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Case Scenario 2 School Nurse Notes 0900: VS T 101.4°F (38.6°C) oral, HR 110 BPM, RR 20 bpm, BP 116/58 mmHg, SpO2 97% RA, pain 7/10 on 0 to 10 pain scale, weight 123.5 lb (56 kg), height 67 inches (170.1 cm) Pain: Pain is located in the posterior aspect of the neck, radiating to the front of the head and is described as neck stiffness and a constant aching pain. Has eye pain. Reports feeling better if lying still with the head on a pillow and the lights off. Gastrointestinal: Abdomen soft, non-tender, non-distended. No appetite, ate some cereal and milk before coming to school. Vomited x1 today but reports consistent nausea, aggravated with movement and light. Bowel sounds heard in all 4 quadrants. Had a BM last evening. Integumentary: Petechial rash noted on lower legs, denies itch or sweating. Respiratory: Lungs sounds clear. Denies cough or shortness of breath. Cardiovascular: No cyanosis, capillary refill is 2 seconds. No edema. No tenderness in the lower extremities. Genitourinary: No bladder distention. Reports voiding yellow urine. Musculoskeletal: Muscle strength weak. Nuchal rigidity. Neurological: Sleepy. Positive Brudzinki’s sign noted. Positive Kernig’s sign. 0945: The school nurse contacts the adolescent’s pediatrician to report assessment findings, including fever, pain characteristics, nuchal rigidity, petechial rash, and the positive Brudzinki and Kernig sign. The pediatrician asks the nurse to call EMS and take the adolescent to the ED. The ped

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