Nursing Clinical Log

Clinical Log - PAGE 1 -

Subjective

A 4-year old patient was endorsed under my care during the 8 hour shift The patient has been diagnosed with NEMO syndrome with a history of streptococcus pneumonia meningitis at the age of 1 . NEMO syndrome has an alternative name of X-linked anhidrotic ectodermal dysplasia with immunodeficiency . It affects multiple organs and presents with vesiculo-bulluos lesions with erythma with linear arrangement on the extremities and lateral aspects of the trunk . These erythematous lesions evolve into verrucous lesions after weeks to month . These lesions are

then followed by atrophy or depigmentation . The immunodeficiency causes the patient to develop pus-forming bacterial infections early in life . As they get older , they have higher risk to become susceptible to mycobacterial infections

The patient has resultant blindness , deafness and severe developmental delay . He was admitted due to the worsening perirectal sore following the hospitalization 13 days ago for inpatient and outpatient treatment with antibiotics . The perirectal open sore is one of the manifestations of NEMO syndrome . It is located on the patient 's left buttock which was first noticed by the patient 's mother . The patient was observed to be more fussy and possibly having slightly increased seizure activity , mild gingival bleeding and cough . It is noted that the patient exhibits the symptoms of NEMO mutation with immunodeficiency specifically frequent serious infections and poor immunity . Thus , the return of service (ROS is the open wound located in his left buttock

The patient doesn 't have the ability to perform self-care...