Sample Answer for NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN Included After Question<\/strong><\/em><\/h2>\nImagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.<\/p>\n
In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.<\/p>\n
To Prepare<\/strong><\/h2>\n\n- By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the \u201cCourse Announcements\u201d section of the classroom for your assignment from your Instructor.<\/li>\n
- 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.<\/li>\n<\/ul>\n
With regard to the case study you were assigned:<\/h2>\n\n- Review this week’s Learning Resources, and consider the insights they provide about the case study.<\/li>\n
- Consider what history would be necessary to collect from the patient in the case study you were assigned.<\/li>\n
- 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?<\/li>\n
- Identify\u00a0at least five<\/strong>\u00a0possible conditions that may be considered in a differential diagnosis for the patient.<\/li>\n<\/ul>\n
The Case Study Assignment<\/strong><\/h2>\nUse 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.<\/p>\n
By Day 6 of Week 9<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nSubmission and Grading Information<\/strong><\/p>\nTo submit your completed Assignment for review and grading, do the following:<\/strong><\/p>\n\n- Please save your Assignment using the naming convention \u201cWK9Assgn1+last name+first initial.(extension)\u201d as the name.<\/li>\n
- Click the\u00a0Week 9 Assignment 1 Rubric\u00a0<\/strong>to review the Grading Criteria for the Assignment.<\/li>\n
- Click the\u00a0Week 9 Assignment 1 <\/strong>link. You will also be able to \u201cView Rubric\u201d for grading criteria from this area.<\/li>\n
- Next, from the Attach File area, click on the\u00a0Browse My Computer<\/strong>\u00a0button. Find the document you saved as \u201cWK9Assgn1+last name+first initial.(extension)\u201d and click\u00a0Open<\/strong>.<\/li>\n
- If applicable: From the Plagiarism Tools area, click the checkbox for\u00a0I agree to submit my paper(s) to the Global Reference Database<\/strong>.<\/li>\n
- Click on the\u00a0Submit<\/strong>\u00a0button to complete your submission.<\/li>\n<\/ul>\n
Grading Criteria<\/strong><\/h2>\n <\/p>\n
\n- Chapter 7, \u201cMental Status\u201dThis chapter revolves around the mental status evaluation of an individual\u2019s overall cognitive state. The chapter includes a list of mental abnormalities and their symptoms.<\/li>\n<\/ul>\n
![\"NURS](\"https:\/\/nursingassignmentcrackers.com\/wp-content\/uploads\/2023\/03\/NURS-6512-Assignment-1-Case-Study-Assignment-Assessing-Neurological-Symptoms-IN-300x138.png\")
NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN<\/figcaption><\/figure>\n\n- Chapter 23, \u201cNeurologic System\u201dThe authors of this chapter explore the anatomy and physiology of the neurologic system. The authors also describe neurological examinations and potential findings.<\/li>\n<\/ul>\n
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care<\/em> (6th ed.). St. Louis, MO: Elsevier Mosby.<\/p>\n <\/p>\n
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN<\/strong><\/a><\/span><\/h3>\nA Sample Answer For the Assignment: NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN<\/strong><\/h2>\nTitle: <\/strong> NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN<\/strong><\/h2>\nPatient Information:<\/strong><\/h3>\nInitials: H.F.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Age: 47 Years\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sex: Female\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Race: Caucasian<\/p>\n
S.<\/u><\/strong><\/p>\nCC<\/strong> (chief complaint): \u201cI am experiencing pain in my right wrist\u201d<\/p>\nHPI<\/strong>: H.F., a 47-year-old Caucasian female with obesity, sought medical attention at the clinic due to her primary concern of experiencing pain in her right wrist, accompanied by sensations of numbness and tingling in the index, middle finger, and thumb. The patient has provided an account of experiencing these symptoms approximately fourteen days prior. Nevertheless, she expresses apprehension regarding the discomfort, as it causes her to inadvertently release her hairstyling implements.<\/p>\nLocation: Right wrist<\/p>\n
Onset: two weeks ago<\/p>\n
Character: Numbness and pain in her right wrist<\/p>\n
Associated signs and symptoms: Thumb, middle, and index finger tingling<\/p>\n
Timing: the whole day<\/p>\n
Exacerbating\/ relieving factors: Worse while doing tasks with the wrist joint. When the wrist is stationary, the discomfort is reduced.<\/p>\n
Severity: 6\/10<\/p>\n
Current Medications<\/strong>:<\/h2>\n\n- Ibuprofen at a dosage of 400mg taken orally as needed,<\/li>\n
- Hydrochlorothiazide at a dosage of 25mg taken orally every morning<\/li>\n
- Amlodipine at a dosage of 10mg taken orally once daily.<\/li>\n<\/ul>\n
Allergies: <\/strong>Allergic to sulfur. No\u00a0environmental or food allergies.<\/p>\nPMHx<\/strong>: The patient exhibits obesity and has a documented history of hypertension.<\/p>\n\n- Immunization status: The patient has received all necessary vaccinations, including Tdap in October 2020, the Influenza Vaccine during the current season, and completed the COVID-19 Vaccines with Boosters in 2021.<\/li>\n
- Surgeries: without any prior surgical history<\/li>\n
- Hospitalization: There is no record of any hospitalizations.<\/li>\n<\/ul>\n
Soc Hx<\/strong>: The patient is a hairdresser who works five blocks from her house in a neighborhood spa. She claims to have a history of sometimes consuming alcohol while smoking cigarettes. She does not, however, admit to using marijuana or any other illegal substance. She presently lives as a family with her husband and three kids. During her free time, she enjoys singing and reading. She exercises by taking the dog for a 30-minute walk every evening. She affirms that she eats a healthy diet and sleeps well for around 8 hours each night.<\/p>\nFam Hx<\/strong>: The patient has two siblings, the younger of whom has just received an asthma\u00a0diagnosis while the other is well. Both of her parents are still living; the mother has a history of T2DM and HTN, while the father has a history of HTN and esophagostomy. She is unaware of the medical history of her grandparents.<\/p>\nROS<\/strong>:<\/h2>\nGENERAL: denies any symptoms of heat or cold sensitivity, reduced appetite, sluggishness, chills, fever, or recent weight changes.<\/p>\n
HEENT: Head: denies experiencing seizures, headaches, or dizziness. Eye: denies any discomfort, discharge, vision disturbances, photophobia, or blurriness. Ear: denies\u00a0discharge, tinnitus, discomfort, or hearing loss. Nose: denies having sneeze fits, sinus pain, a runny nose, or nose bleeding. Throat: denies pain, swallowing issues, or voice hoarseness.<\/p>\n
SKIN: denies rash or itching.<\/p>\n
CARDIOVASCULAR: denies having orthopnea, arrhythmias, elevated blood pressure, or palpitations.<\/p>\n
RESPIRATORY: denies having a cough, producing phlegm, having breathing problems, or breathing quickly.<\/p>\n
GASTROINTESTINAL: denies experiencing vomiting, heartburn, heartburn pain, discomfort, or abdominal distention.<\/p>\n
GENITOURINARY: denies having hematuria, vaginal discharge, incontinence, dysuria, oliguria, frequent urination, or burning pain.<\/p>\n
NEUROLOGICAL: denies experiencing ataxia, a headache, paralysis, syncope, or abnormalities in bowel or bladder control. reports tingling and numbness in the middle, index, and thumb fingers.<\/p>\n
MUSCULOSKELETAL: a right wrist ache is reported. denies muscular pain, joint stiffness, or joint swelling. demonstrates the complete range of motion in other joints.<\/p>\n
HEMATOLOGIC: denies bleeding issues, easy bruising, or anemia.<\/p>\n
LYMPHATICS: denies splenectomy or lymphadenopathy.<\/p>\n
PSYCHIATRIC: denies experiencing hallucinations or other psychological symptoms such as anxiety, sadness, or thoughts of homicide or suicide.<\/p>\n
ENDOCRINOLOGIC: denies a tendency to sweat excessively, polyuria, polydipsia, or sensitivity to heat and cold.<\/p>\n
ALLERGIES: Sulfur allergy is reported.<\/p>\n
O.<\/u><\/strong><\/p>\nPhysical exam<\/strong>: Vital signs<\/strong>: BP- 138\/86 mmHg, PR-86, RR-19, Temp- 98.9, SpO2-98% on room air, Ht- 5\u20199\u201d, Wt- 210 lbs., BMI-31.01<\/p>\nGENERAL: a female who is obese and adequately attired. Clear speaking, the patient is focused and aware X4. The patient\u00a0responds to inquiries adequately and is not visibly distressed.<\/p>\n
HEENT: Head: normal-sized, trauma-free, and without scars. Eye: Sclera and conjunctiva are clear. No significant redness, discharge, or tearing. Ear: Typical pinna with an unobstructed tympanic membrane. It is normal for the external auditory canal. Nose: nasal mucous membrane that is wet. No sinuses or discomfort to the touch. Throat: pink, wet mucous membrane in the mouth. The tonsils and posterior pharynx are not erythematous, and the uvula is in the middle.<\/p>\n
MUSCULOSKELETAL: Gait and musculoskeletal development are normal. displays a healthy body posture without any joint or bone swelling or abnormalities. Right thumb abduction shows weakness, with a 3\/5 poor strength. Positive Hoffmann-Tinel and Phalen indicators. All the muscles of the other limb are strong and their tendon reflexes are normal.<\/p>\n
NEUROLOGICAL: Aware and well-grounded in time, location, and people. quite helpful throughout the assessment. All of the cranial nerves are mostly unharmed. demonstrates typical reactions. The right hand’s middle finger, thumb, and index finger all feel numb and tingly.<\/p>\n
Diagnostic results<\/strong>: The complete blood count (CBC) reveals a white blood cell count (WBC) of 8.9. Additionally, a comprehensive metabolic panel (CMP) including differentials is performed.\u00a0 The glucose level is measured at 125, while the HgbA1c level is recorded as 4.5%, indicating the need to exclude any potential presence or occurrence. Neuropathy associated with type 2 diabetes mellitus (T2DM). The concentration of C-reactive protein in the sample is 4.2 mg\/L (Attal & Didier Bouhassira, 2023).<\/p>\nDiagnostic Tests:<\/strong><\/h2>\n\n- An X-ray examination of the right wrist was conducted to assess the presence of arthritic changes (Genova et al., 2020).<\/li>\n
- Test for bone density to rule out osteoporosis.<\/li>\n
- nerve conduction analysis.<\/li>\n
- Manual: Tinel sign and Durkans Test (Zhang et al., 2020).<\/li>\n<\/ul>\n
A<\/u><\/strong>.<\/u><\/p>\nDifferential Diagnoses:<\/strong><\/h2>\n\n- Carpal tunnel syndrome (CTS): This condition is characterized by symptoms such as tingling and numbness in the fingers, which occur due to compression of the median nerve within the carpal tunnel (Malakootian et al., 2022). This condition is commonly regarded as an occupational disease characterized by repetitive wrist and finger extension and flexion. However, certain cases of CTS may have an unknown cause, and the risk of developing CTS can be influenced by various factors, including genetic and acquired factors. A nerve conduction study is a precise diagnostic tool used to identify both normal and abnormal values of nerve function. Diagnostic laboratory results can also be utilized for the identification of increased levels of inflammatory markers. The patient exhibits multiple risk factors for developing this disease, including occupational factors and obesity.<\/li>\n
- Peripheral neuropathy: This condition\u00a0is linked to hand numbness. The patient’s gender, familial history, and weight contribute to their increased risk of developing type 2 diabetes mellitus (T2DM) (Selvarajah et al., 2019). Peripheral neuropathy is a frequently observed symptom associated with T2DM, characterized by a gradual onset. A two-point discrimination test was conducted, revealing decreased sensitivity in the patient’s right arm. The patient reports no decrease in sensation in the lower extremities. If the patient experiences altered symptoms and exhibits new-onset neuropathy in the lower extremities, I will contemplate reevaluating the A1C levels and potentially diagnose diabetic peripheral neuropathy based on diagnostic assessments. Diabetic individuals exhibit significant declines in hand and finger dexterity relative to their healthy counterparts.<\/li>\n
- Wartenberg\u2019s syndrome: This condition\u00a0presents as paresthesia or pain occurring along the radial aspect of the forearm, with symptoms radiating toward\u00a0the thumb and middle fingers. The pain arises due to the compression of the superficial radial nerve. Potential external factors may include the presence of a wristwatch or objects exerting pressure on the nerve (Kuschner & Berihun, 2021). The technique of palpation in the vicinity of the radial nerve region is employed to detect potential masses located both superficially and deeply. The utilization of the Tinel’s sign aids in the confirmation of this particular diagnosis.<\/li>\n
- Lupus: This\u00a0is an autoimmune disease characterized by immune system dysfunction, resulting in inflammation, a high body temperature, joint pain, malaise, and rash. DNA methylation is a specific and reliable biomarker for the diagnosis of lupus, exhibiting cell-type specificity (Fanouriakis et al., 2020). DNA methylation is more prominent in patients with active disease compared to those in remission. The lupus band test (LBT) is a direct immunofluorescent approach conducted through skin biopsy. It is particularly valuable in cases where clinical and laboratory data are inconclusive for diagnosing lupus.<\/li>\n
- Type 2 Diabetes Mellitus (T2DM): The patient is at a heightened risk of developing T2DM. In the event of a gradual increase in the patient’s HbA1c, it is recommended to implement a prediabetes protocol involving lifestyle modifications such as dietary changes, exercise, and regular monitoring of HbA1c levels. Diabetic peripheral neuropathy (DNP) is characterized by progressive metabolic and inflammatory alterations that result in impaired daily functioning and reduced independence (Wu et al., 2021). Fasting lipid levels should be included in laboratory tests to assess cholesterol levels and provide education on cholesterol, triglycerides, LDL, and HDL levels.<\/li>\n<\/ol>\n
\u00a0<\/strong><\/p>\n\u00a0<\/strong><\/p>\nReferences<\/strong><\/h2>\nAttal, N., & Didier Bouhassira. (2023).\u00a0Neuropathic Pain<\/em>. https:\/\/doi.org\/10.1093\/med\/9780197616345.001.0001<\/a><\/p>\nFanouriakis, A., Tziolos, N., Bertsias, G., & Boumpas, D. T. (2020). Update \u039fn the Diagnosis and Management of Systemic Lupus Erythematosus.\u00a0Annals of the Rheumatic Diseases<\/em>,\u00a080<\/em>(1), annrheumdis-2020-218272. https:\/\/doi.org\/10.1136\/annrheumdis-2020-218272<\/a><\/p>\nGenova, A., Dix, O., Saefan, A., Thakur, M., & Hassan, A. (2020). Carpal Tunnel Syndrome: A Review of Literature.\u00a0Cureus<\/em>,\u00a012<\/em>(3). https:\/\/doi.org\/10.7759\/cureus.7333<\/a><\/p>\nKuschner, S. H., & Berihun, H. (2021). Robert Wartenberg Syndrome and Sign: A Review Article.\u00a0The Open Orthopaedics Journal<\/em>,\u00a015<\/em>(1), 13\u201316. https:\/\/doi.org\/10.2174\/1874325002115010013<\/a><\/p>\nMalakootian, M., Soveizi, M., Gholipour, A., & Oveisee, M. (2022). Pathophysiology, Diagnosis, Treatment, and Genetics of Carpal Tunnel Syndrome: A Review.\u00a0Cellular and Molecular Neurobiology<\/em>. https:\/\/doi.org\/10.1007\/s10571-022-01297-2<\/a><\/p>\nSelvarajah, D., Kar, D., Khunti, K., Davies, M. J., Scott, A. R., Walker, J., & Tesfaye, S. (2019). Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention.\u00a0The Lancet Diabetes & Endocrinology<\/em>,\u00a07<\/em>(12), 938\u2013948. https:\/\/doi.org\/10.1016\/s2213-8587(19)30081-6<\/a><\/p>\nWu, B., Niu, Z., & Hu, F. (2021). Study on Risk Factors of Peripheral Neuropathy in Type 2 Diabetes Mellitus and Establishment of Prediction Model.\u00a0Diabetes & Metabolism Journal<\/em>,\u00a045<\/em>(4), 526\u2013538. https:\/\/doi.org\/10.4093\/dmj.2020.0100<\/a><\/p>\nZhang, D., Chruscielski, C., Blazar, P., & Earp, B. (2020). Accuracy of Provocative Tests for Carpal Tunnel Syndrome.\u00a0Journal of Hand Surgery Global Online<\/em>,\u00a02<\/em>(3), 121\u2013125. https:\/\/doi.org\/10.1016\/j.jhsg.2020.03.002<\/a><\/p>\nA Sample Answer 2 For the Assignment: NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN<\/strong><\/h2>\nTitle: <\/strong> NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN<\/strong><\/h2>\nPatient Information:<\/strong><\/h3>\nA.Y, 20 year-old African American male<\/p>\n
S.<\/u><\/strong><\/p>\nCC<\/strong> \u201cI have been experiencing intermittent headaches that diffuse all over the head with greatest intensity and pressure above the eyes.\u201d<\/p>\nHPI<\/strong>: The patient came with complaints of intermittent headaches for the last one week. The headaches diffuse all over the head with greatest intensity and pressure above the eyes and spreads through the nose, cheekbones, and jaw. The client reports that analgesics such as acetaminophen provide him with relieve that is not long lasting. The associated symptoms include nausea and photophobia. The severity of pain as reported by the patient was 8\/10.<\/p>\nCurrent Medications<\/strong>: The patient has been using acetaminophen 1 gm TDS for the last four days.<\/p>\nAllergies: <\/strong>The client denied any food, drug, or environmental allergy.<\/p>\nPMHx<\/strong>: The client\u2019s immunization history is up to date.<\/p>\nSoc Hx<\/strong>: The client is a college student undertaking a degree in information technology. He does not smoke or take alcohol. He engages in active physical activity, as he is a member of the university basketball team. His social support comprises of his family members and friends.<\/p>\nFam Hx<\/strong>: The client denied any chronic illnesses in the family.<\/p>\nROS<\/strong>:<\/p>\nGENERAL: \u00a0The patient appeared well-groomed for the occasion without any signs of malaise or weight loss. He denied fever and chills.<\/p>\n
HEENT: \u00a0Eyes: The client denied visual loss, blurred vision, double vision or yellow sclerae. He reported photophobia during the episodes of intermittent headaches.<\/p>\n
Ears, Nose, Throat: \u00a0He denied hearing loss, sneezing, congestion, runny nose or sore throat.<\/p>\n
SKIN: \u00a0He denied rash, scars, or itching.<\/p>\n
CARDIOVASCULAR: \u00a0He denied chest pain, chest pressure, chest discomfort, palpitations or edema.<\/p>\n
RESPIRATORY: \u00a0He denied shortness of breath, difficulty in breathing, cough or sputum.<\/p>\n
GASTROINTESTINAL: \u00a0Denies anorexia, vomiting or diarrhea. He also denied abdominal pain or blood. He reported nausea during episodes of intermittent headaches.<\/p>\n
GENITOURINARY: \u00a0He denied burning on urination, increased urinary frequency, or changes in smell and color of urine.<\/p>\n
NEUROLOGICAL: \u00a0The patient reports intermittent headaches, denies syncope, dizziness, paralysis, numbness, and tingling of the extremities. He also denied changes in bladder and bwel control.<\/p>\n
MUSCULOSKELETAL: \u00a0The patient denied muscle, back pain, joint pain or stiffness.<\/p>\n
HEMATOLOGIC: \u00a0He denied anemia, bleeding or bruising.<\/p>\n
LYMPHATICS: \u00a0He denied enlarged nodes with absence of a history of splenectomy.<\/p>\n
PSYCHIATRIC: \u00a0He denied history of depression or anxiety.<\/p>\n
ENDOCRINOLOGIC: \u00a0He denied history of sweating, cold or heat intolerance. He also denied polyuria or polydipsia.<\/p>\n
ALLERGIES: \u00a0He denied history of asthma, hives, eczema or rhinitis.<\/p>\n
O.<\/u><\/strong><\/p>\nPhysical exam<\/strong>:<\/h2>\nGeneral: The patient appears well groomed, with lack of evidence of weight loss and fatigue<\/p>\n
Vitals<\/strong>: Temp 36.7, BP 122\/76 P-80, RR 20, SPO2 96,<\/p>\nHead<\/strong>: normocephalic, with no lesions, evidence of trauma, with symmetric facial features. The maxillary and frontal sinuses are tender on palpation.<\/p>\nEars<\/strong>: The ears are symmetric with absence of ear drainage, loss of balance, and grey tympanic membranes<\/p>\nEyes<\/strong>: the eyes are symmetric, without jaundice and bleeding. Normal visual acuity<\/p>\nNose<\/strong>: Absence of nasal flaring, discharge, and septum deviation<\/p>\nThroat<\/strong>: Absence of tonsillitis<\/p>\nNeck<\/strong>: symmetric trachea noted with absence of neck rigidity, swelling, and gross abnormalities of the thyroid<\/p>\nCardiovascular<\/strong>: presence of S1 and S2, with absence of peripheral edema and advantageous sounds<\/p>\nGastrointestinal<\/strong>: Absence of abdominal swelling, scars, with normal bowel movements.<\/p>\nRespiratory<\/strong>: Lung sounds clear with absence of advantageous sounds<\/p>\nNeurological<\/strong>: Client is oriented to self, place, time, and events. Pupil reactive to light and equal in size with equal grip in both hands and symmetrical facial features. The self-reported headache is rated at 8\/10. There is the presence of intermittent headache, photophobia, and nausea.<\/p>\nDiagnostic results<\/strong>: One of the recommended diagnostic investigations that should be performed for the client is nasal scrapping. Nasal scraping should be performed to obtain a sample for test for esinophils. Radiological investigations are also recommended in case of severe symptoms. The investigations include a head CT scan to detect any abnormalities such as tissue involvement, inflammation of the meninges, and tumors. A MRI may also be done to determine the presence of any abnormality in the brain tissue and soft tissue pathology. Bacterial sinusitis may also be diagnosed by performing sinus aspiration (Iskandar & Triayudi, 2020).<\/p>\nA<\/u><\/strong>.<\/u><\/p>\nDifferential Diagnoses <\/strong><\/h2>\nSinusitis<\/strong>: The first differential diagnosis for the client in this case study is sinusitis. Sinusitis is a condition characterized by the inflammation of the nasal cavities. The symptoms often last for a period of less than a month. Patients with sinusitis experience symptoms that include frontal headaches with feelings of fullness. Patients also experience other accompanying symptoms that include nausea, vomiting, photophobia, and nasal drainage. The physical assessment findings may reveal tenderness of the sinuses (Iskandar & Triayudi, 2020). The patient in the case study has symptoms that align with this diagnosis, hence, it being the primary diagnosis.<\/p>\nMigraine headache<\/strong>: migraine headache is the secondary diagnosis for the patient in this case study. Patients with migraine headache experience severe, throbbing headache. The accompanying symptoms include photophobia, phonophobia, nausea, and vomiting (Ha & Gonzalez, 2019). This is however a least diagnosis because of the patient experiencing feelings of fullness and involvement of the sinuses.<\/p>\nAllergic rhinitis<\/strong>: The other possible diagnosis for the client is allergic rhinitis. Patients with allergic rhinitis experience symptoms that include headaches, nasal drainage, coughing, sneezing, and pressure on the cheeks and nose (Scadding et al., 2017). Allergic rhinitis is however the least likely diagnosis due to the absence of a history of allergic reaction by the client.<\/p>\nFacial pain syndrome<\/strong>: Facial pain syndrome is the other potential diagnosis for the client in the case study. Facial pain syndrome is attributed to pain affecting the trigeminal nerve. The symptoms associated with it include pain on touching the face, speaking, chewing or brushing teeth (Benoliel & Gaul, 2017). Facial pain syndrome is however the least likely diagnosis due to the absence of pain upon stimulation of the facial muscles.<\/p>\nAcute bacterial pharyngitis<\/strong>: Acute bacterial pharyngitis is the last potential diagnosis for the client. Acute bacterial pharyngitis is attributed to step bacterial infection. Patients experience symptoms that include difficulty in swallowing, headache, chills, and malaise. The patient however does not experience difficulty in swallowing, fever, and chills, hence, acute bacterial pharyngitis not being the primary differential (Harberger & Graber, 2021).<\/p>\n\n- <\/li>\n<\/ol>\n
This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.<\/p>\n
<\/p>\n
References<\/h2>\n
Benoliel, R., & Gaul, C. (2017). Persistent idiopathic facial pain. Cephalalgia<\/em>, 37<\/em>(7), 680\u2013691. https:\/\/doi.org\/10.1177\/0333102417706349<\/a><\/p>\nHa, H., & Gonzalez, A. (2019). Migraine Headache Prophylaxis. American Family Physician<\/em>, 99<\/em>(1), 17\u201324.<\/p>\nHarberger, S., & Graber, M. (2021). Bacterial Pharyngitis. In StatPearls<\/em>. StatPearls Publishing. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK559007\/<\/a><\/p>\nIskandar, A., & Triayudi, A. (2020). Early Diagnosis of Sinusitis Using Expert System Methods: Early Diagnosis of Sinusitis Using Expert System Methods. Jurnal Mantik<\/em>, 4<\/em>(2), 1231\u20131236. https:\/\/doi.org\/10.35335\/mantik.Vol4.2020.927.pp1231-1236<\/a><\/p>\nScadding, G. K., Kariyawasam, H. H., Scadding, G., Mirakian, R., Buckley, R. J., Dixon, T., Durham, S. R., Farooque, S., Jones, N., Leech, S., Nasser, S. M., Powell, R., Roberts, G., Rotiroti, G., Simpson, A., Smith, H., & Clark, A. T. (2017). BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition 2017; First edition 2007). Clinical & Experimental Allergy<\/em>, 47<\/em>(7), 856\u2013889. https:\/\/doi.org\/10.1111\/cea.12953<\/a><\/p>\nContent<\/strong><\/h3>\nName:\u00a0NURS_6512_Week_9_Assignment1_Rubric<\/strong><\/h3>\n\n- Grid View<\/a><\/li>\n
- List View<\/a><\/li>\n<\/ul>\n
\n\n\n\u00a0<\/strong><\/td>\nExcellent <\/strong><\/td>\nGood <\/strong><\/td>\nFair <\/strong><\/td>\nPoor <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nUsing the Episodic\/Focused SOAP Template:
\n\u00b7\u00a0Create documentation or an episodic\/focused note in SOAP format about the patient in the case study to which you were assigned.<\/strong><\/strong>\u00b7\u00a0\u00a0Provide evidence from the literature to support diagnostic tests that would be appropriate for your case.<\/td>\nPoints Range: 45 (45%) – 50 (50%)<\/p>\nThe response clearly, accurately, and thoroughly follows the SOAP format to document the patient in the assigned case study. The response thoroughly and accurately provides detailed evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study.<\/td>\n
Points Range: 39 (39%) – 44 (44%)<\/p>\nThe response accurately follows the SOAP format to document the patient in the assigned case study. The response accurately provides detailed evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study.<\/td>\n
Points Range: 33 (33%) – 38 (38%)<\/p>\nThe response follows the SOAP format to document the patient in the assigned case study, with some vagueness and inaccuracy. The response provides evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study, with some vagueness or inaccuracy in the evidence selected.<\/td>\n
Points Range: 0 (0%) – 32 (32%)<\/p>\nThe response incompletely and inaccurately follows the SOAP format to document the patient in the assigned case study. The response provides incomplete, inaccurate, and\/or missing evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study.<\/td>\n<\/tr>\n
\n\u00b7\u00a0\u00a0 List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. <\/strong><\/td>\nPoints Range: 30 (30%) – 35 (35%)<\/p>\nThe response lists five distinctly different and detailed possible conditions for a differential diagnosis of the patient in the assigned case study and provides a thorough, accurate, and detailed justification for each of the five conditions selected.<\/td>\n
Points Range: 24 (24%) – 29 (29%)<\/p>\nThe response lists four to five different possible conditions for a differential diagnosis of the patient in the assigned case study and provides an accurate justification for each of the five conditions selected.<\/td>\n
Points Range: 18 (18%) – 23 (23%)<\/p>\nThe response lists three to four possible conditions for a differential diagnosis of the patient in the assigned case study, with some vagueness and\/or some inaccuracy in the conditions and\/or justification for each.<\/td>\n
Points Range: 0 (0%) – 17 (17%)<\/p>\nThe response lists three or fewer, or is missing, possible conditions for a differential diagnosis of the patient in the assigned case study, with inaccurate or missing justification for each condition selected.<\/td>\n<\/tr>\n
\n
- \n
- By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the \u201cCourse Announcements\u201d section of the classroom for your assignment from your Instructor.<\/li>\n
- 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.<\/li>\n<\/ul>\n
With regard to the case study you were assigned:<\/h2>\n
- \n
- Review this week’s Learning Resources, and consider the insights they provide about the case study.<\/li>\n
- Consider what history would be necessary to collect from the patient in the case study you were assigned.<\/li>\n
- 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?<\/li>\n
- Identify\u00a0at least five<\/strong>\u00a0possible conditions that may be considered in a differential diagnosis for the patient.<\/li>\n<\/ul>\n
The Case Study Assignment<\/strong><\/h2>\n
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.<\/p>\n
By Day 6 of Week 9<\/strong><\/h2>\n
Submit<\/strong> your Assignment.<\/p>\n
Submission and Grading Information<\/strong><\/p>\n
To submit your completed Assignment for review and grading, do the following:<\/strong><\/p>\n
- \n
- Please save your Assignment using the naming convention \u201cWK9Assgn1+last name+first initial.(extension)\u201d as the name.<\/li>\n
- Click the\u00a0Week 9 Assignment 1 Rubric\u00a0<\/strong>to review the Grading Criteria for the Assignment.<\/li>\n
- Click the\u00a0Week 9 Assignment 1 <\/strong>link. You will also be able to \u201cView Rubric\u201d for grading criteria from this area.<\/li>\n
- Next, from the Attach File area, click on the\u00a0Browse My Computer<\/strong>\u00a0button. Find the document you saved as \u201cWK9Assgn1+last name+first initial.(extension)\u201d and click\u00a0Open<\/strong>.<\/li>\n
- If applicable: From the Plagiarism Tools area, click the checkbox for\u00a0I agree to submit my paper(s) to the Global Reference Database<\/strong>.<\/li>\n
- Click on the\u00a0Submit<\/strong>\u00a0button to complete your submission.<\/li>\n<\/ul>\n
Grading Criteria<\/strong><\/h2>\n
<\/p>\n
- \n
- Chapter 7, \u201cMental Status\u201dThis chapter revolves around the mental status evaluation of an individual\u2019s overall cognitive state. The chapter includes a list of mental abnormalities and their symptoms.<\/li>\n<\/ul>\n
NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN<\/figcaption><\/figure>\n - \n
- Chapter 23, \u201cNeurologic System\u201dThe authors of this chapter explore the anatomy and physiology of the neurologic system. The authors also describe neurological examinations and potential findings.<\/li>\n<\/ul>\n
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care<\/em> (6th ed.). St. Louis, MO: Elsevier Mosby.<\/p>\n
<\/p>\n
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN<\/strong><\/a><\/span><\/h3>\n
A Sample Answer For the Assignment: NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN<\/strong><\/h2>\n
Title: <\/strong> NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN<\/strong><\/h2>\n
Patient Information:<\/strong><\/h3>\n
Initials: H.F.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Age: 47 Years\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sex: Female\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Race: Caucasian<\/p>\n
S.<\/u><\/strong><\/p>\n
CC<\/strong> (chief complaint): \u201cI am experiencing pain in my right wrist\u201d<\/p>\n
HPI<\/strong>: H.F., a 47-year-old Caucasian female with obesity, sought medical attention at the clinic due to her primary concern of experiencing pain in her right wrist, accompanied by sensations of numbness and tingling in the index, middle finger, and thumb. The patient has provided an account of experiencing these symptoms approximately fourteen days prior. Nevertheless, she expresses apprehension regarding the discomfort, as it causes her to inadvertently release her hairstyling implements.<\/p>\n
Location: Right wrist<\/p>\n
Onset: two weeks ago<\/p>\n
Character: Numbness and pain in her right wrist<\/p>\n
Associated signs and symptoms: Thumb, middle, and index finger tingling<\/p>\n
Timing: the whole day<\/p>\n
Exacerbating\/ relieving factors: Worse while doing tasks with the wrist joint. When the wrist is stationary, the discomfort is reduced.<\/p>\n
Severity: 6\/10<\/p>\n
Current Medications<\/strong>:<\/h2>\n
- \n
- Ibuprofen at a dosage of 400mg taken orally as needed,<\/li>\n
- Hydrochlorothiazide at a dosage of 25mg taken orally every morning<\/li>\n
- Amlodipine at a dosage of 10mg taken orally once daily.<\/li>\n<\/ul>\n
Allergies: <\/strong>Allergic to sulfur. No\u00a0environmental or food allergies.<\/p>\n
PMHx<\/strong>: The patient exhibits obesity and has a documented history of hypertension.<\/p>\n
- \n
- Immunization status: The patient has received all necessary vaccinations, including Tdap in October 2020, the Influenza Vaccine during the current season, and completed the COVID-19 Vaccines with Boosters in 2021.<\/li>\n
- Surgeries: without any prior surgical history<\/li>\n
- Hospitalization: There is no record of any hospitalizations.<\/li>\n<\/ul>\n
Soc Hx<\/strong>: The patient is a hairdresser who works five blocks from her house in a neighborhood spa. She claims to have a history of sometimes consuming alcohol while smoking cigarettes. She does not, however, admit to using marijuana or any other illegal substance. She presently lives as a family with her husband and three kids. During her free time, she enjoys singing and reading. She exercises by taking the dog for a 30-minute walk every evening. She affirms that she eats a healthy diet and sleeps well for around 8 hours each night.<\/p>\n
Fam Hx<\/strong>: The patient has two siblings, the younger of whom has just received an asthma\u00a0diagnosis while the other is well. Both of her parents are still living; the mother has a history of T2DM and HTN, while the father has a history of HTN and esophagostomy. She is unaware of the medical history of her grandparents.<\/p>\n
ROS<\/strong>:<\/h2>\n
GENERAL: denies any symptoms of heat or cold sensitivity, reduced appetite, sluggishness, chills, fever, or recent weight changes.<\/p>\n
HEENT: Head: denies experiencing seizures, headaches, or dizziness. Eye: denies any discomfort, discharge, vision disturbances, photophobia, or blurriness. Ear: denies\u00a0discharge, tinnitus, discomfort, or hearing loss. Nose: denies having sneeze fits, sinus pain, a runny nose, or nose bleeding. Throat: denies pain, swallowing issues, or voice hoarseness.<\/p>\n
SKIN: denies rash or itching.<\/p>\n
CARDIOVASCULAR: denies having orthopnea, arrhythmias, elevated blood pressure, or palpitations.<\/p>\n
RESPIRATORY: denies having a cough, producing phlegm, having breathing problems, or breathing quickly.<\/p>\n
GASTROINTESTINAL: denies experiencing vomiting, heartburn, heartburn pain, discomfort, or abdominal distention.<\/p>\n
GENITOURINARY: denies having hematuria, vaginal discharge, incontinence, dysuria, oliguria, frequent urination, or burning pain.<\/p>\n
NEUROLOGICAL: denies experiencing ataxia, a headache, paralysis, syncope, or abnormalities in bowel or bladder control. reports tingling and numbness in the middle, index, and thumb fingers.<\/p>\n
MUSCULOSKELETAL: a right wrist ache is reported. denies muscular pain, joint stiffness, or joint swelling. demonstrates the complete range of motion in other joints.<\/p>\n
HEMATOLOGIC: denies bleeding issues, easy bruising, or anemia.<\/p>\n
LYMPHATICS: denies splenectomy or lymphadenopathy.<\/p>\n
PSYCHIATRIC: denies experiencing hallucinations or other psychological symptoms such as anxiety, sadness, or thoughts of homicide or suicide.<\/p>\n
ENDOCRINOLOGIC: denies a tendency to sweat excessively, polyuria, polydipsia, or sensitivity to heat and cold.<\/p>\n
ALLERGIES: Sulfur allergy is reported.<\/p>\n
O.<\/u><\/strong><\/p>\n
Physical exam<\/strong>: Vital signs<\/strong>: BP- 138\/86 mmHg, PR-86, RR-19, Temp- 98.9, SpO2-98% on room air, Ht- 5\u20199\u201d, Wt- 210 lbs., BMI-31.01<\/p>\n
GENERAL: a female who is obese and adequately attired. Clear speaking, the patient is focused and aware X4. The patient\u00a0responds to inquiries adequately and is not visibly distressed.<\/p>\n
HEENT: Head: normal-sized, trauma-free, and without scars. Eye: Sclera and conjunctiva are clear. No significant redness, discharge, or tearing. Ear: Typical pinna with an unobstructed tympanic membrane. It is normal for the external auditory canal. Nose: nasal mucous membrane that is wet. No sinuses or discomfort to the touch. Throat: pink, wet mucous membrane in the mouth. The tonsils and posterior pharynx are not erythematous, and the uvula is in the middle.<\/p>\n
MUSCULOSKELETAL: Gait and musculoskeletal development are normal. displays a healthy body posture without any joint or bone swelling or abnormalities. Right thumb abduction shows weakness, with a 3\/5 poor strength. Positive Hoffmann-Tinel and Phalen indicators. All the muscles of the other limb are strong and their tendon reflexes are normal.<\/p>\n
NEUROLOGICAL: Aware and well-grounded in time, location, and people. quite helpful throughout the assessment. All of the cranial nerves are mostly unharmed. demonstrates typical reactions. The right hand’s middle finger, thumb, and index finger all feel numb and tingly.<\/p>\n
Diagnostic results<\/strong>: The complete blood count (CBC) reveals a white blood cell count (WBC) of 8.9. Additionally, a comprehensive metabolic panel (CMP) including differentials is performed.\u00a0 The glucose level is measured at 125, while the HgbA1c level is recorded as 4.5%, indicating the need to exclude any potential presence or occurrence. Neuropathy associated with type 2 diabetes mellitus (T2DM). The concentration of C-reactive protein in the sample is 4.2 mg\/L (Attal & Didier Bouhassira, 2023).<\/p>\n
Diagnostic Tests:<\/strong><\/h2>\n
- \n
- An X-ray examination of the right wrist was conducted to assess the presence of arthritic changes (Genova et al., 2020).<\/li>\n
- Test for bone density to rule out osteoporosis.<\/li>\n
- nerve conduction analysis.<\/li>\n
- Manual: Tinel sign and Durkans Test (Zhang et al., 2020).<\/li>\n<\/ul>\n
A<\/u><\/strong>.<\/u><\/p>\n
Differential Diagnoses:<\/strong><\/h2>\n
- \n
- Carpal tunnel syndrome (CTS): This condition is characterized by symptoms such as tingling and numbness in the fingers, which occur due to compression of the median nerve within the carpal tunnel (Malakootian et al., 2022). This condition is commonly regarded as an occupational disease characterized by repetitive wrist and finger extension and flexion. However, certain cases of CTS may have an unknown cause, and the risk of developing CTS can be influenced by various factors, including genetic and acquired factors. A nerve conduction study is a precise diagnostic tool used to identify both normal and abnormal values of nerve function. Diagnostic laboratory results can also be utilized for the identification of increased levels of inflammatory markers. The patient exhibits multiple risk factors for developing this disease, including occupational factors and obesity.<\/li>\n
- Peripheral neuropathy: This condition\u00a0is linked to hand numbness. The patient’s gender, familial history, and weight contribute to their increased risk of developing type 2 diabetes mellitus (T2DM) (Selvarajah et al., 2019). Peripheral neuropathy is a frequently observed symptom associated with T2DM, characterized by a gradual onset. A two-point discrimination test was conducted, revealing decreased sensitivity in the patient’s right arm. The patient reports no decrease in sensation in the lower extremities. If the patient experiences altered symptoms and exhibits new-onset neuropathy in the lower extremities, I will contemplate reevaluating the A1C levels and potentially diagnose diabetic peripheral neuropathy based on diagnostic assessments. Diabetic individuals exhibit significant declines in hand and finger dexterity relative to their healthy counterparts.<\/li>\n
- Wartenberg\u2019s syndrome: This condition\u00a0presents as paresthesia or pain occurring along the radial aspect of the forearm, with symptoms radiating toward\u00a0the thumb and middle fingers. The pain arises due to the compression of the superficial radial nerve. Potential external factors may include the presence of a wristwatch or objects exerting pressure on the nerve (Kuschner & Berihun, 2021). The technique of palpation in the vicinity of the radial nerve region is employed to detect potential masses located both superficially and deeply. The utilization of the Tinel’s sign aids in the confirmation of this particular diagnosis.<\/li>\n
- Lupus: This\u00a0is an autoimmune disease characterized by immune system dysfunction, resulting in inflammation, a high body temperature, joint pain, malaise, and rash. DNA methylation is a specific and reliable biomarker for the diagnosis of lupus, exhibiting cell-type specificity (Fanouriakis et al., 2020). DNA methylation is more prominent in patients with active disease compared to those in remission. The lupus band test (LBT) is a direct immunofluorescent approach conducted through skin biopsy. It is particularly valuable in cases where clinical and laboratory data are inconclusive for diagnosing lupus.<\/li>\n
- Type 2 Diabetes Mellitus (T2DM): The patient is at a heightened risk of developing T2DM. In the event of a gradual increase in the patient’s HbA1c, it is recommended to implement a prediabetes protocol involving lifestyle modifications such as dietary changes, exercise, and regular monitoring of HbA1c levels. Diabetic peripheral neuropathy (DNP) is characterized by progressive metabolic and inflammatory alterations that result in impaired daily functioning and reduced independence (Wu et al., 2021). Fasting lipid levels should be included in laboratory tests to assess cholesterol levels and provide education on cholesterol, triglycerides, LDL, and HDL levels.<\/li>\n<\/ol>\n
\u00a0<\/strong><\/p>\n
\u00a0<\/strong><\/p>\n
References<\/strong><\/h2>\n
Attal, N., & Didier Bouhassira. (2023).\u00a0Neuropathic Pain<\/em>. https:\/\/doi.org\/10.1093\/med\/9780197616345.001.0001<\/a><\/p>\n
Fanouriakis, A., Tziolos, N., Bertsias, G., & Boumpas, D. T. (2020). Update \u039fn the Diagnosis and Management of Systemic Lupus Erythematosus.\u00a0Annals of the Rheumatic Diseases<\/em>,\u00a080<\/em>(1), annrheumdis-2020-218272. https:\/\/doi.org\/10.1136\/annrheumdis-2020-218272<\/a><\/p>\n
Genova, A., Dix, O., Saefan, A., Thakur, M., & Hassan, A. (2020). Carpal Tunnel Syndrome: A Review of Literature.\u00a0Cureus<\/em>,\u00a012<\/em>(3). https:\/\/doi.org\/10.7759\/cureus.7333<\/a><\/p>\n
Kuschner, S. H., & Berihun, H. (2021). Robert Wartenberg Syndrome and Sign: A Review Article.\u00a0The Open Orthopaedics Journal<\/em>,\u00a015<\/em>(1), 13\u201316. https:\/\/doi.org\/10.2174\/1874325002115010013<\/a><\/p>\n
Malakootian, M., Soveizi, M., Gholipour, A., & Oveisee, M. (2022). Pathophysiology, Diagnosis, Treatment, and Genetics of Carpal Tunnel Syndrome: A Review.\u00a0Cellular and Molecular Neurobiology<\/em>. https:\/\/doi.org\/10.1007\/s10571-022-01297-2<\/a><\/p>\n
Selvarajah, D., Kar, D., Khunti, K., Davies, M. J., Scott, A. R., Walker, J., & Tesfaye, S. (2019). Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention.\u00a0The Lancet Diabetes & Endocrinology<\/em>,\u00a07<\/em>(12), 938\u2013948. https:\/\/doi.org\/10.1016\/s2213-8587(19)30081-6<\/a><\/p>\n
Wu, B., Niu, Z., & Hu, F. (2021). Study on Risk Factors of Peripheral Neuropathy in Type 2 Diabetes Mellitus and Establishment of Prediction Model.\u00a0Diabetes & Metabolism Journal<\/em>,\u00a045<\/em>(4), 526\u2013538. https:\/\/doi.org\/10.4093\/dmj.2020.0100<\/a><\/p>\n
Zhang, D., Chruscielski, C., Blazar, P., & Earp, B. (2020). Accuracy of Provocative Tests for Carpal Tunnel Syndrome.\u00a0Journal of Hand Surgery Global Online<\/em>,\u00a02<\/em>(3), 121\u2013125. https:\/\/doi.org\/10.1016\/j.jhsg.2020.03.002<\/a><\/p>\n
A Sample Answer 2 For the Assignment: NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN<\/strong><\/h2>\n
Title: <\/strong> NURS 6512 Assignment 1 Case Study Assignment Assessing Neurological Symptoms IN<\/strong><\/h2>\n
Patient Information:<\/strong><\/h3>\n
A.Y, 20 year-old African American male<\/p>\n
S.<\/u><\/strong><\/p>\n
CC<\/strong> \u201cI have been experiencing intermittent headaches that diffuse all over the head with greatest intensity and pressure above the eyes.\u201d<\/p>\n
HPI<\/strong>: The patient came with complaints of intermittent headaches for the last one week. The headaches diffuse all over the head with greatest intensity and pressure above the eyes and spreads through the nose, cheekbones, and jaw. The client reports that analgesics such as acetaminophen provide him with relieve that is not long lasting. The associated symptoms include nausea and photophobia. The severity of pain as reported by the patient was 8\/10.<\/p>\n
Current Medications<\/strong>: The patient has been using acetaminophen 1 gm TDS for the last four days.<\/p>\n
Allergies: <\/strong>The client denied any food, drug, or environmental allergy.<\/p>\n
PMHx<\/strong>: The client\u2019s immunization history is up to date.<\/p>\n
Soc Hx<\/strong>: The client is a college student undertaking a degree in information technology. He does not smoke or take alcohol. He engages in active physical activity, as he is a member of the university basketball team. His social support comprises of his family members and friends.<\/p>\n
Fam Hx<\/strong>: The client denied any chronic illnesses in the family.<\/p>\n
ROS<\/strong>:<\/p>\n
GENERAL: \u00a0The patient appeared well-groomed for the occasion without any signs of malaise or weight loss. He denied fever and chills.<\/p>\n
HEENT: \u00a0Eyes: The client denied visual loss, blurred vision, double vision or yellow sclerae. He reported photophobia during the episodes of intermittent headaches.<\/p>\n
Ears, Nose, Throat: \u00a0He denied hearing loss, sneezing, congestion, runny nose or sore throat.<\/p>\n
SKIN: \u00a0He denied rash, scars, or itching.<\/p>\n
CARDIOVASCULAR: \u00a0He denied chest pain, chest pressure, chest discomfort, palpitations or edema.<\/p>\n
RESPIRATORY: \u00a0He denied shortness of breath, difficulty in breathing, cough or sputum.<\/p>\n
GASTROINTESTINAL: \u00a0Denies anorexia, vomiting or diarrhea. He also denied abdominal pain or blood. He reported nausea during episodes of intermittent headaches.<\/p>\n
GENITOURINARY: \u00a0He denied burning on urination, increased urinary frequency, or changes in smell and color of urine.<\/p>\n
NEUROLOGICAL: \u00a0The patient reports intermittent headaches, denies syncope, dizziness, paralysis, numbness, and tingling of the extremities. He also denied changes in bladder and bwel control.<\/p>\n
MUSCULOSKELETAL: \u00a0The patient denied muscle, back pain, joint pain or stiffness.<\/p>\n
HEMATOLOGIC: \u00a0He denied anemia, bleeding or bruising.<\/p>\n
LYMPHATICS: \u00a0He denied enlarged nodes with absence of a history of splenectomy.<\/p>\n
PSYCHIATRIC: \u00a0He denied history of depression or anxiety.<\/p>\n
ENDOCRINOLOGIC: \u00a0He denied history of sweating, cold or heat intolerance. He also denied polyuria or polydipsia.<\/p>\n
ALLERGIES: \u00a0He denied history of asthma, hives, eczema or rhinitis.<\/p>\n
O.<\/u><\/strong><\/p>\n
Physical exam<\/strong>:<\/h2>\n
General: The patient appears well groomed, with lack of evidence of weight loss and fatigue<\/p>\n
Vitals<\/strong>: Temp 36.7, BP 122\/76 P-80, RR 20, SPO2 96,<\/p>\n
Head<\/strong>: normocephalic, with no lesions, evidence of trauma, with symmetric facial features. The maxillary and frontal sinuses are tender on palpation.<\/p>\n
Ears<\/strong>: The ears are symmetric with absence of ear drainage, loss of balance, and grey tympanic membranes<\/p>\n
Eyes<\/strong>: the eyes are symmetric, without jaundice and bleeding. Normal visual acuity<\/p>\n
Nose<\/strong>: Absence of nasal flaring, discharge, and septum deviation<\/p>\n
Throat<\/strong>: Absence of tonsillitis<\/p>\n
Neck<\/strong>: symmetric trachea noted with absence of neck rigidity, swelling, and gross abnormalities of the thyroid<\/p>\n
Cardiovascular<\/strong>: presence of S1 and S2, with absence of peripheral edema and advantageous sounds<\/p>\n
Gastrointestinal<\/strong>: Absence of abdominal swelling, scars, with normal bowel movements.<\/p>\n
Respiratory<\/strong>: Lung sounds clear with absence of advantageous sounds<\/p>\n
Neurological<\/strong>: Client is oriented to self, place, time, and events. Pupil reactive to light and equal in size with equal grip in both hands and symmetrical facial features. The self-reported headache is rated at 8\/10. There is the presence of intermittent headache, photophobia, and nausea.<\/p>\n
Diagnostic results<\/strong>: One of the recommended diagnostic investigations that should be performed for the client is nasal scrapping. Nasal scraping should be performed to obtain a sample for test for esinophils. Radiological investigations are also recommended in case of severe symptoms. The investigations include a head CT scan to detect any abnormalities such as tissue involvement, inflammation of the meninges, and tumors. A MRI may also be done to determine the presence of any abnormality in the brain tissue and soft tissue pathology. Bacterial sinusitis may also be diagnosed by performing sinus aspiration (Iskandar & Triayudi, 2020).<\/p>\n
A<\/u><\/strong>.<\/u><\/p>\n
Differential Diagnoses <\/strong><\/h2>\n
Sinusitis<\/strong>: The first differential diagnosis for the client in this case study is sinusitis. Sinusitis is a condition characterized by the inflammation of the nasal cavities. The symptoms often last for a period of less than a month. Patients with sinusitis experience symptoms that include frontal headaches with feelings of fullness. Patients also experience other accompanying symptoms that include nausea, vomiting, photophobia, and nasal drainage. The physical assessment findings may reveal tenderness of the sinuses (Iskandar & Triayudi, 2020). The patient in the case study has symptoms that align with this diagnosis, hence, it being the primary diagnosis.<\/p>\n
Migraine headache<\/strong>: migraine headache is the secondary diagnosis for the patient in this case study. Patients with migraine headache experience severe, throbbing headache. The accompanying symptoms include photophobia, phonophobia, nausea, and vomiting (Ha & Gonzalez, 2019). This is however a least diagnosis because of the patient experiencing feelings of fullness and involvement of the sinuses.<\/p>\n
Allergic rhinitis<\/strong>: The other possible diagnosis for the client is allergic rhinitis. Patients with allergic rhinitis experience symptoms that include headaches, nasal drainage, coughing, sneezing, and pressure on the cheeks and nose (Scadding et al., 2017). Allergic rhinitis is however the least likely diagnosis due to the absence of a history of allergic reaction by the client.<\/p>\n
Facial pain syndrome<\/strong>: Facial pain syndrome is the other potential diagnosis for the client in the case study. Facial pain syndrome is attributed to pain affecting the trigeminal nerve. The symptoms associated with it include pain on touching the face, speaking, chewing or brushing teeth (Benoliel & Gaul, 2017). Facial pain syndrome is however the least likely diagnosis due to the absence of pain upon stimulation of the facial muscles.<\/p>\n
Acute bacterial pharyngitis<\/strong>: Acute bacterial pharyngitis is the last potential diagnosis for the client. Acute bacterial pharyngitis is attributed to step bacterial infection. Patients experience symptoms that include difficulty in swallowing, headache, chills, and malaise. The patient however does not experience difficulty in swallowing, fever, and chills, hence, acute bacterial pharyngitis not being the primary differential (Harberger & Graber, 2021).<\/p>\n
- \n
- <\/li>\n<\/ol>\n
This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.<\/p>\n
<\/p>\n
References<\/h2>\n
Benoliel, R., & Gaul, C. (2017). Persistent idiopathic facial pain. Cephalalgia<\/em>, 37<\/em>(7), 680\u2013691. https:\/\/doi.org\/10.1177\/0333102417706349<\/a><\/p>\n
Ha, H., & Gonzalez, A. (2019). Migraine Headache Prophylaxis. American Family Physician<\/em>, 99<\/em>(1), 17\u201324.<\/p>\n
Harberger, S., & Graber, M. (2021). Bacterial Pharyngitis. In StatPearls<\/em>. StatPearls Publishing. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK559007\/<\/a><\/p>\n
Iskandar, A., & Triayudi, A. (2020). Early Diagnosis of Sinusitis Using Expert System Methods: Early Diagnosis of Sinusitis Using Expert System Methods. Jurnal Mantik<\/em>, 4<\/em>(2), 1231\u20131236. https:\/\/doi.org\/10.35335\/mantik.Vol4.2020.927.pp1231-1236<\/a><\/p>\n
Scadding, G. K., Kariyawasam, H. H., Scadding, G., Mirakian, R., Buckley, R. J., Dixon, T., Durham, S. R., Farooque, S., Jones, N., Leech, S., Nasser, S. M., Powell, R., Roberts, G., Rotiroti, G., Simpson, A., Smith, H., & Clark, A. T. (2017). BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition 2017; First edition 2007). Clinical & Experimental Allergy<\/em>, 47<\/em>(7), 856\u2013889. https:\/\/doi.org\/10.1111\/cea.12953<\/a><\/p>\n
Content<\/strong><\/h3>\n
Name:\u00a0NURS_6512_Week_9_Assignment1_Rubric<\/strong><\/h3>\n
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\n \u00a0<\/strong><\/td>\n Excellent <\/strong><\/td>\n Good <\/strong><\/td>\n Fair <\/strong><\/td>\n Poor <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n \n Using the Episodic\/Focused SOAP Template:
\n\u00b7\u00a0Create documentation or an episodic\/focused note in SOAP format about the patient in the case study to which you were assigned.<\/strong><\/strong>\u00b7\u00a0\u00a0Provide evidence from the literature to support diagnostic tests that would be appropriate for your case.<\/td>\nPoints Range: 45 (45%) – 50 (50%)<\/p>\n The response clearly, accurately, and thoroughly follows the SOAP format to document the patient in the assigned case study. The response thoroughly and accurately provides detailed evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study.<\/td>\n
Points Range: 39 (39%) – 44 (44%)<\/p>\n The response accurately follows the SOAP format to document the patient in the assigned case study. The response accurately provides detailed evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study.<\/td>\n
Points Range: 33 (33%) – 38 (38%)<\/p>\n The response follows the SOAP format to document the patient in the assigned case study, with some vagueness and inaccuracy. The response provides evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study, with some vagueness or inaccuracy in the evidence selected.<\/td>\n
Points Range: 0 (0%) – 32 (32%)<\/p>\n The response incompletely and inaccurately follows the SOAP format to document the patient in the assigned case study. The response provides incomplete, inaccurate, and\/or missing evidence from the literature to support diagnostic tests that would be appropriate for the patient in the assigned case study.<\/td>\n<\/tr>\n
\n \u00b7\u00a0\u00a0 List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. <\/strong><\/td>\n Points Range: 30 (30%) – 35 (35%)<\/p>\n The response lists five distinctly different and detailed possible conditions for a differential diagnosis of the patient in the assigned case study and provides a thorough, accurate, and detailed justification for each of the five conditions selected.<\/td>\n
Points Range: 24 (24%) – 29 (29%)<\/p>\n The response lists four to five different possible conditions for a differential diagnosis of the patient in the assigned case study and provides an accurate justification for each of the five conditions selected.<\/td>\n
Points Range: 18 (18%) – 23 (23%)<\/p>\n The response lists three to four possible conditions for a differential diagnosis of the patient in the assigned case study, with some vagueness and\/or some inaccuracy in the conditions and\/or justification for each.<\/td>\n
Points Range: 0 (0%) – 17 (17%)<\/p>\n The response lists three or fewer, or is missing, possible conditions for a differential diagnosis of the patient in the assigned case study, with inaccurate or missing justification for each condition selected.<\/td>\n<\/tr>\n
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- Chapter 23, \u201cNeurologic System\u201dThe authors of this chapter explore the anatomy and physiology of the neurologic system. The authors also describe neurological examinations and potential findings.<\/li>\n<\/ul>\n
- Click the\u00a0Week 9 Assignment 1 <\/strong>link. You will also be able to \u201cView Rubric\u201d for grading criteria from this area.<\/li>\n