A computed tomography (CT) scan of his head is shown in the exhibit. The rest of the examination is within normal limits. An area of bluish discoloration is seen on his left eyelids and cheek. His height and weight are at the 67th and 54th percentile for his age. Physical examination reveals normal vital signs. There is no history of fever or head trauma. His developmental milestones were slightly delayed. His birth history and family history are not available. Past medical history is significant for mild mental retardation and complex partial seizures sometimes leading to secondary generalized seizures. The headaches are moderate-to-severe in intensity, unilateral, mostly affecting the left side, and pulsatile in nature. Students: Educators’ Pro Tips for Tough TopicsĪ 10-year-old boy is brought to a family physician by his mother with a history of recurrent headaches.Maternity Nursing and Care of the Childbearing Family.A review of previous medical records reveals the following chest X-ray taken 2 months ago. Examination with an otoscope reveals a swollen canal and a bulging tympanic membrane.

His left ear is tender and appears red and irritated. Today, the vital signs include: temperature 39.0☌ (102.0☏), blood pressure 100/65 mm Hg, heart rate 110/min, and respiratory rate 30/min. He is up to date on all vaccines and is meeting all developmental milestones. The boy was born at 39 weeks gestation via spontaneous vaginal delivery. During his last ear infection, there was some discussion of myringotomy. He has had multiple minor respiratory tract infections with productive cough and ear infections over the last year he has also been hospitalized once with community-acquired pneumonia. The condition started a week ago, and his parents are concerned that he has developed another ear infection. Students: Educators’ Pro Tips for Tough TopicsĪ 3-year-old boy is brought to his pediatrician’s office because of prolonged ear pulling and discomfort.

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