit.  A week later returned due to night terrors. Today presented to clinic for tooth pain, one week after the night terrors. Mother reports night terrors are still occurring at least once a week.  M.M. is still not aware of the night terrors.  Mother is concerned because yesterday M.M. would not eat reporting that her teeth hurt and was sleeping more after school.  Today, she has some swelling to left lower jaw and mother reported a fever.  No temperature was obtained but she had felt warm.  Mother gave her a dose of Tylenol and her mood improved.  Mother reports not having seen a dentist yet.  They try to brush her teeth twice a day but sometimes allow her to brush them.

PMH: Born at 39 weeks’ gestation via cesarean section for being in a breech position. There were no complications at birth. There were no complications throughout the pregnancy. The infant’s mother denies tobacco use, drug use, or alcohol use during pregnancy. The infant was breastfed. Allergies: No known drug allergies Medications: Disney Princess Gummy Vitamin Social History: The child lives with her mother and father who have been married for 2 years. Both parents work full-time. She started public school two months ago which is full day kindergarten. Father Vapes in the home.  Both parents report social drinkers on the weekend, “couple of beers with dinner.” There are no firearms in the house. Family History: Mother and father deny any significant medical history. Health Maintenance/Promotion:

Review of Systems General: Concerned about not eating, and sleep morning.  Skin: Denies any rash, lesions, or concerns with eczema. Head: Denies headache, trauma or falls. Swelling noted to lower jaw. ENT: Denies any concerns ears, nose, or throat. Reporting tooth pain when eating.  Neck: Denies pain with ROM neck. Denies masses or lumps.  CV: Denies any chest pain, cyanosis, heart racing or sweating.  Lungs: Denies any cough, congestion, wheezing, or difficulty breathing.GI: Denies food intolerances. Denies weight loss, nausea, vomiting, constipation or diarrhea.GU: Negative for burning or blood in urine. Musculoskeletal: Denies pain, trauma, and numbness.  Neurological: denies changes in senses.  Psych: Denies difficulty concentrating, tearful episodes, anxiety or seclusion.  Endocrine: Denies increase thirst or urination.  Hematologic: Denies bruising or bleeding.

Objective VS: Temperature: 100F, 97/71, HR: 100, RR: 20, 100% on RA, Ht: 55in (93.52%), Wt.: 97 lbs. (98.3%), BMI: 22.54(97%).General: Well developed, well-nourished and hydrated, no apparent distress. Appropriate dressed. Skin: No evidence of rash or lesions. Head: Normocephalic. Eyes: The lids and conjunctiva are normal. Pupils are irises are normal fundoscopic exam reveals red reflex present bilaterally.

ENT: Normal external ears and nose. Normal external auditory canals and tympanic membranes. Hearing is grossly normal. Dental caries B, C, M, L. Swelling, erythema noted to gingivae to left lower tooth line and right upper posterior gum line Oropharynx: normal mucosa, palate, and posterior pharynx. Neck: Supple, Small non-mobile adenopathy on L posterior cervical chain.CV: Normal rate and rhythm. Normal S1 and S2 heart sounds heard on auscultation with no S3 or S4. No murmurs. Femoral pulse 2+ bilaterally. Lungs: Normal respiratory rate and pattern with no apparent distress. Bilateral breath sounds clear on auscultation without rales, rhonchi, or wheezes. Abd: Normal bowel sounds. No masses or tenderness or organomegaly observed.GU: Normal female genitalia. Tanner stage 1. MSK: Grossly normal tone and muscle strength. Normal range of motion in extremities.

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