Unit 4

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Nov 24, 2024

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Unit 4 - Nutritional Evaluation First part of the discussion board is to identify all pertinent positive and negative information . Positive  Nightmares twice a week for three months  Parents unable to calm patient during episodes  Child does not remember episodes  BMI 97% Negative  No developmental or behavioral concerns  Kindergarten  Active in soccer  Engages with peers (New friend Jaden)  Normal exam Would there be any other information you would want to obtain? Regarding the nightmares, the provider should ask for additional information regarding the child’s sleep habits. Questions to ask would be the routine for getting the child to sleep, nightlights, medications, screen time or electronic devices before bed, room environment, sleep aids such as a stuffed animal or blanket, and snoring (Garzon Maaks et al., 2020). Family history of sleep disorders should also be obtained at this time. Nutrition history such as dinner time meals and bedtime snack is also appropriate to obtains. This information is also useful regarding the patient’s BMI. Then create a differential diagnosis list with at least 3 possibly actual diagnosis based on your findings. 1: Night Terrors 2: Nonrapid or rapid eye movement parasomnia 3: Obesity with Sleep Disordered Breathing Second part is to create a plan utilizing clinical practice guidelines for the priority diagnosis. Treatment for night terrors usually isn’t necessary. However, if they begin to routinely disrupt sleep, disrupt family members, or cause injury, intervention may be warranted. Treatment generally focuses on the underlying triggers such as stress or sleep apnea (Van Horn & Street, 2023). Establishing a regular and healthy bedtime routine is also encouraged. This includes creating a quiet and calming environment before bed, going to bed at a scheduled time, and getting adequate sleep. If the previously stated

recommendations fail, a consult may be needed for a pediatric sleep specialist, counseling or psychiatry. Hi Larion! Great job on your post. I agree with your primary diagnosis of night terrors. Additional questions to ask to support this diagnosis are specific to the patient’s sleep patterns, habits, and pertinent family history. I also chose nightmares as a differential diagnosis but chose night terror as the primary since the child does not remember them even upon waking. Night terrors usually occur in the first cycle of sleep and often are not remembered by the patient (Garzon Maaks et al., 2020). I also included obesity as a different diagnosis due to the child’s size and stature since it could be a factor affecting her sleep. Unless there are violent episodes of harm or family disturbances, there is no treatment for night terrors other than establishing a regular healthy sleep pattern. If the night terrors worsen or the patient experiences harm, a sleep specialist or psychiatrist should be consulted. Great job! References: Garzon Maaks, D. L., Starr, N. B., Brady, M. A., Gaylord, N. M., Driessnack, M., & Duderstadt, K. G. (2020). Pediatric primary care . (7th ed.) Elsevier.

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