ST Thomas University Neck Swelling Infections Case Study 3 Discussion
For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. Your instructor will assign you your case number.Case 1Case 2Case 3Chief Complaint(CC) “I am here today due to frequent and watery bowel movements”“I have pain in my belly”“neck swelling”History of Present Illness (HPI)A 37-year-old European American female presents to your practice with “loose stools” for about three days. One event about every three hoursA 25-year-old female presents to the emergency room (ER) with complaints of severe abdominal pain for 2 weeks . The pain is sharp and crampy It hurts if I run, sit down hard, or if I have sexA 42-year-old African American female who refers that she has been noticing slow and progressive swelling on her neck for about a year. Also she stated she has lost weight without any food restrictionPMHNo contributory Patient deniesPatient denies PSHAppendectomy at the age of 14 Surgical removal of benign left breast nodule 2 years agoDrug HxNo medsBirth controlNo medication at the timeAllergiesPenicillinNKANKASubjectiveFever and chills, Lost appetite Flatulence No mucus or blood on stoolsNausea and vomiting, Last menstrual period 5 days ago, New sexual partner about 2 months ago, No condoms, he hates them No pain, blood or difficulty with urinationMild difficult to shallow, Neck feels tight, Pt states she feels PalpitationsObjective Data PEB/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110; BMI 17.8B/P 138/90; temperature 99°F; (RR) 20; (HR) 110, regular; oxygen saturation (PO2) 96%; pain 5/10 B/P 158/90; Pulse 102; RR 20; Temp 99.2; Ht 5,4; wt 114; BMI 19.6 Generalwell-developed female in no acute distress, appears slightly fatiguedacute distress and severe pain42-year-old female appears thin. She is anxious – pacing in the room and fidgeting, but in no acute distress. HEENTAtraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous.Atraumatic, normocephalic, PERRLA, EOMI, conjunctiva and sclera clear; nares patent, nasopharynx clear, good dentition. Piercing in her right nostril and lower lip.Bulging eyes NeckSuppleDiffuse enlargement of the thyroid glandLungsCTA AP&LCTA AP&LCTA AP&LCardS1S2 without rub or gallopS1S2 without rub or gallopS1S2 without rub, TachycardiaAbdpositive bowel sounds (BS) in all four quadrants; no masses; no organomegaly noted; diffuse, mild, bilateral lower quadrant pain noted Mild diffuse tenderness.• INSPECTION: no masses or thrills noted; no discoloration and skin is warm to; no tattoos or piercings; abdomen is nondistended and round• AUSCULTATION: bowel sounds (BS) are normal in all four quadrants, no bruits noted• PALPATION: on palpation, abdomen is tender to touch in four quadrants; tenderness noted on light palpation, deep palpation reveals no masses, spleen and liver unremarkable• PERCUSSION: tympany heard in all quadrants, no dullness noted in abdominal areabenign, normoactive bowel sounds x 4GU Non contributory• EXTERNAL: mature hair distribution; no external lesions on labia• INTROITUS: slight green-gray discharge, no lesions• VAGINAL: normal rugae; moderate amount of green discharge on vaginal walls• CERVIX: nulliparous os with small amount of purulent discharge from os with positive cervical motion tenderness (CMT)• UTERUS: ante-flexed, normal size, shape, and position• ADNEXA: bilateral tenderness with fullness; both ovaries without masses• RECTAL: deferred• VAGINAL DISCHARGE: green in color Non contributoryExtno cyanosis, clubbing or edemano cyanosis, clubbing or edemano cyanosis, clubbing or edemaIntegumentgood skin turgor noted, moist mucous membranesintact without lesions masses or rashesThin skin, Increase moistureNeuroNo obvious deformities, CN grossly intact II-XIINo obvious deficits and CN grossly intact II-XIINo obvious deficits and CN grossly intact II-XIIOnce you received your case number, answer the following questions:What other subjective data would you obtain?What other objective findings would you look for?What diagnostic exams do you want to order?Name 3 differential diagnoses based on this patient presenting symptoms?Give rationales for your each differential diagnosis.Submission Instructions:Your instructor will assign you your case number and you will post on the case number you have been assigned.You will reply to the other two case studies (One of each).Your 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.You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) All replies must be constructive and use literature where possible.Grading Rubric Your assignment will be graded according to the grading rubric.Discussion RubricCriteriaRatingsPointsIdentification of Main Issues, Problems, and Concepts5 pointsDistinguishedIdentify and demonstrate a sophisticated understanding of the issues, problems, and concepts.4 pointsExcellentIdentifies and demonstrates an accomplished understanding of most of the issues, problems, and concepts.2 pointsFairIdentifies and demonstrates an acceptable understanding of most of the issues, problems, and concepts.1 pointPoorIdentifies and demonstrates an unacceptable understanding of most issues, problems, and concepts.5 pointsUse of Citations, Writing Mechanics and APA Formatting Guidelines3 pointsDistinguishedEffectively 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.2 pointsExcellentEffectively 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.1 pointFairIneffectively 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.0 pointPoorIneffectively uses the literature and other resources to inform their work. Unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.3 pointsResponse to Posts of Peers2 pointsDistinguishedThe student constructively responded to two other posts and either extended, expanded, or provided a rebuttal to each.1 pointFairThe student constructively responded to one other post and either extended, expanded, or provided a rebuttal.0 pointPoorThe student provided no response to a peer's post. 2 points