NURS 6512 week 4 assignment

NURS 6512 Week 4 Assignment 1 – Differential Diagnosis for Skin Conditions

In NURS 6512 week 4 assignment, the accurate identification of a patient’s skin condition involves a process called differential diagnosis. This systematic approach helps healthcare professionals evaluate physical symptoms, vital signs, and patient descriptions, narrowing down potential causes until the most likely diagnosis is established. For this assignment, you will analyze visual depictions of skin conditions, document your findings, and apply differential diagnosis techniques to determine the most probable diagnosis.

Preparation:

• Review the provided Skin Conditions document and select one skin condition to focus on for your assignment.
• Analyze the abnormal physical features in your selected graphic, using appropriate clinical terminologies to describe them.
• Investigate possible diagnoses that align with the observed abnormalities, narrowing down to the most probable condition.
• Document your findings using the SOAP (Subjective, Objective, Assessment, and Plan) note format. Use the Comprehensive SOAP Template for additional guidance.

Completion:

• Choose one skin condition graphic and document it in the SOAP note format, including clinical terms to describe physical characteristics.
• Develop a differential diagnosis list with 3-5 potential conditions, and select the most likely one, justifying your choice using at least three evidence-based references.

Patient Information:

• Subjective Data: Include the patient’s chief complaint (CC), history of present illness (HPI), medications, allergies, past medical history (PMH), past surgical history (PSH), social history, family history, and lifestyle factors.
• Objective Data: Note observations from the physical exam, including vital signs and descriptions of skin abnormalities, along with any necessary diagnostic tests.
• Assessment: Prioritize the most likely diagnosis, listing differential diagnoses with supporting evidence based on clinical guidelines.

By using this structured approach, you will accurately analyze the skin condition and document the process of diagnosis.

NURS 6512 Week 6 Assignment: Assessing the Abdomen

In NURS 6512 Week 6, abdominal pain diagnosis can be a complex and time-consuming process, as shown by the case of a woman who initially presented with severe abdominal cramping. She was diagnosed with diverticulitis, but a precautionary CAT scan revealed a pancreatic growth, later diagnosed as pancreatic cancer, which was the actual cause of the cramping. This highlights the importance of thorough abdominal assessments to avoid misdiagnosis.

For this assignment, you will analyze a SOAP note that details abnormal abdominal findings in a clinical setting. You will explore the patient’s history, conduct relevant physical exams and diagnostic tests, and develop a differential diagnosis, considering various possible conditions.

Abdominal Assessment Case Study

SUBJECTIVE:

• Chief Complaint (CC): “My stomach hurts, I have diarrhea, and nothing seems to help.”
• History of Present Illness (HPI): JR, a 47-year-old white male, reports generalized abdominal pain that began 3 days ago. He has not taken any medications as he was unsure of what to take. He describes the pain as a 5/10 today, though it was as high as 9/10 when it first began. He can eat, but experiences nausea afterward.
• Past Medical History (PMH): Hypertension, Diabetes, history of gastrointestinal bleeding 4 years ago.
• Medications: Lisinopril 10mg, Amlodipine 5mg, Metformin 1000mg, Lantus 10 units qhs.
• Allergies: No known drug allergies (NKDA).
• Family History (FH): No family history of colon cancer. Father has diabetes mellitus type 2 and hypertension. Mother has hypertension, hyperlipidemia, and GERD.
• Social History: Denies tobacco use, occasional alcohol use, married, with 3 children (1 daughter, 2 sons).

OBJECTIVE:

• Vital Signs (VS): Temp: 99.8°F, BP: 160/86, RR: 16, P: 92, Height: 5’10”, Weight: 248 lbs.
• Heart: Regular rate and rhythm (RRR), no murmurs.
• Lungs: Clear to auscultation (CTA), symmetrical chest wall.
• Skin: Intact without lesions, no urticaria.
• Abdomen (Abd): Soft, hyperactive bowel sounds, positive pain in the left lower quadrant (LLQ).
• Diagnostics: None performed.

ASSESSMENT:

• Primary Assessment: Left lower quadrant pain.
• Differential Diagnosis: Gastroenteritis.

Preparation for Assignment:

To complete this assignment:

• Review the SOAP note case study and consider what additional history needs to be collected.
• Reflect on the necessary physical exams and diagnostic tests for further investigation.
• Develop a differential diagnosis by considering at least five potential conditions, supported by current evidence-based literature.

Completion:

• Subjective Analysis: Assess any missing details that should be included in the subjective section.
• Objective Analysis: Identify any additional objective information needed for a complete evaluation.
• Assessment Evaluation: Determine if the current assessment is supported by the available information. Explain why or why not.
• Diagnostic Tests: Suggest appropriate diagnostic tests and how they could be used to support a diagnosis.
• Differential Diagnosis: Identify three potential conditions to consider, explaining your rationale based on evidence from at least three current references.

Walden – NURS 6512 Week 4 Assignment – Advanced Health Assessment and Diagnostic Reasoning

Module 3 Overview

Dr. Tara Harris provides an introduction to the expectations for Module 3. As you go through this module, plan your time effectively to accommodate Discussions, Case Study Lab Assignments, DCE Assignments, and the Midterm exam.

Focus Area: Skin, Hair, and Nails – Week 4

This week’s media resources include content from Seidel’s Guide to Physical Examination. It is highly recommended that you also access the online resources accompanying the text, specifically focusing on videos and animations in Chapter 8 that cover the assessment of the skin, hair, and nails.

Accessing the Online Resources

To access the online resources included with Seidel’s Guide to Physical Examination, follow these steps:

1. Visit the site: Evolve Elsevier.
2. Complete the free online registration.
3. Once registered, log in to the student site, navigate to the textbook, and access the desired content, including checklists, videos, and animations.

Note: Clicking APA citation URLs from the textbook will not directly link to content. Use the Evolve menu to locate resources.

Suturing Tutorials

To support your learning, the following suturing technique tutorials are available:

1. Tulane Center for Advanced Medical Simulation & Team Training’s Suturing Technique (5 minutes) Watch here
2. Mikheil’s Basic Suturing Techniques (9 minutes) Watch here

Additional Tutorials

1. Incision and drainage of an abscess – New England Journal of Medicine (10 minutes) Watch here
2. Dermablade Use for Shave Biopsies – PersonnaBlades (5 minutes) Watch here

Assignment 1: Lab Assignment – Differential Diagnosis for Skin Conditions

Proper diagnosis of skin conditions relies on differential diagnosis, a systematic process of narrowing down possible causes based on physical findings and patient symptoms.

To Prepare:

1. Review the Skin Conditions document in the Learning Resources and select one condition for this Lab Assignment.
2. Analyze the physical characteristics of the condition you selected and describe them using clinical terminology.
3. Explore possible causes of the skin condition and formulate a differential diagnosis.
4. Search for an evidence-based article on your chosen condition from the Walden Library.
5. Refer to the Comprehensive SOAP Exemplar and use the SOAP Template provided in this week’s resources to guide your Lab Assignment.

Lab Assignment Instructions:

• Choose one skin condition graphic and document it in the SOAP note format.
• Use clinical terminologies to describe the condition.
• Develop a differential diagnosis of three to five possible conditions.
• Determine the most likely diagnosis and justify your reasoning with at least three references—one from current literature and two from this week’s Learning Resources.

Submission Details:

• Save your assignment with the filename format: “WK4Assgn1+last name+first initial.(extension).”
• Submit it by Day 7 of Week 4 through the Week 4 Assignment 1 link. Be sure to review the grading rubric and check for plagiarism before submission.

Grading Criteria: To access the rubric for this assignment, visit the “Week 4 Assignment 1 Rubric” link.

Week 4 Assignment Sample Paper
NURS 6512 Week 4 Assignment – Advanced Health Assessment and Diagnostic Reasoning

Subjective Data

Chief Complaint:
Patient No. 1 is a middle-aged white male presenting with multiple red, oval-shaped bumps on the chest that bleed when scratched or cut.

History of Present Illness:
The patient reports the development of red moles that began in his early thirties. Over time, these moles have increased in both size and number as he has aged.

Objective Data

Upon physical examination, the patient exhibits multiple chest skin growths (lesions), varying from small red macules to larger dome-topped polypoid papules. Lesion color ranges from bright to dark red, depending on the stage of development and any trauma applied.

Assessment
Differential Diagnosis:

1. Acute Urticaria:
   This skin reaction involves smooth, slightly elevated, erythematous papules and plaques accompanied by severe itching. Unlike this case, acute urticaria is self-limited, with papules resolving within several days without scarring. Chronic urticaria can persist longer but typically affects various parts of the body (Guastafierro et al., 2019).
2. Insect Bites (e.g., bed bugs):
   Insect bites cause blood-filled lesions that worsen after sleep. These lesions, which are larger (up to 6 cm), typically appear in exposed areas such as the arms and face, often forming a linear pattern. This presentation differs from the current scenario, where the lesions are primarily on the chest.
3. Bacillary Angiomatosis:
   This condition manifests as multiple red, purple, or flesh-colored lesions, commonly in immunocompromised individuals. Symptoms such as bone pain, fever, and weight loss often accompany the lesions, which usually affect the oral mucosa, nose, and genital areas (Swetter & Geller, 2018). In this case, no such systemic symptoms are present.
4. Melanoma:
   A form of skin cancer, melanoma typically presents as non-healing sores, red lumps that bleed when scratched, and rough, scaly red spots. Melanomas frequently affect the chest and back, though they are more common in women. The absence of any cancerous features makes this diagnosis less likely in this case (Espinosa et al., 2018).

Most Likely Diagnosis

The most probable diagnosis is Cherry Angioma, a common skin growth resulting from the overgrowth of blood capillaries. Typically affecting individuals over 30, these lesions are bright to dark red, oval-shaped, and prone to bleeding when scratched. Cherry angiomas are painless, primarily affecting the chest, abdomen, and back, and tend to increase in number and size with age (Espinosa et al., 2018).

Plan of Care

Since cherry angiomas are benign and mostly painless, treatment is generally cosmetic. Removal options include excision (shaving the lesion off) and electrodesiccation (burning the lesion to destroy the blood vessels). Both methods may result in scarring. For patients concerned about scars, biopsies may be performed on traumatized lesions.

References

Espinosa Lara, P., Medina-Puente, C., Riquelme Oliveira, A., & Jiménez-Reyes, J. (2018). Eruptive cherry angiomas developing in a patient treated with ramucirumab. Acta Oncologica, 57(5), 709-711.

Guastafierro, A., Verdura, V., Di Pace, B., Faenza, M., & Rubino, C. (2019). The Influence of Breast Cancer on the Distribution of Cherry Angiomas on the Anterior Thoracic Wall: A Case Series Study. Dermatology, 235(1), 65-70.

Swetter, S., & Geller, A. (2018). Melanoma: Clinical features and diagnosis. U: UpToDate.

Week 4 Assignment 1: Digital Clinical Experience (DCE): Health History Assessment

In Week 3, you started your DCE: Health History Assessment. This week, you will complete and submit the assessment using the Shadow Health platform.

To Prepare:

1. Review Learning Resources: Go over this week’s Learning Resources and the Taking a Health History program from Week 3. Incorporate these strategies into your assessment.
2. Download Checklists: Review the Student Checklist: Health History Guide and the History Subjective Data Checklist from this week’s resources to ensure all key assessment components are included.
3. Use the DCE Documentation Template: Download the Health History Documentation Template and complete your notes using this format.
4. Access Shadow Health: Login to Shadow Health via the link in your Blackboard classroom.
5. Watch Orientation Videos: Review the Shadow Health Student Orientation and the Useful Tips and Tricks to familiarize yourself with the platform.
6. Review the Assignment Rubric: Check the Week 4 DCE Health History Assessment Rubric for the grading criteria and requirements.

DCE Health History Assessment:

Complete the following tasks in Shadow Health:

• Orientation: (15 minutes)
• Conversation Concept Lab: (50 minutes)
• Health History of Tina Jones: (180 minutes)

You may attempt the assessment multiple times to achieve the required score of 80% or higher before the Week 4 deadline.

Submission and Grading:

By Day 7 of Week 4:

1. Complete the DCE assignments in Shadow Health.
2. Download your Lab Pass and submit it to Blackboard. (Save as “LastName_FirstName_AssignmentName.”)
3. Copy your Documentation Notes from Shadow Health and submit them through the Blackboard assignment link.
4. Download, sign, and submit the Student Acknowledgement Form.

Grading Criteria:

• Access your rubric via: Week 4 Assignment 2 DCE Rubric

Submit Your Assignment by Day 7:

• Lab Pass Submission: Week 4 Lab Pass
• Documentation Notes Submission: Week 4 Documentation Notes for Assignment 2
• Student Acknowledgement Form Submission: Week 4 Assignment 2 DCE Student Acknowledgement Form

Assignment 3 (Optional): Practice Assessment of Skin, Hair, and Nails Examination

To prepare for your Comprehensive (Head-to-Toe) Physical Assessment due in Week 9, you are encouraged to practice performing a skin, hair, and nails examination on a volunteer patient.

To Prepare:

1. Arrange a time to conduct the assessment on your volunteer.
2. Download the Skin, Hair, and Nails Student Checklist and review Seidel’s Guide to Physical Examination.
3. Complete the examination, covering all checklist areas.

What’s Coming Up in Week 5?

Next week, you will:

• Assess the head, neck, eyes, ears, nose, and throat (HEENT).
• Complete a Case Study on Skin, Hair, Nails, and HEENT.
• Perform a DCE focused exam for cough.

Required Media for Week 5:

• Review videos and animations from Seidel’s Guide to Physical Examination before completing your assignments.

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