NSG 6020 iHuman case: Rachael Hardy V3 PC Assignment
| Discussion Question 1 In the history collection of questions, I overlooked asking if the patient felt fatigued, had trouble sleeping, or experienced any weight changes. Additionally, I missed inquiring about the patient’s family history of diseases. Both these questions play a crucial role in enhancing diagnostic accuracy. Bickley (2016) emphasizes the significance of collecting family history to improve diagnostic assessment. |
| Discussion Question 2 The physical exam wasn’t focused and needed to be more specific; a full head-to-toe assessment wasn’t necessary. Additionally, I overlooked palpating the radial pulse as the initial choice for assessing the heart rate in a conscious adult, which is a common practice (Bickley, 2016). This adjustment would enhance the efficiency of the examination. NSG 6020 iHuman case: Rachael Hardy V3 PC. |
| Discussion Question 3: One crucial finding in my list was the breast lump. A significant physical exam step would be to check for lymph node involvement when there’s a report of a breast lump. As stated by Bickley (2016), “Nodes that are large (≥1 to 2 cm) and firm or hard, matted together, or fixed to the skin or underlying tissues suggest malignancy.” This examination helps in assessing the potential severity of the situation. |
| Discussion Question 4 The assessment I conducted overlooked the evaluation of family history, which is essential in cases of breast cancer as it can contribute to the patient’s risk. In iHuman, it’s emphasized, “The next step is to consider those clinical factors (here, listed as problems) that should, or may, impact the differential diagnosis (DDx): Family history of breast cancer (mother; diagnosed at age 48).” Incorporating family history into the assessment is crucial for a comprehensive understanding of potential risk factors. |
| Discussion Question 5: One missed differential diagnosis during the assessment is breast abscess, which is crucial because it’s classified as a “cannot miss” diagnosis, as highlighted in iHuman. If a patient is diagnosed with a breast abscess and it remains untreated, it could lead to a worsening infection or even death. Bickley (2016) emphasizes, “However, any breast mass should be carefully evaluated and usually warrants further investigation by ultrasound, aspiration, mammography, or biopsy.” This highlights the importance of a thorough examination in such cases. NSG 6020 iHuman case: Rachael Hardy V3 PC. |
Bickley, L. (2016). Bates Guide to Physical Examination and History Taking (12th Ed.). Philadelphia, PA: Lippincott, William & Wilkins. NSG 6020 iHuman case: Rachael Hardy V3 PC
Also Read: i-human case study answers
