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    NURS 227 Pediatric Nursing Proctored Exam

    Patient 1 Client 1: 6-year-old boy with gradual limp and mild hip/knee pain for 2 months. Afebrile. Patient 2 Client 2: 12-year-old overweight adolescent with sudden hip pain and externally rotated leg. Patient 3 Client 3: 5-year-old with recent viral illness and acute hip pain: low-grade fever, able to bear some weight. Indicate the most likely diagnosis for these patients

    Explanation & Rationale

    Patient 2: The 12-year-old overweight adolescent presents with sudden hip pain and externally rotated leg, which are classic signs of SCFE. This condition occurs when the femoral head slips posteriorly at the growth plate, often in overweight adolescents during rapid growth. Immediate recognition is critical because the hip must be stabilized to prevent further slippage and long-term complications. • Patient 1: The 6-year-old boy has a gradual limp and mild hip/knee pain for two months, with no fever. This presentation is typical for Legg-Calvé-Perthes disease, a pediatric avascular necrosis of the femoral head. It is usually insidious, affects children aged 4–8, and causes mild pain and limping over weeks to months. Early diagnosis allows interventions to maintain hip function. • Patient 3: The 5-year-old with a recent viral illness presents with acute hip pain, low-grade fever, and is still able to bear weight. Transient synovitis is a self-limiting inflammation of the hip joint often following a viral infection. It is common in children aged 3–8 years, presents acutely, and typically resolves with rest and anti-inflammatory treatment.

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