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Discussion Question 1

Evidence-based practice will be the cornerstone of your advanced practice career. Choose a health disease process that is common in the adult population and post your choice to the discussion question area with the title “Health Disease Choice.” If a health disease is posted, pick another one so that there will be a discussion on a variety of health disease processes.

Once you have decided on your topic, research two evidence-based articles. Cite your references in APA format. Do not look for less common and seldom-seen diseases; instead, look for the typical problems that you anticipate seeing in your practice as an advanced practice nurse. On the basis of the literature search and adult disease process, also discuss what parts of the complete health history would be essential in understanding a patient’s current health state and work-up completed to date.

Discussion Question 2

Differential diagnoses must be considered before choosing a final diagnosis. What criteria must be met before a final diagnosis can be made? Give an example of three differential diagnoses for a patient who complains of a sore throat. Support your differential diagnoses with a brief statement of reason. You do not have to have a final diagnosis for this patient; just work up the differential diagnoses. This is a common complaint for many patients.

Expert Solution Preview

Introduction:

As a medical professor, it is my responsibility to design assignments and assessments that promote evidence-based practice and critical thinking skills among medical college students. In this particular assignment, students are required to choose a common health disease process in the adult population and conduct research to find evidence-based articles. They are then expected to discuss the essential components of a complete health history and the necessary work-up for patients with the chosen disease.

Answer to Discussion Question 1:

The chosen health disease process for this assignment is chronic obstructive pulmonary disease (COPD). COPD is a prevalent ailment among the adult population, characterized by chronic bronchitis and emphysema. It significantly affects the patient’s respiratory system and overall health.

In order to understand a patient’s current health state and the work-up completed to date, several components of the complete health history are essential. First and foremost, a detailed account of the patient’s respiratory symptoms such as cough, sputum production, shortness of breath, and wheezing is crucial. Additionally, it is important to explore the patient’s smoking history, occupational exposures, and environmental factors that may contribute to the development or exacerbation of COPD.

Furthermore, a thorough assessment of the patient’s past medical history, including any previous episodes of exacerbation or hospitalizations, should be taken into consideration. The family history of respiratory diseases, particularly COPD, should also be documented. Furthermore, a review of the patient’s medication history, including bronchodilators, corticosteroids, and oxygen therapy, is necessary for a comprehensive understanding of their current health state and management.

In conclusion, for a patient with COPD, a complete health history should encompass respiratory symptoms, smoking history, past medical history, family history, and medication history. These components provide crucial insights into the patient’s current health state and guide the work-up and management decisions.

Answer to Discussion Question 2:

Before a final diagnosis can be made, certain criteria must be met, including careful consideration of differential diagnoses. Differential diagnoses involve generating a list of possible diseases or conditions that could explain the patient’s presenting symptoms. The process of differential diagnosis requires the healthcare provider to systematically analyze the patient’s symptoms, medical history, physical examination findings, and any relevant diagnostic tests.

For a patient presenting with a complaint of a sore throat, three differential diagnoses could be:
1. Streptococcal pharyngitis (strep throat): This is a common bacterial infection causing a sore throat. Symptoms typically include sudden onset, severe throat pain, fever, swollen lymph nodes, and absence of cough.
2. Viral pharyngitis: A viral infection, such as the common cold or influenza, can also cause a sore throat. Symptoms may include a mild-to-moderate sore throat, nasal congestion, cough, and systemic symptoms such as fever and body aches.
3. Gastroesophageal reflux disease (GERD): Although less common, GERD can manifest with symptoms such as a chronic sore throat, heartburn, regurgitation, and a sour taste in the mouth. These symptoms may worsen after eating or lying down.

Each differential diagnosis is supported by specific reasons. Streptococcal pharyngitis presents with severe throat pain, fever, and swollen lymph nodes, and absence of cough, while viral pharyngitis is often accompanied by mild-to-moderate sore throat, nasal congestion, cough, and systemic symptoms. GERD, on the other hand, may present with a chronic sore throat along with symptoms of heartburn, regurgitation, and sour taste in the mouth.

It is important to note that these are just examples of differential diagnoses and not a final diagnosis. Further evaluation such as throat swab cultures, rapid strep tests, or ruling out other causes will be required to reach a definitive diagnosis.

In summary, before a final diagnosis can be made, healthcare providers must consider differential diagnoses based on the patient’s symptoms, medical history, physical examination findings, and relevant diagnostic tests. It is crucial to systematically evaluate each potential diagnosis and gather additional information to confirm or rule out each possibility.

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