For this Case Study Assignment, you will determine the physical exams and diagnostic tests that would be most appropriate for gaining information and better understanding of your patient’s condition. Then, based on your analysis, you will formulate a differential diagnosis for the patient

For this Case Study Assignment, you will determine the physical exams and diagnostic tests that would be most appropriate for gaining information and better understanding of your patient’s condition. Then, based on your analysis, you will formulate a differential diagnosis for the patient

For this Case Study Assignment, you will determine the physical exams and diagnostic tests that would be most appropriate for gaining information and better understanding of your patient’s condition. Then, based on your analysis, you will formulate a differential diagnosis for the patient

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools to help in understanding a patient’s condition. In turn, beginning with a differential diagnosis supports the process of further applying information to narrow the possibilities of what the condition may be and working to arrive at the most accurate diagnosis for planning treatment.

For this Case Study Assignment, you will determine the physical exams and diagnostic tests that would be most appropriate for gaining information and better understanding of your patient’s condition. Then, based on your analysis, you will formulate a differential diagnosis for the patient.

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Our focus this week is on Differential Diagnosis and Diagnostic Testing

The first step you should take as a provider to properly diagnose a patient’s condition is to begin listing all the possible diagnosis.   This list of potential diagnosis is considered differential diagnosis.  It is from this list you will begin to include / exclude diagnosis until you reach the one you will develop your treatment plan for. You basically become a detective in identifying possibilities and then look at symptoms, labs, and diagnostics to reach your conclusion.    The more experienced and knowledgeable you are the better your list of potential diagnosis will be.   Please be sure to review the Walden generated required media to review this topic.

The second topic this week is Diagnostic testing.   As a provider, you must take the next step in utilizing tests to assist in identifying the diagnosis and then monitoring your treatment plan for effectiveness.    You need to understand what test are valid, reliable, and valuable in clinical practice.

• Case Study Assignment

Miss Washington is a 71 y/o female who presents with a new leg ulcer that appeared after a fall 1 week ago. The patient is coughing and wheezing. She tells you that “I’m feeling terrible.” Vital signs appear stable with no fever.

Resources

Learning Resources

Required Readings

• Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). Elsevier Mosby.
  • Chapter 3, “Examination Techniques and Equipment”
    This chapter explains the physical examination techniques of inspection, palpation, percussion, and auscultation. This chapter also explores special issues and equipment relevant to the physical exam process.
• Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). F. A. Davis Company.
  • Chapter 2, “The Comprehensive History and Physical Exam”
• i-Human Patients. (2023). i-Human Patients case player student manualDownload i-Human Patients case player student manual. i-Human Patients by Kaplan. (PDF)

Required Media

To access this resource, use the Access i-Human Patients link from the Start Here Module.

• i-Human Patients Cases. (2023). Case studies: Marvin Webster, Jr. [Video]. i-Human Patients by Kaplan.
• Walden University, LLC. (2024). Differential diagnosis[Video]. Walden University Canvas. https://waldenu.instructure.com/

Supplemental Resources 

Note: These readings are intended to serve as supplementary to the Lecturio content and required textbook readings provided in this course. Please refer/review these supplementary resources should you need help in reinforcing concepts and in preparation for completing this week’s Assessments.

• Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Student checklist: Health history guideDownload Student checklist: Health history guide. In Seidel’s guide to physical examination (9th ed.). Elsevier Mosby.
  Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center.
• Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). 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.
  • Chapter 1, “Clinical Reasoning, Evidence-Based Practice, and Symptom AnalysisDownload Clinical Reasoning, Evidence-Based Practice, and Symptom Analysis”
    This chapter introduces the diagnostic process, which includes performing an analysis of the symptoms and then formulating and testing a hypothesis. The authors discuss how becoming an expert clinician takes time and practice in developing clinical judgment.
• Nyante, S. J., Benefield, T. S., Kuzmiak, C. M., Earnhardt, K., Pritchard, M., & Henderson, L. M. (2021). Population‐level impact of coronavirus disease 2019 on breast cancer screening and diagnostic proceduresLinks to an external site.. Cancer, 127(12), 2111–2121. https://doi.org/10.1002/cncr.33460
• To prepare:

Review this week’s Learning Resources.

• Review the details of the patient case study.
• Consider what physical exams and diagnostic tests would be most appropriate to gather more information about the patient’s condition.
• Reflect on how the results would be used to make a diagnosis.
• Identify three to five (3–5)possible conditions that may be considered in a differential diagnosis for the patient.

Assignment: Diagnostic Reasoning 

Include the following:

• Identify the patient’s chief complaint.
• Identify what physical exams and diagnostic tests would be most appropriate to gather more information about the patient’s condition. Be specific and explain your reasoning.
• Explain how the results would be used to make a diagnosis.
• Identify three to five (3–5)possible conditions that may be considered in a differential diagnosis for the patient. Explain your thinking.

Rubric

NURS_6512_Week 3_Assignment 1_Rubric

NURS_6512_Week 3_Assignment 1_Rubric
Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeIdentify the patient’s chief complaint.	15 to >12.0 pts Excellent The response clearly, accurately, and in detail explains the assigned patient’s chief complaint. 12 to >9.0 pts Good The response accurately explains the assigned patient’s chief complaint. 9 to >6.0 pts Fair The response vaguely and with some inaccuracy explains the assigned patient’s chief complaint. 6 to >0 pts Poor The response is inaccurate and/or missing an explanation of the assigned patient’s chief complaint.	15 pts
This criterion is linked to a Learning OutcomeIdentify what physical exams and diagnostic tests would be most appropriate to gather more information about the patient’s condition. Be specific and explain your reasoning.	20 to >17.0 pts Excellent The response clearly, accurately, and in detail Identifies physical exams and diagnostic tests that are most appropriate to gather more information about the patient’s condition; reasoning for the exams/tests is clear, accurate, and detailed. 17 to >14.0 pts Good The response accurately Identifies physical exams and diagnostic tests that are most appropriate to gather more information about the patient’s condition; reasoning for the exams/tests is specific and accurate. 14 to >13.0 pts Fair The response vaguely and with some inaccuracy Identifies physical exams and diagnostic tests that are appropriate to gather more information about the patient’s condition; reasoning for the exams/tests is vague and somewhat accurate. 13 to >0 pts Poor The response is inaccurate and/or missing identification of physical exams and diagnostic tests that are appropriate to gather more information about the patient’s condition; reasoning for the exams/tests is inaccurate or missing.	20 pts
This criterion is linked to a Learning OutcomeExplain how the results would be used to make a diagnosis.	15 to >12.0 pts Excellent The response clearly, accurately, and in detail explains how the results would be used to make a diagnosis. 12 to >9.0 pts Good The response accurately explains how the results would be used to make a diagnosis. 9 to >6.0 pts Fair The response vaguely and with some inaccuracy explains how the results would be used to make a diagnosis. 6 to >0 pts Poor The response explains inaccurately and/or is missing how the results would be used to make a diagnosis.	15 pts
This criterion is linked to a Learning OutcomeIdentify three to five (3–5) possible conditions that may be considered in a differential diagnosis for the patient. Explain your thinking.	35 to >29.0 pts Excellent The response clearly, accurately, and in detail identifies four or five possible conditions that may be considered in a differential diagnosis for the patient; with clear, accurate, and detailed reasoning for each possible condition. 29 to >23.0 pts Good The response accurately identifies three to five possible conditions that may be considered in a differential diagnosis for the patient; with accurate reasoning for each possible condition. 23 to >17.0 pts Fair The response vaguely and lacking specificity identifies three possible conditions that may be considered in a differential diagnosis for the patient; with vague reasoning for each possible condition. 17 to >0 pts Poor The response inadequately identifies fewer than three possible conditions that may be considered in a differential diagnosis for the patient; with inadequate or missing reasoning for each possible condition.	35 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting: Paragraph Development and Organization — Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused and neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.	5 to >4.0 pts Excellent Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 4 to >3.0 pts Good Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. 3 to >2.0 pts Fair Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic. 2 to >0 pts Poor Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.	5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting: English Writing Standards — Correct grammar, mechanics, and proper punctuation	5 to >4.0 pts Excellent Uses correct grammar, spelling, and punctuation with no errors. 4 to >3.0 pts Good Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3 to >2.0 pts Fair Contains several (3 or 4) grammar, spelling, and punctuation errors. 2 to >0 pts Poor Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.	5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting: APA The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.	5 to >4.0 pts Excellent Uses correct APA format with no errors. 4 to >3.0 pts Good Contains a few (1 or 2) APA format errors. 3 to >2.0 pts Fair Contains several (3 or 4) APA format errors. 2 to >0 pts Poor Contains many (≥ 5) APA format errors.	5 pts
Total Points: 100

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