NURS6512 WEEK10 assignment Advanced Health Assessment & Diagnostic Reasoning

Assignment 1: Lab Assignment: Assessing the Genitalia andRectum
 
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Patients are frequently uncomfortable discussing withhealthcare professionals issues that involve the genitalia and rectum;however, gathering an adequate history and properly conducting a physical examare vital. Examining case studies of genital and rectal abnormalities can helpprepare advanced practice nurses to accurately assess patients with problems inthese areas.
 
In this Lab Assignment, you will analyze an Episodic notecase study that describes abnormal findings in patients seen in a clinicalsetting. You will consider what history should be collected from the patients,as well as which physical exams and diagnostic tests should be conducted. Youwill also formulate a differential diagnosis with several possible conditions.
 
To Prepare
Review the Episodic note case study your instructor providesyou for this weeks Assignment. Please see the Course Announcements sectionof the classroom for your Episodic note case study.
Based on the Episodic note case study:
Review this weeks Learning Resources, and consider theinsights they provide about the case study. Refer to Chapter 3 of the Sullivanresource to guide you as you complete your Lab Assignment.
Search the Walden library or the Internet for evidence-basedresources to support your answers to the questions provided.
Consider what history would be necessary to collect from thepatient in the case study.
Consider what physical exams and diagnostic tests would beappropriate to gather more information about the patients condition. How wouldthe results be used to make a diagnosis?
Identify at least five possible conditions that may beconsidered in a differential diagnosis for the patient.
The LabAssignment questions
Using evidence-based resources from your search, answer thefollowing questions and support your answers using current evidence from theliterature.
 
Analyze the subjective portion of the note. List additionalinformation that should be included in the documentation.
Analyze the objective portion of the note. List additionalinformation that should be included in the documentation.
Is the assessment supported by the subjective and objectiveinformation? Why or why not?
Would diagnostics be appropriate for this case, and howwould the results be used to make a diagnosis?
Would you reject/accept the current diagnosis? Why or whynot? Identify three possible conditions that may be considered as adifferential diagnosis for this patient. Explain your reasoning using at leastthree different references from current evidence-based literature.
 
 
CASE STUDY
1.       Case Study Assignment  Thisweek you will be reviewing another SOAP note and reflecting on the additionalinformation that you would be needing.  This is notin SOAP format, you will use headings for each section, and give medialogue on what information is missing in each section.  You will provide5 differentials and reflect on the questions posed for the assignment.  Besure to support with scholarly references.
Week 10: Special ExaminationsBreast, Genital, Prostate, andRectal GENITALIA ASSESSMENT
Subjective:
CC: I have bumps on my bottom that I want to have checked out.
HPI: AB, a 21-year-old WFcollege student reports to your clinic with external bumps on her genital area.She states the bumps are painless and feel rough. She states she is sexuallyactive and has had more than one partner during the past year. Her initialsexual contact occurred at age 18. She reports no abnormal vaginal discharge.She is unsure how long the bumps have been there but noticed them about a weekago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; theexam results were normal. She reports one sexually transmitted infection(chlamydia) about 2 years ago. She completed the treatment for chlamydia asprescribed.
PMH: AsthmaMedications: Symbicort160/4.5mcg Allergies: NKDA
FH: No hx of breast or cervicalcancer, Father hx HTN, Mother hx HTN, GERD
Social: Denies tobacco use;occasional etoh, married, 3 children (1 girl, 2 boys)
Objective:VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 510; WT 169lbsHeart: RRR, no murmursLungs: CTA, chest wallsymmetricalGenital: Normal female hair pattern distribution; no masses orswelling. Urethral meatus intact without erythema or discharge. Perineumintact. Vaginal mucosa pink and moist with rugae present, pos for firm, round,small, painless ulcer noted on external labiaAbd: soft, normoactive bowelsounds, neg rebound, neg murphys, neg McBurneyDiagnostics: HSV specimenobtained
Assessment:Chancre