ReferencesSeller, R. H., & Symons, A. B. (2012). Differential diagnosis of common complaints(6th ed.). Philadelphia, PA: W. B. Saunders Company.Slatosky, J., Shipton, B., & Wahba H. (2000). Thyroiditis: differential diagnosis and management. American Family Physician6(1). Retrieved from NURS-6511D-19, Advanced Health Assessment 2013 Summer Qtr 06.03.2013-08.25.2013-PT1 MSN-FNP Instructor: Dr. Katryna McCoy 07/03/2013Week 5:Review of Case Study # 2 - Assessing the Ears Nose and Throat Case 2:Focused Throat ExamLily is a 20-year-old student at the local community college. When some of her friends and classmates told her about an outbreak of flu-like symptoms sweeping her campus over the past two weeks, Lily figured she shouldn't take her three-day sore throat lightly. Your clinic has treated a few cases similar to Lily's. All the patients reported decreased appetite, headaches, andpain with swallowing. As Lily recounts these symptoms to you, you notice that she has a runny nose and a slight hoarseness in her voice but doesn't sound congested.The Health History to be collected from the PatientHer recent appetiteTemperatureDoes she have any allergies?
If she had been around anyone with known or possible infectionIf she was in any crowded area recentlyIf she had traveled outside the USAIf yes where did she go?What is her recent fluid intake and output?If she had recent frequent coughsDid she take any form of medication for this problem?What did she take?Has she being having head ache?If she had any difficulty swallowingHow long since she had runny nose and hoarseness?Did she lose her voice totally?If she had recent respiratory infectionDo you smoke? How Long?Physical Exams and Diagnostic tests to Help DiagnoseIt is important for practitioners to identify normalcy in patients to know when there is deviation from what is expected. As stated in this week’s discussion outline some throat problems may be minor in nature, but subtle symptoms may advance to life threatening situations and need early assessment and treatment. Most individuals have heard the term ear, nose and throat (ENT) and many of these individuals are aware of the interconnection between them. Healthcare
practitioners should therefore have no problem in explaining to most patients the importance of assessing ear, nose and throat if needed when there is a complaint of another area. The patient’s voice quality will be assessed for difficulty or uneasiness in phonation, or making laryngeal speech sound. Patient should also be monitored for dystonia (a disorder of voice volume which is harsh, nasal or breathy sounds, or the pitch for example monotony of pitch or loudness may suggest disease of the larynx (Seidel, Ball, Dains, Flynn, Solomon, & Stewart, 2011). We must take into consideration the substance of illnessThe patient’s head should be tilted backward to inspect palate and uvula for changes in color or general appearance. To observe the soft palate for symmetry with uvula remaining in the midline ask patient to say “ah” depressing the tongue if necessary (Seidel, et al 2011). Examine the
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- Allergy, Sinusitis, Inflammations, Seidel