NSG 6020 Health assessment week 1 discussion
Discussion Question 1
The omission of inquiring about breast lumps or discharge during my examination of Racheal is a crucial oversight. Despite the absence of nipple discharge, it is imperative to ask about it, as most instances are benign. However, it is essential to recognize that nipple discharge, coupled with a breast lump or mass, could potentially signify breast cancer (Goolsby & Grubbs, 2014). This emphasizes the importance of comprehensive questioning to ensure a thorough understanding of the patient’s condition.
Discussion Question 2
A significant lesson learned is that a head-to-toe physical exam is not universally necessary and can be distressing for the patient. Research highlights that history-taking often plays a more pivotal role in diagnosis than physical examination. In certain cases, such as patients presenting with breast-related concerns, focusing on pertinent aspects rather than conducting a complete physical exam is more patient-centered. Additionally, mastering virtual tools, like the blood pressure cuff, is vital for obtaining accurate vital signs, which serve as crucial indicators during assessments (Goolsby & Grubbs, 2014). Improving proficiency in virtual platforms like iHuman will enhance the overall clinical skills.
Discussion Question 3
A key finding in my assessment was the discovery of two palpable right breast lumps during the breast examination. Proper execution of a breast exam is essential, especially considering the patient’s personal and family medical history. The technique involves using the middle three fingers in a circular motion, applying steady pressure to palpate three levels: superficial, medium, and chest wall (Bickley, 2016). This emphasizes the significance of clinical breast exams, breast self-awareness, and mammography in comprehensive breast cancer screening (Goolsby & Grubbs, 2014).
Discussion Question 4
Despite initial challenges in navigating the program, the summary review at the end clarified the patient’s history comprehensively. A notable omission was the oversight of Racheal’s history of atypical ductal hyperplasia, which is crucial due to the absence of a follow-up post-biopsy nearly three years ago. While atypical ductal hyperplasia is benign, its presence elevates the risk of developing breast cancer, particularly considering the patient’s first-degree relative with a history of breast cancer (Buttaro et al., 2017). This underscores the importance of meticulous attention to the patient’s medical history for accurate risk assessment.
Discussion Question 5
I failed to include fibroadenoma as a potential differential diagnosis during my assessment. Fibroadenomas, typically prevalent in women aged 15 to 35, manifest as solid, noncancerous breast lumps (Buttaro et al., 2017). These lumps are characterized by being painless, mobile upon touch, and possessing a firm, rubbery, or hard texture. Fibroadenomas often exhibit a well-defined shape. Emphasizing the significance of patients promptly reporting any new lump or alterations in breast tissue to their healthcare provider is crucial for proactive and comprehensive breast health management.
References
- Bickley, L. S. (2016). Bates’ guide to physical examination and history-taking. Lippincott Williams & Wilkins.
- Buttaro, T. M., Trybulski, J., Polgar-Bailey, P., & Sandberg-Cook, J. (2017). Primary care: A collaborative practice. Elsevier Health Sciences.
- Goolsby, M. J., & Grubbs, L. (2014). Advanced assessment: Interpreting findings and formulating differential diagnoses. FA Davis.
Discussion Question 1
I missed asking Racheal about breast lumps or discharge, which is crucial as nipple discharge, although often benign, can sometimes indicate breast cancer. Discharge accompanied by a lump or mass in the breast raises concern (Goolsby & Grubbs, 2014). Additionally, I overlooked inquiring about any history of trauma to her breast, which could have helped identify problems related to breast injury, such as contusions, pain, and tenderness.
Discussion Question 2
One of my errors was not performing a complete physical exam. While it’s debated whether history alone or examination is more diagnostic, a thorough physical exam remains essential in clinical practice. I also neglected to palpate all lymph nodes, critical for detecting signs of infections, cancers, and immune diseases, emphasizing the importance of comprehensive examinations (Goolsby & Grubbs, 2014).
Discussion Question 3
A key finding was the identification of two palpable right breast lumps. Conducting a proper breast examination is crucial, and performing it soon after the menstrual period enhances effectiveness. Clinical exams, breast self-awareness, and mammography together offer comprehensive breast cancer screening (Goolsby & Grubbs, 2014).
Discussion Question 4
No missed items were reported.
Discussion Question 5
Breast lipoma was not considered, given the unilateral, painless, and mobile mass symptoms. However, RH’s history of weight loss and axillary lymphadenopathy ruled out this diagnosis. Breast cancer emerged as the primary diagnosis due to a family history of breast cancer, a prior atypical ductal hyperplasia diagnosis, recent weight loss, and axillary lymphadenopathy (Goolsby & Grubbs, 2014).
Reference
Goolsby, M., Grubbs, L. (2014). Advanced Assessment: Interpreting Findings and Formulating Differential Diagnoses, 3rd Edition. F.A. Davis Company. VitalBook file. nsg 6020 Health assessment week 1 discussion.
NSG 6020 Week 1 Discussion Assignment Latest SU
Assignment 2: Discussion Questions
The discussion assignment serves as a platform for engaging in meaningful conversations around relevant topics aligned with the covered course competencies.
For this task, navigate to the Discussion Area and contribute a response to one of the questions posted. You have the option to reply to your peers’ contributions for either of the questions.
Support your responses with information from the course materials, including readings and the South University Online Library. Ensure proper citation of your sources using APA format.
Initiate your engagement early in the week by reviewing and responding to your classmates’ posts. Respond to at least two initial posts from your peers. Engage in the discussion by posing questions, offering clarifications, presenting viewpoints with rationales, challenging aspects of the discussion, or highlighting connections between different lines of reasoning. Remember to cite your sources when responding to classmates.
Discussion Question 1: Health Disease Choice
Select a common health disease prevalent in the adult population and share your choice by posting it in the discussion question area under the title “Health Disease Choice.” In case a health disease is already mentioned, opt for another to diversify the discussion. While conducting your research, focus on finding two evidence-based articles related to your chosen health disease. Cite your references following the APA format. Emphasize typical problems encountered in advanced practice nursing rather than rare diseases. Based on the literature search and the selected adult disease process, discuss the essential components of a complete health history necessary for understanding a patient’s current health status and the work-up completed to date.
Discussion Question 2: Differential Diagnoses Criteria
Consideration of differential diagnoses is a crucial step before arriving at a final diagnosis. Outline the criteria that must be met before determining a final diagnosis. Provide an example by presenting three differential diagnoses for a patient with a sore throat, supporting each with a brief statement of reason. It’s not necessary to provide a final diagnosis; instead, focus on working through the differential diagnoses. Sore throat is a common complaint, and exploring various possibilities will enhance your diagnostic skills in managing patients.
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