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NURS 680A Advanced Health/Physical Assessment Week 7 Discussion Forum

NURS 680A Advanced Health/Physical Assessment Week 7 Discussion Forum

NURS 680A Advanced Health/Physical Assessment Week 7 Discussion Forum

Complete your weekly discussion prompt.

Select one of the following case studies to address:

  1. An 89-year old female complains of a “stabbing chest pain” and points to the area just below her scapula at the right mid-clavicular line. She states that she had an upper respiratory infection last week that “just seems to hang on.” No other complaints.
  2. A 58-year old male presents with a complaint of severe chest pain over the past hour. He did not call 911 “because I don’t have the money for an ambulance.”

For the case you have chosen, post in the discussion:

  • Discuss what questions you would ask the patient, what physical exam elements you would include, and what further testing you would want to have performed.
  • In SOAP format, list:
    • Pertinent positive and negative information
    • Differential and working diagnosis
    • Treatment plan, including: pharmacotherapy with complementary and OTC therapy, diagnostics (labs and testing), health education and lifestyle changes, age-appropriate preventive care, and follow-up to this visit.
  • Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.
  • In your peer replies, please reply to at least one peer who chose a different case study.

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Sample solution

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  • m elements you would include, and what further testing you would want to have performed.
  • In SOAP format, list:
    • Pertinent positive and negative information
    • Differential and working diagnosis
    • Treatment plan, including: pharmacotherapy with complementary and OTC therapy, diagnostics (labs and testing), health education and lifestyle changes, age-appropriate preventive care, and follow-up to this visit.
  • Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.
  • In your peer replies, please reply to at least one peer who chose a different case study.

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Afton Zediker

Jun 20, 2022Jun 20 at 11:14am

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Would you be comfortable seeing this patient in a family practice setting?  You will be presented with situations often where patients prefer to not go to the hospital or the emergency room due to costs but there are times where we need to be their advocates and get them to the place where their best options for care depending on their situation and symptoms.

Annie Essagholian

Jun 23, 2022Jun 23 at 12:25pm

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I would not feel comfortable seeing this patient with EKG reading showing ST elevation. Based on this EKG reading this patient is having a heart attack also called myocardial infarction. ST segment is short and there is no electrical activity in that section and it is expected to be flat. ST segment elevation means that there is a total blockage in the main chambers of the heart. Blockages in the chambers of the heart can seriously damage the heart muscles. In ST elevation it is the muscles in the ventricles that are not getting sufficient blood flow. This is very dangerous because the lungs and the body receive blood from the ventricles and if there is an interruption in the flow that means the lungs and the body are not getting sufficient supply of blood (my.clevelandclinic.org). This type of heart attack is very serious and can follow with serious complications and death. The elevation of ST is an indication that there is an interruption in the blood flow in the  lower chambers of the heart. If I get a patient in the office setting that complains of chest pain and I get an EKG reading like the one above, I will call 911 immediately as any delay in the care will result in permeant damage to the heart and even death. Patient education is very important for patients who are at risk for heart attack or in general. It is very important for patients to understand that chest pains are serious and if they suspect themselves or anyone to be having a heart attack to call 911 immediately. Of course a lot of patients will be worried about insurance the cost of transportation if they call 911. However patients need to know that chest pain is an emergency and they shouldn’t worry about the cost at that time. According to the American Heart Association, in 2016 cardiovascular disease was listed as the underlying cause of death in approximately one out of every three deaths in the United States (bvhealtsystem.org). There are many reasons why individuals wont call 911 when they are experiencing cardiac symptoms, they wait to see if their symptoms will subside, they think they can just drive themselves, and they might be afraid of the treatment. It is very important to educate the public about recognizing cardiac emergencies and it’s symptoms, and not to hesitate to call 911.

Expert health articles. Blanchard Valley Health System. (n.d.). Retrieved June 23, 2022, from https://www.bvhealthsystem.org/expert-health-articles/call-911-for-chest-painstroke-symptoms

What is a Stemi heart attack? Cleveland Clinic. (n.d.). Retrieved June 23, 2022, from https://my.clevelandclinic.org/health/diseases/22068-stemi-heart-attack

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