10/5/2014 Creighton University College of Nursing Differential Diagnosis Exercise (DDE) Name: Mary M. McAuliffe Clinical Sign or Presenting Problem : Fever A. Identify appropriate history questions to be asked of the patient, nursing staff, or family in order to discriminate critical characteristics or attributes about the presenting problem. HPI Onset: When did you first notice the fever? Where were you when you first began having the symptoms? Location: Not applicable Duration: Is the fever constant or does it come and go? When is it worst? Have you noticed a pattern to the fevers? When is it the highest? When is it the lowest? Characteristics: How high has your fever gotten? How long does it last? Associated Symptoms: Are you …show more content…
ALLERGIES: Thorough review of all medication, food, and environmental allergies is necessary. MEDICATIONS: Any use of diuretics, pain medications, antiarrhythmic agents, anti-seizure drugs, sedatives, antibiotics, antihistamines, barbiturates, cephalosporins, salicylates, and sulfonamides?(Ross & Basello, 2003) FAMILY HX: Family history of chronic leukemia, lymphomas, renal cell carcinomas or metastatic cancers (Ross & Basello, 2003) Any family history of immunocompromise? SOCIAL HX: Any recent travel? If so, where to and for what duration of time? Causes (if recent travel to distant countries) may include Malaria, Viral Hepatitis, Diarrheal disorders, or Typhoid fever (Merck’s Manual, 2014). If recent travel around U.S., causes may include tick exposure (rickettsiosis, Lyme’s disease), mosquito exposure (arboviral encephalitis), wild animal exposure (rabies), fleas (plague), cat-scratch disease or toxoplasmosis, reptiles (salmonella), or bats (rabies) (Merck’s Manual, 2014). Any drug use? Drugs that can cause increased heat production include amphetamines, cocaine, ecstasy, and anesthetics (Merck’s Manuals, 2014). ROS Constitutional: overall health status including physical, mental, and functional health (ADL’s, etc), recent weight loss or weight gain, fever, chills, repeated infections HEENT: headache, ear pain, runny nose, sore throat, neck pain or stiffness Cardiovascular: chest pain
Treatment for epilepsy is often focused on controlling the seizures with the least amount of medication as possible. Antiepileptic drugs (AEDs) are the class used to accomplish this. Some of the AEDs that are used most often are Clonazepam, Diazepam, Divalproex, Gabapentin, and Phenytoin. The most common side effects of these medications include nausea, vomiting, sedation, fatigue, and lethargy. (Kwan,1; Benbadis, 3-5; Huethers,637)
In this process a particular patient is selected and then the information is gathered about the treatment, care or services the patient has received at the hospital. This is done through interviewing, questionnaires and scrutiny of documents related to the patient (Uselton, Kienle, Murdaugh & Coe, 2010).
years ago with vague complaints of (C/O) intermittent fatigue, joint pain, low-grade fever, and unintentional
Every year in the U.S., between 8,000 to 18,000 people are hospitalized with Legionnaires’ disease. When people catch Legionnaires’ disease, they start to develop headaches, muscle aches, and a high fever that can lead to as high as 104° or 105°.The disease can naturally be found in hot tubs, decorative fountains, and in cooling towers.
2.1In order to find out the find out the history, preferences, wishes and needs of the individual I would need sources of information, this could include asking the individual, their family and friends or carers, other
The nurse could ask the client what they know about their condition, risk factors, and
Discuss how an understanding of nursing-sensitive indicators could assist the nurses in this case in identifying issues that may interfere with patient care.
To measure his health status, Justin and the case manager will meet with the doctor to discuss his CD4 level and his viral load. Justin will be considered healthy when he is able to achieve a viral load number of less than twenty and a CD4 level between 500 and 1,500. This will determine if Justin is medication compliant and is following the doctor’s medical treatment plan. Justin and the case manager will meet with the doctor in the first week of every month over the course of a year to discuss Justin’s health status. If Justin is able to remain undetectable (viral load below 20) for eight months, the case manager will determine Justin is medication compliant and is motivated to remain physically
7. Which collaborative problem will the nurse include in a care plan for a patient admitted to the
Sadly, on occasion, someone with HD may not have a history of HD in the family. This is caused by a ‘new mutation’ that is a gene present for the first time in a family member, that can happen
They recorded each item prospectively, in relation to the patient's condition at the time, after asking structured questions of the patient's primary nurse and reviewing the patient's record to verify appropriate information. For all patient-specific information, the nurses relied primarily on the answers of the respondent or care giver. Thus, although charting practices had changed in a few of the facilities between 1982 and 1986, the method of eliciting data was relatively immune to the changes. (Shaughnessy, 1990) In addition to collecting data on the patients, the nurses conducted a survey among administrators and staff members in order to verify information about the facilities obtained from other sources.
Question #1: What are your initial observation of the patient? Include name, age, marital status, profession, behavior, etc.
This entity was first published by Beasley et al in 2002. The case of 17 patients showed male and Caucasian predominance with average age of 62 years. Average time to onset of symptoms was 19 days, and the most common symptoms includes cough, shortness of breath and constitutional symptoms like fatigue or malaise1.
The development of warm pathogen disease theory was a paradigm shift in the development of disease theory. Recognition of the unique characteristics of warm disease, it’s the rapid onset, severe symptoms and, contagious nature warranted a new category. Due to it’s severity, quick identification and treatment was imperative.
In order to be compliant with Joint Commission standards for Record of care, Treatment and services an assessment was done which is