Lymphadenopathy

Template

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LocationChoose one

Node characterChoose any

Systemic symptomsChoose any

Likely sourceChoose one

AssessmentChoose any

Assessment (concerning)Choose anyNot in the note with these choices

TestingChoose any

PlanChoose any

Plan (further evaluation)Choose oneNot in the note with these choices

Follow-upChoose one

Follow-up reasonChoose anyJoins the line above

Counseling

Lymph nodes often swell when the body fights off common infections, and they can take several weeks to shrink back down. Recommended supportive care with tylenol or motrin as needed for tenderness. Return precautions given including a node that keeps growing or becomes hard, red, or painful, a node above the collarbone, prolonged fever, night sweats, weight loss, easy bruising, tiredness that is not improving, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

CounselingNot in the note with these choices

Because of how this lymph node looks or feels, the tests and visits above will help find the cause. Most enlarged nodes in children still turn out to be from infections. Return precautions given including a node that grows quickly, fever, night sweats, weight loss, easy bruising, trouble breathing, tiredness that is not improving, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Lymphadenopathy
• Localized cervical lymphadenopathy
• Small, soft, mobile, nontender nodes without overlying redness or fluctuance
• No fever, night sweats, weight loss, bruising, pallor, or hepatosplenomegaly
• Most consistent with reactive lymphadenopathy
• Observation, since most enlarged nodes in children are reactive
• Follow up in 2-4 weeks to recheck node size

Lymph nodes often swell when the body fights off common infections, and they can take several weeks to shrink back down. Recommended supportive care with tylenol or motrin as needed for tenderness. Return precautions given including a node that keeps growing or becomes hard, red, or painful, a node above the collarbone, prolonged fever, night sweats, weight loss, easy bruising, tiredness that is not improving, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Localized vs generalized; drainage area
Node character: hard, fixed, matted, size
Reactive vs concerning
Serologies EBV, CMV, Bartonella

Return precautions in the template

a node that keeps growing or becomes hardredpainfula node above the collarboneprolonged fevernight sweatsweight losseasy bruisingtiredness that is not improving

Sources

Pediatric Care Online, Lymphadenopathy (thin sources)

Few formal guidelines cover this topic, so the template also leans on expert opinion.