NURS 6512N Assignment: Assessing the Ears, Nose, and Throat -

Sample Answer for NURS 6512N Assignment: Assessing the Ears, Nose, and Throat Included After Question

Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment.

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.

NURS 6512N Assignment Assessing the Ears, Nose, and Throat

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.

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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.

By Day 6 of Week 5

Submit your Assignment.

Submission and Grading Information

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Please save your Assignment using the naming convention “WK5Assgn1+last name+first initial.(extension)” as the name.
Click the Week 5 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
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A Sample Answer For the Assignment: NURS 6512N Assignment: Assessing the Ears, Nose, and Throat

Title: NURS 6512N Assignment: Assessing the Ears, Nose, and Throat

Patient Information: Initials: Lily Age: 20 years Sex: Female Race- White

CC (chief complaint): “Sore throat.”

HPI: Lily is a 20-year-old White female presenting with a chief complaint of a sore throat. She states that the sore throat started three days. She took the symptom seriously after she found out that there was a flu outbreak in their college two weeks ago. She is worried that her symptoms could be linked to the flu outbreak. Lily also states that she has a reduced appetite, headache, and pain when swallowing. Some of her classmates have been treated in the clinic after presenting with similar symptoms.

Current Medications: None

Allergies: None

PMHx: No history of chronic medical illnesses or surgeries. The last TT was 4 years ago; my Last Flu shot was 15 months ago.

Soc Hx: Lily is a student at a local community college pursuing a Diploma in Culinary Arts. She lives with her parents and has one older and younger brother. Her hobbies include baking and trying new recipes. She admits to taking alcohol on weekends and using recreational marijuana but denies smoking.

Fam Hx: No history of chronic illnesses in the family.

ROS:

GENERAL: Reports appetite disturbance. Negative for fever, weight changes, or increased fatigue.

HEENT: Head: Reports headache. Negative for head injury. Eyes: Negative for vision changes, excessive lacrimation, or eye pain. Ears: Denies ear pain, discharge, tinnitus, or hearing loss. Note: Reports runny nose. Negative for nasal congestion or sneezing. Throat: Reports sore throat, slight hoarseness, and pain when swallowing.

SKIN: Denies itchiness, rashes, or lesions.

CARDIOVASCULAR: Denies chest pain, edema, dyspnea on exertion, or palpitations.

RESPIRATORY: Negative for SOB, cough, wheezing, or sputum.

GASTROINTESTINAL: Negative for nausea, vomiting, abdominal pain, diarrhea, or constipation.

GENITOURINARY: Negative for urinary or vaginal symptoms.

NEUROLOGICAL: Reports headache. Negative for dizziness, tingling sensations, or paralysis.

MUSCULOSKELETAL: Negative for muscle pain, joint pain, or stiffness.

HEMATOLOGIC: Negative for bruises or bleeding.

LYMPHATICS: Negative for lymph node swelling.

PSYCHIATRIC: Negative for anxiety, depression, or suicidal symptoms.

ENDOCRINOLOGIC: Negative for excessive perspiration, heat/cold intolerance, excessive hunger/thirst, or polyuria.

ALLERGIES: No history of eczema or hives.

Physical exam:

Vital Signs: BP- 122/76; HR- 84; Temp- 98.4; Resp- 16

GENERAL: Female patient in no acute distress. She is neat and appropriately dressed and maintains eye contact. The patient is alert and oriented.

HEENT: Head is symmetrical and normocpehalic. Eyes: White sclera, Pink conjunctiva, PERRLA. Ears: TMs are shiny and patent bilaterally. Nose: Runny nose. The mucous membranes appear glistening and glassy. Throat: Slight voice hoarseness; Pharynx appears normal, without ulceration, signs of inflammation, or exudates.

RESPIRATORY: Smooth and effortless respirations. The lungs are clear on auscultation bilaterally.

CARDIOVASCULAR: Regular heart rate and rhythm. S1 and S2 are present. S gallop and systolic murmurs are absent.

Diagnostic results: No diagnostic tests were ordered.

Differential Diagnoses (list a minimum of 3 differential diagnoses).

Common Cold/ Upper Respiratory tract infection (URI): Pappas (2018) explains that URI is an acute, self-limited upper airway viral infection that often involves the lower respiratory tract. The characteristic symptoms include rhinorrhea, nasal congestion, and sore or scratchy throat. Other clinical features include headache, cough, facial and ear pressure, loss of sense of smell and taste, and voice hoarseness (Jaume et al., 2020). The patient has a runny nose, sore throat, pain when swallowing, headache, and hoarseness making this a presumptive diagnosis.
Vasomotor rhinitis: Clinical features include headache, rhinorrhea, nasal congestion, sneezing, postnasal drip, facial pressure, coughing, and throat clearing (Crisci & Ardusso, 2020; Agnihotri & McGrath, 2019). The patient has positive symptoms like rhinorrhea and headache, making this a differential diagnosis.
Influenza: This is a highly contagious acute viral respiratory infection. Clinical manifestations of influenza include severe headache, sore throat, fever, chills, cough, rhinorrhea, red-watery eyes, muscle aches, severe fatigue, and general body weakness (Phetcharakupt et al., 2021). GI symptoms include nausea, vomiting, loss of appetite, abdominal pain, and diarrhea (Chow et al., 2019). The patient has positive symptoms of influenza, like headaches, sore throat, rhinorrhea, and suppressed appetite.
Acute Sinusitis: Acute sinusitis is characterized by facial pain, frontal headache, nasal discharge, nasal blockage, persistent cough, maxillary dental pain, and hypersomnia (Patel & Hwang, 2018). It is a differential based on positive findings of rhinorrhea and headache.
Tonsillitis: The clinical features include sore throat, fever, difficult and painful swallowing, foul breath, tender cervical lymph nodes, and swollen tonsils with purulent exudates (Pérez et al., 2020). The patient has a sore throat and painful swallowing consistent with Tonsillitis. However, she has no fever or inflamed Tonsillar glands ruling out Tonsillitis as the primary diagnosis.

This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

References

Agnihotri, N. T., & McGrath, K. G. (2019). Allergic and non-allergic rhinitis. Allergy and asthma proceedings, 40(6), 376–379. https://doi.org/10.2500/aap.2019.40.4251

Chow, E. J., Doyle, J. D., & Uyeki, T. M. (2019). Influenza virus-related critical illness: prevention, diagnosis, treatment. Critical care, 23(1), 1–11. https://doi.org/10.1186/s13054-019-2491-9

Crisci, C. D., &Ardusso, L. (2020). A Precision Medicine Approach to Rhinitis Evaluation and Management. Current treatment options in allergy, 7(1), 93–109. https://doi.org/10.1007/s40521-020-00243-1

Jaume, F., Valls-Mateus, M., &Mullol, J. (2020). Common Cold and Acute Rhinosinusitis: Up-to-Date Management in 2020. Current Allergy and asthma reports, 20(7), 28. https://doi.org/10.1007/s11882-020-00917-5

Pappas, D. E. (2018). The Common Cold. Principles and Practice of Pediatric Infectious Diseases, 199–202.e1. https://doi.org/10.1016/B978-0-323-40181-4.00026-8

Patel, Z. M., & Hwang, P. H. (2018). Acute Bacterial Rhinosinusitis. Infections of the Ears, Nose, Throat, and Sinuses, 133–143. https://doi.org/10.1007/978-3-319-74835-1_11

Pérez, R. P., González, F. Á., Baquero-Artigao, F., Cañete, M. C., i Bru, J. D. L. F., Landaluce, A. F., … & Fernández, J. S. (2020). Diagnosis and treatment of acute tonsillopharyngitis. Consensus document update. Anales de Pediatría (English Edition), 93(3), 206-e1. https://doi.org/10.1016/j.anpedi.2020.05.004

Phetcharakupt, V., Pasomsub, E., & Kiertiburanakul, S. (2021). Clinical manifestations of influenza and performance of rapid influenza diagnostic test: A university hospital setting. Health science reports, 4(4), e408. https://doi.org/10.1002/hsr2.408

Grading Rubric

Performance Category	100% or highest level of performance 100% 16 points	Very good or high level of performance 88% 14 points	Acceptable level of performance 81% 13 points	Inadequate demonstration of expectations 68% 11 points	Deficient level of performance 56% 9 points	Failing level of performance 55% or less 0 points
Total Points Possible= 50	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic topics.	Presentation of information was exceptional and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was good, but was superficial in places and included all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information was minimally demonstrated in all of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in one of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in two of the following elements: Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.	Presentation of information is unsatisfactory in three or more of the following elements Provides evidence of scholarly inquiry relevant to required TD topic(s). Presents specific information from scholarly sources to develop a comprehensive presentation of facts. Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.* Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
	16 Points	14 Points	13 Points	11 Points	9 Points	0 Points
Application of Course Knowledge Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations	Presentation of information was exceptional and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was good, but was superficial in places and included all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information was minimally demonstrated in the all of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in one of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from and scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in two of the following elements: Applies principles, knowledge and information from scholarly resources to the required topic. Applies facts, principles or concepts learned from scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.	Presentation of information is unsatisfactory in three of the following elements Applies principles, knowledge and information and scholarly resources to the required topic. Applies facts, principles or concepts learned scholarly resources to a professional experience. Application of information is comprehensive and specific to the required topic.
	10 Points	9 Points			6 Points	0 Points
Interactive Dialogue Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic.	Demonstrated all of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 3 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.			Demonstrated 2 of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.	Demonstrated 1 or less of the following: Initial post must be a minimum of 300 words. The peer and instructor responses must be a minimum of 150 words each. Responses are substantive Responses are related to the topic of discussion.
	8 Points	7 Points	6 Points	5 Points	4 Points	0 Points
Grammar, Syntax, APA Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error.	The following was present: 0-3 errors in APA format AND Responses have 0-3 grammatical, spelling or punctuation errors AND Writing style is generally clear, focused on topic,and facilitates communication.	The following was present: 4-6 errors in APA format. AND/OR Responses have 4-5 grammatical, spelling or punctuation errors AND/OR Writing style is somewhat focused on topic.	The following was present: 7-9 errors in APA format. AND/OR Responses have 6-7 grammatical, spelling or punctuation errors AND/OR Writing style is slightly focused on topic making discussion difficult to understand.	The following was present: 10- 12 errors in APA format AND/OR Responses have 8-9 grammatical, spelling and punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand.	The following was present: 13 – 15 errors in APA format AND/OR Responses have 8-10 grammatical, spelling or punctuation errors AND/OR Writing style is not focused on topic, making discussion difficult to understand. AND/OR The student continues to make repeated mistakes in any of the above areas after written correction by the instructor.	The following was present: 16 to greater errors in APA format. AND/OR Responses have more than 10 grammatical, spelling or punctuation errors. AND/OR Writing style does not facilitate communication
	0 Points Deducted					5 Points Lost
Participation Requirements	Demonstrated the following: Initial, peer, and faculty postings were made on 3 separate days					Failed to demonstrate the following: Initial, peer, and faculty postings were made on 3 separate days
	0 Points Lost					5 Points Lost
Due Date Requirements	Demonstrated all of the following: The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.					Demonstrates one or less of the following. The initial posting to the graded threaded discussion topic is posted within the course no later than Wednesday, 11:59 pm MT. A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT.