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NSG550 Diagnostic Reasoning for Nurse Practitioners

Module 1 Discussion

Provide a brief introduction of your professional self and anything else you want to share with your online classmates.

 

NSG550 Diagnostic Reasoning for Nurse Practitioners

Module 2 Discussion

A 48-year-old white man presents with unremitting right flank pain. He denies dysuria or fever. He does report significant nausea without vomiting. He has never experienced anything like this before.

What is the probable diagnosis?

What are other possible diagnoses?

At this stage of the case study, what diagnostic studies and basic treatments are most appropriate to order and why?

Please be specific and precise with answers. A table format or bullet points would be beneficial in presenting your information with clarity or organization.

Reference for management of the case study:

http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/kidney-stones-in-adults/Pages/facts.aspx

 

 NSG550 Diagnostic Reasoning for Nurse Practitioners

Module 3 Discussion

A 30-year-old woman presents to your office with the chief complaint of urinating more frequently. Over the last several years she has noticed a weight gain of 40 lbs. She has tried numerous diets. The patient’s only other pertinent history is that she was told to watch her diet during pregnancy because of excessive weight gain. Her baby had to be delivered by cesarean because he weighed more than 9 lbs. Her family history is not known, as she was adopted.

What is the probable diagnosis?

What are other possible diagnoses?

At this stage of the case study, what diagnostic studies and basic treatments are most appropriate to order and why?

Please be specific and precise with answers. A table format or bullet points would be beneficial in presenting your information with clarity or organization.

Reference for management of the case study:

Retrieved from

https://diabetesjournals.org/care/issue/45/Supplement_1 Please access the pdf download from this link.

NSG550 Diagnostic Reasoning for Nurse Practitioners

Module 4 Discussion

A 32-year-old nurse presents to your office with a complaint of intermittent episodes of pain, stiffness, and swelling in both hands and wrists for approximately 1 year. The episodes last for several weeks and then resolve. More recently, she noticed similar symptoms in her knees and ankles. 

What is the probable diagnosis?

What are other possible diagnoses?

At this stage of the case study, what diagnostic studies and basic treatments are most appropriate to order and why?

Please be specific and precise with answers. A table format or bullet points would be beneficial in presenting your information with clarity or organization.

Reference for management of the case study:

http://emedicine.medscape.com/article/331715-overview

 

NSG550 Diagnostic Reasoning for Nurse Practitioners

Module 5 Discussion

A 52-year-old man presents to your office for an acute visit because of coughing and shortness of breath. He is well known to you because of multiple office visits in the past few years for similar reasons. He has a chronic “smoker’s cough,” but reports that in the past 2 days his cough has increased, his sputum has changed from white to green in color, and he has had to increase the frequency with which he uses his albuterol inhaler. He denies having a fever, chest pain, peripheral edema, or other symptoms. His medical history is significant for hypertension, peripheral vascular disease, and two hospitalizations for pneumonia in the past 5 years. He has a 40 year history of smoking and continues to smoke two packs of cigarettes a day.

What is the probable diagnosis?

What are other possible diagnoses?

At this stage of the case study, what diagnostic studies and basic treatments are most appropriate to order and why?

Please be specific and precise with answers. A table format or bullet points would be beneficial in presenting your information with clarity or organization.

Reference for management of the case study:

From the 2019 Global Strategy for Prevention, Diagnosis, and Management of COPD. Retrieved from https://goldcopd.org/gold-reports/

 

 

NSG550 Diagnostic Reasoning for Nurse Practitioners

Module 6 Discussion

A 56-year-old man comes into your office as a new patient. Seven years ago, at a work-related health screening, he was diagnosed with hypertension with a blood pressure of 140/90. He saw a physician who prescribed a “medication” and encouraged him to lose some weight, diet, and exercise. Since that time, the patient has not sought medical attention.

What is the probable diagnosis?

What are other possible diagnoses?

At this stage of the case study, what diagnostic studies and basic treatments are most appropriate to order and why?

Please be specific and precise with answers. A table format or bullet points would be beneficial in presenting your information with clarity or organization.

Reference for management of the case study:

https://www.acc.org/~/media/Non-Clinical/Files-PDFs-Excel-MS-Word-etc/Guidelines/2017/Guidelines_Made_Simple_2017_HBP.pdf

 

NSG550 Diagnostic Reasoning for Nurse Practitioners

Module 8 Discussion

A 42-year-old Hispanic woman presents to the primary care office complaining of 24 hours of steady epigastric and right upper abdominal pain with sudden onset and several episodes of nausea and vomiting. She has experienced similar painful episodes in the past, usually in the evening following heavy meals, but the episodes always resolved spontaneously within hours. This time the pain did not improve, so she sought medical attention. She has no medical history and takes no medications. She is married, has three children, and does not drink alcohol or smoke cigarettes.

On examination, she is febrile, tachycardic with a heart rate of 104 bpm, blood pressure 115/74 mm Hg, and shallow respirations of 22 breaths per minute. She is moving uncomfortably on the stretcher, her skin is warm and diaphoretic, and she is jaundiced. Her abdomen is soft, mildly distended with marked right upper quadrant and epigastric tenderness to palpation; muscle guarding and rebound tenderness; hypoactive bowel sounds; and no masses or organomegaly appreciated.

What is the probable diagnosis?

What are other possible diagnoses?

At this stage of the case study, what diagnostic studies and basic treatments are most appropriate to order and why?

Please be specific and precise with answers. A table format or bullet points would be beneficial in presenting your information with clarity or organization.

Reference for management of the case study:

Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK459328/

Reference most current articles for each category.

 

NSG550 Diagnostic Reasoning for Nurse Practitioners

Module 9 Discussion

A 67-year-old woman presents to your office, accompanied by her daughter, with complaints of extreme confusion and agitation. She had been doing reasonably well until 3–4 weeks ago; however, her family says her memory has been getting worse over the last 2 years. Initially she had problems remembering recent events and people’s names and had a tendency to dwell in the past. She got lost several times driving, most recently in a familiar neighborhood.

What is the probable diagnosis?

What are other possible diagnoses?

At this stage of the case study, what diagnostic studies and basic treatments are most appropriate to order and why?

Please be specific and precise with answers. A table format or bullet points would be beneficial in presenting your information with clarity or organization.

Reference for management of the case study:

http://emedicine.medscape.com/article/1134817-overview

 

NSG550 Diagnostic Reasoning for Nurse Practitioners

Module 10 Discussion

A 59-year-old woman comes into the doctor’s office for a health maintenance examination. The breasts are nontender and without masses. Mammography revealed a small cluster of calcifications.

What is the probable diagnosis?

What are other possible diagnoses?

At this stage of the case study, what diagnostic studies and basic treatments are most appropriate to order and why?

Please be specific and precise with answers. A table format or bullet points would be beneficial in presenting your information with clarity or organization.

Reference for management of the case study:

Retrieved from https://www.acog.org/About-ACOG/News-Room/Statements/2016/ACOG-Statement-on-Breast-Cancer-Screening-Guidelines?IsMobileSet=false

In addition, click on https://www.acog.org/Patients/FAQs/Mammography-and-Other-Screening-Tests-for-Breast-Problems

 

NSG550 Diagnostic Reasoning for Nurse Practitioners

Module 11 Discussion

A 58-year-old African-American woman presents complaining of worsening shortness of breath and palpitations for about 1 week. She reports feeling “dizzy” on and off for the past few months; the dizziness is associated with weakness that has been worsening for the past month. She has been feeling “too tired” to even walk to her backyard and water her flower bed that she used to do “all the time.” She has been so dyspneic walking up the stairs at her home that she moved downstairs to the guest room about a week ago.

What is the probable diagnosis?

What are other possible diagnoses?

At this stage of the case study, what diagnostic studies and basic treatments are most appropriate to order and why?

Please be specific and precise with answers. A table format or bullet points would be beneficial in presenting your information with clarity or organization.

Reference for management of the case study is this week’s article on Anemia found in Medscape.

 

NSG550 Diagnostic Reasoning for Nurse Practitioners

Module 12 Discussion

A 65-year-old man comes to your office for the evaluation of lower back pain. For the past 3 days, he has had a sharp, burning pain in his left lower back, which would radiate to his flank and, sometimes, all the way around to his abdomen. The pain comes and goes, feels like an “electric shock,” is unrelated to activity, and can be severe. He has had no injury to his back and has no history of back problems in the past. He denies fever, urinary symptoms, or gastrointestinal symptoms. Upon examination you note he has a rash is in the area of the pain. On examination he has an eruption consisting of patches of erythema with clusters of vesicles extending in a dermatomal distribution from his left lower back to the midline of his abdomen.

What is the probable diagnosis?

What are other possible diagnoses?

At this stage of the case study, what diagnostic studies and basic treatments are most appropriate to order and why?

Please be specific and precise with answers. A table format or bullet points would be beneficial in presenting your information with clarity or organization.

Reference for management of the case study:

https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/q—t/shingles/diagnosis-treatment

 

NSG550 Diagnostic Reasoning for Nurse Practitioners

Clinical Note

Chooses a patient and uses initials when identifying the patient

Chief Complaint and History of Present Illness

Past Medical and Surgical History

Medications and Allergies

Family History

Social History

Review of Systems

Physical Examination

Assessment and Plan; provides comprehensive treatment plan and communicates clinical reasoning. Scholarly support and citations provided.

Reference list as per APA

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