NSG 6020 WEEK 6 DISCUSSION
Latest 2023 / 2024
Discussion Question 1
Based on your performance and the expert feedback in your HISTORY collection, describe two missed questions and your understanding of why they were important to collect for this case history. Use specific references from your text to explain.
The patient addressed many aspects of the HPI. However, I would ask him to rate the pain on a pain scale, 0 to 10, to assess severity. I would also ask does the pain radiate to any other place in the body. The patient stated he has also been out of his medications for several weeks, I would have inquired about the patient being out of medications. Is there a financial reason, or is there side effects that he doesn’t like? He may need services to help receive medications, or a medication changed due to side effects.
Discussion Question 2
Based on your performance and the expert feedback in your PHYSICAL EXAM collection, describe two errors in your exam performance or documentation.Use specific references from your text to explain the importance of these findings in correct assessment of this client.
The student did assess dorsalis pedis, and posterior tibia pulses of the extremities.However, I would grade the pulses. Does the patient have +2 brisk and normal, or +1 From your course textbook, Bates' Guide to Physical Examination and History
• The Peripheral Vascular System
From the textbook, Advanced Assessment, read:
• Peripheral Vascular System
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diminished or weaker than expected? Asymmetric diminished pulses could indicate arterial occlusion from atherosclerosis or embolism. Edema should also be assessed based on location. For example, is it confined to the ankles, or does it extend up the leg? The edema should also be graded on a scale from one to four, mild or pitting. The student noted that the patient cardiovascular exam was unremarkable, however, the arteries should have been assessed for bruits. Stenosis or occlusion of abdominal, renal, iliac, or femoral arteries, can affect distal pulses (Goolsby &Grubbs, 2015).
Discussion Question 3
Based on your performance on the PHYSICAL EXAM collection, describe one key finding that you included in your list and describe a specific physical exam that you can perform at the point-of-care to further evaluate the finding. Use specific references from your text.This patient has not been to the doctor’s office in six months. I believe he needed a comprehensive physical exam, then what was given during the case study. The abdomen should have been auscultated for aortic, and renal artery bruits. The eyes should have also been examined for hypertensive changes like: hemorrhages, exudates, A-V nicking, copper or silver wire appearance, or papilledema (Goolsby & Grubbs, 2015).
Discussion Question 4
Based on your performance and the expert feedback in your ASSESSMENT identification of problem categories, choose one missed/incorrect category and use specific references from your text to explain the importance of this category in arriving at correct differential diagnoses for this client.Since starting clinical, my preceptor has taught me the importanance of screening patients for various topics, such as colon cancer, breast cancer, anxiety and depression.This patient is 50 years old, during the visit, he should be asked when was his last colonoscopy. Colonoscopy should be done every 10 years, starting at age 50. This patient
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