Question

History of Present Problem:
Ben Potter is a 4-month-old male presented to the pediatrician’s office for a routine well-child exam. Ben is accompanied
by his mother, Pamela, a 19-year-old single mother. Pamela appears visibly tired and reports that Ben has been getting up
more frequently in the night, crying but refusing to eat. Pamela reports that over the past three weeks, Ben often refuses
his formula feedings and reports episodes of gagging, arching his back, and frequent crying during and immediately
following formula feedings. Pamela reports that she has interpreted this behavior as a sign that she is overfeeding Ben and
has started watering down his Similac.

Important FYI: There is no consensus of a definition of FTT in literature (Kirkland et al 2015)but these authors define
as when weight is less than 2nd percentile for gestation corrected age and sex when plotted out on growth chart Some
sources describe when WT less than 5%

Ben is thin and pale in appearance. Skin folds noted around his buttocks. No respiratory or neurological concerns noted.
Reflexes and muscle tone within normal limits. Ben is alert, minimally interactive, and does not make eye contact with his
mother. Ben’s anterior fontanel is flat and open. Pamela leaves the room during the assessment to make a telephone call
and smoke a cigarette. Ben’s pediatrician makes the decision to transport Ben to the local Children’s Hospital to admit
him for observation. You are the nurse assigned to care for Ben.

Question 1

After interpreting relevant clinical data, what is the primary problem?

Question 2

State the rationale and expected outcomes for the medical plan of care.

Question 3

Medical Management: Rationale: Expected Outcome:

1. Admit to Pediatric
Med/Surg
2. Daily weight
3. Strict I & O
4. Calorie counts
5. Vital signs every 4 hours
6. Similac Advance – per
dietary
7. Monitor feeding
tolerance, patterns, and
behaviors
8. Consult registered
dietician for nutrition
assessment

Question 4

What nursing priority (ies) will guide your plan of care?

Answer 1