D3
\nCase 3
\nMrs. Deer is a 72-year-old female who presents to your office complaining of right upper quadrant pain that has been increasing in intensity over the past 2 days. She would have come sooner, but she lacked transportation and waited until her son could drive her. She states that she has not been sleeping very much because of the pain. She has been nauseous and vomited a couple of times two days ago but has only been drinking fluids. She states that she has not been around anyone else that had an upset stomach. She recalls prior to the onset of pain she had been at a church supper that included meats, refried beans, and many desserts which she sampled. She described the fried pies that she brought to the supper and ate the extras that afternoon.
\nVital Signs: BP 130\/80, HR 85, RR 20, Temp 99.0\u00b0F.
\nDiscuss the following:
\n1) What additional subjective data are you seeking to include past medical history, social, and relevant family history?
\n2) What additional objective data will you be assessing for?
\n3) What are the differential diagnoses that you are considering?
\n4) What laboratory tests will help you rule out some of the differential diagnoses?
\n5) What radiological examinations or additional diagnostic studies would you order?
\n6) What treatment and specific information about the prescription that you will give this patient?
\n7) What are the potential complications from the treatment ordered?
\n8) What additional laboratory tests might you consider ordering?
\n9) What additional patient teaching may be needed?
\n10) Will you be looking for a consult?<\/p>\n
Submission Instructions:
\n\u2022\tYour initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
\n\u2022\tPlease post your initial response by 11:59 PM ET Thursday
\n\u2022\tYou can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.<\/p>\n
Grading Rubric
\n________________________________________
\nYour assignment will be graded according to the grading rubric.
\nDiscussion Rubric
\nCriteria\tRatings\tPoints
\nIdentification of Main Issues, Problems, and Concepts\tDistinguished – 5 points
\nIdentify and demonstrate a sophisticated understanding of the issues, problems, and concepts.\tExcellent – 4 points
\nIdentifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.\tFair – 2 points
\nIdentifies and demonstrate an acceptable understanding of most of issues, problems, and concepts.\tPoor – 1 point
\nIdentifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.\t5 points
\nUse of Citations, Writing Mechanics and APA Formatting Guidelines\tDistinguished – 3 points
\nEffectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.\tExcellent – 2 points
\nEffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.\tFair – 1 point
\nIneffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.\tPoor – 0 points
\nIneffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.\t3 points<\/p>\n
________________________________-
\nWhat additional subjective data are you seeking to include past medical history, social, and relevant family history?
\nTo gather a comprehensive medical history, it is important to ask Mrs. Deer additional subjective questions related to her past medical history, social factors, and relevant family history. The following information would be helpful:<\/p>\n
a) Past Medical History:<\/p>\n
Inquire about any pre-existing medical conditions such as diabetes, hypertension, liver disease, gallbladder disease, or any other relevant conditions.
\nAsk about any previous abdominal surgeries, particularly involving the gallbladder or gastrointestinal tract.
\nDetermine if she has a history of similar episodes of right upper quadrant pain in the past.
\nb) Social History:<\/p>\n
Explore Mrs. Deer’s occupation, as certain jobs may involve exposure to toxins or substances that can affect the liver or gastrointestinal system.
\nAssess her alcohol consumption patterns, as excessive alcohol intake can contribute to liver disease or gallbladder dysfunction.
\nInquire about any recent travel history, particularly to areas with a higher prevalence of certain infections or foodborne illnesses.
\nDiscuss her dietary habits and any recent changes, including the consumption of high-fat or greasy foods.
\nc) Family History:<\/p>\n
Ask about a family history of gallbladder disease, liver disease, or gastrointestinal conditions.
\nInquire about any genetic conditions that may be relevant to her symptoms, such as familial cholelithiasis.
\nWhat additional objective data will you be assessing for?
\nTo further evaluate Mrs. Deer’s condition, the following objective data should be assessed:<\/p>\n
a) Abdominal Examination:<\/p>\n
Perform a thorough abdominal examination, paying particular attention to the right upper quadrant. Palpate for tenderness, hepatomegaly, or any masses.
\nAssess for signs of jaundice, such as yellowing of the skin or sclerae.
\nCheck for any signs of peritoneal irritation, such as guarding or rebound tenderness.
\nb) Laboratory Investigations:<\/p>\n
Complete blood count (CBC) to assess for signs of infection or inflammation.
\nLiver function tests (LFTs) to evaluate liver enzymes, bilirubin levels, and synthetic function.
\nAmylase and lipase levels to rule out pancreatitis.
\nSerum electrolytes and renal function tests to assess overall organ function.
\nCoagulation profile to assess clotting factors and rule out any coagulopathies.
\nWhat are the differential diagnoses that you are considering?
\nBased on the provided information, the possible differential diagnoses to consider include:<\/p>\n
Acute cholecystitis
\nCholedocholithiasis (common bile duct stone)
\nAcute pancreatitis
\nGastroenteritis
\nHepatitis
\nGastric or duodenal ulcer
\nGastrointestinal malignancy
\nWhat laboratory tests will help you rule out some of the differential diagnoses?
\nTo help rule out some of the differential diagnoses, the following laboratory tests would be helpful:<\/p>\n
Abdominal ultrasound: This can assess the gallbladder for the presence of gallstones, gallbladder wall thickening, or signs of cholecystitis.
\nHepatitis serology: To determine if there is an active viral infection contributing to the symptoms.
\nStool studies: To assess for infectious causes of gastroenteritis.
\nLipase levels: Elevated levels would support the diagnosis of acute pancreatitis.
\nComplete metabolic panel: To assess liver function, renal function, and electrolyte levels.
\nTumor markers (e.g., CEA, CA 19-9): If there is suspicion of gastrointestinal malignancy.
\nWhat radiological examinations or additional diagnostic studies would you order?
\nIn addition to the laboratory tests mentioned above, the following radiological examinations and diagnostic studies may be ordered:<\/p>\n
Abdominal CT<\/p>\n","protected":false},"excerpt":{"rendered":"
D3 Case 3 Mrs. Deer is a 72-year-old female who presents to your office complaining of right upper quadrant pain that has been increasing in intensity over the past 2 days. She would have come sooner, but she lacked transportation and waited until her son could drive her. She states that she has not been […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[210,215,212,220,219,209,222,213,211,214,45,218,216,221,208,217],"tags":[232,229,230,224,228,236,233,235,226,234,225,227,223,231],"class_list":["post-727","post","type-post","status-publish","format-standard","hentry","category-1-assignment-help-online-service-for-students-in-the-usa","category-ai-plagiarism-free-essay-writing-tool","category-australian-best-tutors","category-best-trans-tutors","category-buy-essay-uk","category-can-someone-write-my-assignment-for-me","category-cheap-dissertation-writer","category-do-my-essay-assignment","category-help-me-write-my-dissertation","category-help-with-writing-an-essay","category-homework-for-you","category-help-write-my-paper-ai-free","category-online-essay-writers","category-phd-essays","category-write-my-assignment-help-for-college-students","category-write-my-essay-for-me","tag-apa-citation-format-assignment","tag-assignment-help-by-uks-no-1-writing-service","tag-assignment-writers-australia-college-student","tag-assignment-writers-canada-university-cost","tag-assignment-writers-china-english-free-ai","tag-buy-essay-usa","tag-help-write-a-page-assignment","tag-i-need-someone-to-do-my-assignment-within-hours","tag-in-page-paper-write-an-essay","tag-need-to-write-an-essay","tag-professional-assignment-writers-usa","tag-uae-1-cheap-assignment-writing-service","tag-write-a-word-essay","tag-write-pages"],"_links":{"self":[{"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/posts\/727","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/comments?post=727"}],"version-history":[{"count":0,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/posts\/727\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/media?parent=727"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/categories?post=727"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.colapapers.com\/essays\/wp-json\/wp\/v2\/tags?post=727"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}