Case and Discussion
A 60-year-old man comes to your office because of a persistent cough that has been bothering him for the past 3 months. His cough is dry and is more frequent during the evenings. He also notes frequent nasal congestion, especially when he is exposed to dust and cold weather. He reports no hemoptysis, weight loss, wheezing, fever, or changes in his appetite. What additional questions would you ask to learn more about his cough?
• How would you classify his cough based on the duration to help with the diagnosis?
• What diagnostic tests do you want to include to help you with your diagnosis?
Create a differential diagnosis flow sheet for this patient for this patient and include the diagnostics as well as the pharmacological management and rationale related to the differentials. Support your discussion with evidence-based research.
Case and Discussion
A 21-year-old women comes to your office with a 2 day history of right ear pain. She reports that the ear pain began shortly after taking scuba diving lessons. She describes the pain as "a pressure" and also notes "crackling" in the right ear and periodically feeling dizzy.
• What other associated symptoms should you ask about?
• How does the time course help to distinguish among different causes of ear pain?
• How does the age of the patient help with narrowing the diagnostic possibilities?
• What diagnostic tests do you want to include to help you with your diagnosis?
• Create a differential diagnosis flowsheet for this patient and include the diagnostics as well as the pharmacological management and rationale related to the differentials.
PRIMARY CARE DISCUSSION 8
Preventative Care
What questions will you want to ask your patients at every visit in order to get the information needed to provide individualized preventive services?
• How does the age and gender of the patient impact your approach to delivering preventive services and providing health education?
• How does the patient's developmental milestones impact their ability to make healthy changes and take charge of their health?
• What are some risk factors associated with health promotion?
PRIMARY CARE DISCUSSION 9
Helping and Healing Relationships
Consider the various steps of the nursing process in order to address the following critical thinking questions.
• As a health care provider, discuss ways in which you will establish a helping hand and healing relationship with your patient and their families.
• How will you develop professional partnerships with health care team members in your clinical practice?
• What personal behaviors, biases, and attitudes would you have to change to develop these professional relationships?
PRIMARY CARE DISCUSSION 10
Circle of Caring
What are the unique qualities of the Circle of Caring Model and how is it different from holistic nursing theories and biomedical nursing? Support your discussions with examples and reference with evidence-based research.
Sample Solution