Advanced Assessment Interpreting Findings and Formulating Differential

Advanced assessment interpreting findings and

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Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses, 3rd Edition . F.A. Davis Company, 11/2014. VitalBook file (page 214-216) Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of Older Adults . F.A. Davis Company, 2014-01-14. VitalBook file. (page 241) Points Received: 0 of 2 Comments: Question 1 6. Question : Which of the following is considered a “red flag” when diagnosing a patient with pneumonia? Student Answer: Fever of 102 Infiltrates on chest X-ray Pleural effusion on chest X-ray Elevated white blood cell count Instructor Explanation: With pneumonia, the chest film typically reveals an area of infiltrate. It is a red flag if a pleural effusion is also visualized, in which case adequate follow-up to exclude development of an empyema is mandatory. This often involves prompt referral to a pulmonologist for possible thoracentesis. Cultures and Gram stains of sputum are usually not ordered for outpatients. The white blood cell count is often elevated. Goolsby, Mary J., Laurie Grubbs. Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses, 3rd Edition . F.A. Davis Company, 11/2014. VitalBook file. (page 214) Kennedy-Malone, Laurie, Kathleen Fletcher, Lori Martin-Plank. Advanced Practice Nursing in the Care of Older Adults . F.A. Davis Company, 2014-01-14. VitalBook file. (page 240) Points Received: 2 of 2 Comments: Question 1 7. Question : A 23-year-old patient who has had bronchiectasis since childhood is likely to have which of the following: Student Answer: Barrel-shaped chest
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Clubbing Pectus excavatum Prolonged capillary refill Instructor Explanation: In bronchiectasis, there is usually a history of chronic, productive cough. Sputum is typically mucopurulent and produced in increased amounts. Other common findings include shortness of breath, wheezing, fatigue, and possibly hemoptysis. Physical examination reveals rhonchi and/or wheezing. In advanced disease, clubbing and cyanosis may be present. Goolsby, Mary J., Laurie Grubbs. Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses, 3rd Edition . F.A. Davis Company, 11/2014. VitalBook file (page 216) Points Received: 2 of 2 Comments: Question 1 8. Question : Your patient has just returned from a 6-month missionary trip to Southeast Asia. He reports unremitting cough, hemoptysis, and an unintentional weight loss of 10 pounds over the last month. These symptoms should prompt the clinician to suspect: Student Answer: Legionnaires' disease Malaria Tuberculosis Pneumonia Instructor Explanation: Many times, patients with active tuberculosis are essentially symptom free. Some complain of malaise and/or fevers but have no significantly disruptive complaints. When respiratory symptoms occur with tuberculosis, cough is common; the cough is nonproductive at first and is later associated with sputum production. Additionally, patients with tuberculosis may experience progressive dyspnea, night sweats, weight loss, and hemoptysis. It is important to suspect tuberculosis when the patient has travelled to a country where TB is endemic, such as Asia.
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  • F.A. Davis Company, Laurie Grubbs

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