Assessing the Head, Eyes, Ears, Nose, and Throat

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Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment.

Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes but would probably perform a simple strep test.

In this Case Study Assignment, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical assessment and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.

To Prepare

Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP Notes have specific data included in every patient case.

PLEASE USE TEMPLATE TO COMPLETE ASSIGNMENT

With regard to the case study you were assigned:

· Review this week’s Learning Resources and consider the insights they provide.

· Consider what history would be necessary to collect from the patient.

· Consider what physical and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

· Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Case Study 1: Focused Nose

A 28 year old female comes in complaining of a runny nose and itchy eyes. States runny nose, itchy eyes, and ears felt full approximately 9 days ago. “I get this every spring and it seems to last six to eight weeks”. Describes nose is runny with clear mucus. Sneezes on and off all day. Eyes itch so bad she just wants to scratch them out, sometimes feels a tickle in her throat and ears feel full and sometimes pop. Last year took Claritin with relief. Charlotte is alert and oriented. He has pale, boggy nasal mucosa with clear thin secretions and enlarged nasal turbinates, which obstruct airway flow but his lungs are clear. His tonsils are not enlarged but his throat is mildly erythematous.

The Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

Sample Solution

he private sector – is made up of industrial and commercial companies that have developed to react to stable and shifting demands of the market. Each company exists to make a profit and is owned by shareholders, who are the main beneficiaries and not the government. Stakeholders are the ones who decide who the members of the board of directors are. These directors are experts in their field and are responsible for the formulation and implementation of all policies (Leatherbarrow et al 2010). The private sector employs workers through individual business owners, or other nongovernment agencies, jobs include those in financial services, newspapers, hospitality or other nongovernment positions. Private-sector workers tend to have more pay increases, more career choices, greater opportunities for promotions, less job security and less-comprehensive benefit plans than public-sector workers. Working in a more competitive marketplace often means longer hours in a more demanding environment than working for the government.

Public Sector – organisations are owned and controlled by the government (or local government). They aim to provide public services, regularly free at the point of delivery for example, government departments and local authorities provide us with essential services, examples of the are illustrated below:

There are particular goods, called ‘merit goods’ and ‘public goods’ which can cause problems for the private sector, and so they are often better provided by the public sector.

Voluntary or third sector – These are usually social enterprises with primary social objectives. These types of organisations receive funding in the form of donations, public sector bodies or public funds. Motivated by selfless interests rather than commercial though profits are reinvested into the business, hence they have some sort of business mindedness (Martin et al 2009).

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