CASE STUDY 3: Focused Ear Exam Martha brings her 11-year old grandson, James, to your clinic to have his right ear checked. He has complained to her about a mild earache for the past 2 days. His grandmother believes that he feels warm but did not verify this with a thermometer. James states that the pain was worse while he was falling asleep and that it was harder for him to hear. When you begin basic assessments, you notice that James has a prominent tan. When you ask him how he’s been spending his summer, James responds that he’s been spending a lot of time in the pool 

 

Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes but would probably perform a simple strep test.

In this Case Study Assignment, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.

To Prepare

• By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
• Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP Notes have specific data included in every patient case.

With regard to the case study you were assigned:

• Review this week’s Learning Resources and consider the insights they provide.
• Consider what history would be necessary to collect from the patient.
• Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
• Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

5 references not more than 5 years

Zero plagiarism

 

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 11, “Head and Neck”

This chapter reviews the anatomy and physiology of the head and neck. The authors also describe the procedures for conducting a physical examination of the head and neck.
Chapter 12, “Eyes”

In this chapter, the authors describe the anatomy and function of the eyes. In addition, the authors explain the steps involved in conducting a physical examination of the eyes.
Chapter 13, “Ears, Nose, and Throat”

The authors of this chapter detail the proper procedures for conducting a physical exam of the ears, nose, and throat. The chapter also provides pictures and descriptions of common abnormalities in the ears, nose, and throat.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center. 

PLEASE PAY ATTENTION TO MY CASE STUDY AT THE TOP

You are caring for a 59-year-old African American male who is a non-smoker and a non-drinker. The individual has a healthy weight for his height. On weekends, he coaches a youth baseball team in his community and enjoys eating hot dogs and nachos with the children after games. He has been monitoring his blood pressure at the community center and noted that the highest reading was 168/92 mm Hg. He is pleased with this number, as the results were “lower than previous readings.” However, his healthcare provider is still concerned. She informed him about the dietary choices he was making and reminded him to limit his sodium intake. She also renewed the individual’s prescription for a thiazide diuretic and added an ACE inhibitor to his treatment regime.

Please answer the following prompts in your analysis of the case:

1. Speculate how the individual’s ethnicity contributes to his hypertension. Discuss other determinants of health that contribute to the prevalence of hypertensive disease in this population.
2. Discuss the significance of an elevated systolic pressure, even in the absence of diastolic hypertension, detailing the pathophysiology behind elevation in blood pressure and the ultimate development of hypertension.
3. Identify if this individual is at risk for developing heart failure. If so, what type of heart failure would he be most at risk of developing?
4. Briefly discuss the mechanism of action of the two classes of drugs this individual was prescribed for the management of his hypertension.

For additional details, please refer to the Case study guidelines and rubric.

    

Prompt: 

For the case study, be sure to: 

• Introduce main elements and concerns and identify the pathology.
   
• Use the associated questions above to guide your paper and explain the pathology in the development of a plan of care.
   
• Explain the role patient-care technologies (i.e., point of care testing, computer provider order entry, bar-coding medication administration, EMR/EHR) in caring for the individual(s). Be thorough!
   
• Apply critical thinking in analyzing and interpreting the data.
   
• Include evidence to support your analysis of the case.
   
• Write clearly and concisely, following standard rules of grammar.
  Guidelines for Submission: Your paper must be submitted as at least a 2-page Microsoft Word document with double spacing, 12-point Times New Roman font, one-inch margins, and at least two peer-reviewed sources cited in APA format.
   

YOU MUST USE THE CASE STUDY GUIDELINE AND RUBRIC IN ANSWERING THE CASE STUDY QUESTIONS ABOVE.

 Please answer these questions, I need  precise and complete answers:

 

Nurses have a responsibility to perform discharge teaching each day. Are you performing it to the best of your ability? Please read the attached article and discuss the following points:

1. What are some barriers to discharge teaching? 

2. Explain how you could incorporate AskMe3 when teaching patient with a new diagnosis of a chronic disorder?

3. How could nurses be influential in prevention of hospital readmission?

Discharge Teaching.pdf

Among the Resources in this module is the Rutherford (2008) article Standardized Nursing Language: What Does It Mean for Nursing Practice? In this article, the author recounts a visit to a local hospital to view the recent implementation of a new coding system.

During the visit, one of the nurses commented to her, “We document our care using standardized nursing languages but we don’t fully understand why we do” (Rutherford, 2008, para. 1). 

How would you respond to a comment such as this one?

To Prepare:

· Review the concepts of informatics as presented in the Resources, particularly Rutherford, M. (2008) Standardized Nursing Language: What Does It Mean for Nursing Practice?

· Reflect on the role of a nurse leader as a knowledge worker.

· Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

In a 2- to 3-page paper, address the following:

· Explain how you would inform this nurse (and others) of the importance of standardized nursing terminologies.

· Describe the benefits and challenges of implementing standardized nursing terminologies in nursing practice. Be specific and provide examples.

· Be sure to support your paper with peer-reviewed research on standardized nursing terminologies that you consulted from the Library.