Description
Poor Patient Outcome
Relying solely on the classic features of a disease may be misleading. That's because the clinical presentation of a disease often varies: the symptoms and signs of many conditions are non-specific initially and may require hours, days, or even months to develop.
Generating a differential diagnosis; that is, developing a list of the possible conditions that might produce a patient's symptoms and signs — is an important part of
This case portrays a poor patient outcome after a misdiagnosis.
Case scenario
A previously healthy 35-year-old lawyer presents to a primary care office with a chief complaint of chest pain and a non-productive cough. The pain started suddenly 2 hours prior to coming to the office while the patient was sitting at his desk. The patient describes the pain as sharp in nature, constantly present but made worse with inspiration and movement, and with radiation to the base of the neck. His blood pressure in the right arm and other vital signs are normal.
On physical
The following day the patient collapses at home and cannot be resuscitated by the paramedic service. An autopsy reveals a Type 1 aortic dissection with pericardial tamponade.
Written Assignment:
Developing a list of possible conditions that might produce a patient's symptoms and signs is an important part of
- As an NP in primary
care what would you have done differently? - Discuss the importance of creating a list of differentials for this patient. How could it have changed this outcome?
If a serious diagnosis comes to mind based on a patient's symptoms:
- Ask yourself; Have you considered the likelihood of it and whether it needs to be ruled out by testing or referral?
- Because many serious disorders are challenging to diagnose, have you considered ruling out the worst case scenario?
- Ask yourself: Do you have sufficient understanding of the clinical presentation to offer an opinion on the diagnosis?
- What
other diagnosis could it be? How might the treatment to date have altered the patient outcome? - What other diagnostic and laboratory or imaging was needed in order to make a complete differential list? What support tools would you consider using in helping to create a differential diagnosis list?
- Are you familiar with the current clinical practice guidelines for the investigation of a suspected condition such as chest pain?
APA 6TH edition, 8-10 pages with references
Explanation & Answer
Attached.
Running Head: POOR PATIENT OUTCOME
Poor Patient Outcome
Institution Affiliation
Date
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POOR PATIENT OUTCOME
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Introduction
Patients normally visit healthcare facilities when they are feeling unwell and it is the
responsibility of the healthcare professional they meet at the facility to evaluate them and come up
with a diagnosis. Different diseases have almost similar symptoms and that is why it is important
for the healthcare professional to ensure that they arrive and the correct diagnosis. In the event that
the healthcare professional attending to a patient relies on the known features of an ailment can be
misleading and an incorrect diagnosis might be given for the patient. Some symptoms that are
associated with various ailments normally vary and in some cases take hours, days or in some
cases months to develop. It is therefore advisable for the healthcare professional handling a patient
to develop a list of any other ailments that have similar symptoms like the one a patient is
presenting so as to be able to rule out all other possibilities and come up with the correct diagnosis.
It is important for a healthcare provider to provide the accurate diagnosis so that they can also offer
the best treatment. All healthcare providers know that an incorrect diagnosis will lead to improper
treatment which might have devastating effects on the patient and in some cases death.
Primary care
Primary care is the care that is given to a patient when they visit a healthcare facility for
the first time, and it is offered by the healthcare provider the patient makes contact with. The
healthcare provider might be forced to engage other healthcare providers to be able to provide the
best care to the patient. In most cases, patients typically receive primary care from a physician,
nurse practitioner (NP) and even healthcare assistant. The nature of the condition the patient has
been diagnosed with will determine how long he will receive primary care or whether he will be
referred to secondary care. According to the World Health Organization (WHO), primary care is
a critical component of providing quality and effective healthcare to patients who visit healthcare
POOR PATIENT OUTCOME
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facilities since the patient is provided with comprehensive care that is preventive and curative over
a period. Primary care providers are expected to be very knowledgeable in matters to do with
healthcare. One of the characteristics is continuity since in most cases patients prefer to go to the
same healthcare provider for routine checks (Thomsett et al., 2018).
As a Nurse Practitioner in primary care, there are several things I would have done
differently after when handling the lawyer. The first thing I would have done would have been to
note all the symptoms of the patient and would have then proceeded to create a list of differential
diagnosis since I know that some ailments present symptoms that are almost similar. I would have
also consulted other healthcare providers at the facility before proceeding to treat the lawyer. I
would have also recommended that further tests be carried out on the patient to rule out other
ailments before treatment. As a nurse practitioner, I would also have suggested that th...
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