Midterm & Final Exam Instructions

Nursing 523                                                     

 

Please download and review the expanded clinical scenario. Read thru this patient’s story. Answer the following questions in order asked, and answer under the specific heading of each question.  This is NOT a formal APA paper. Please keep your responses as brief as possible while remaining thorough.  Feel free to use tables, algorithms, outlines, or whatever format you believe would best explain your responses, but these must be in the same document you submit, and they must be your responses. Do make sure that you provide responses to each question. As always, please provide all appropriate citations and references and make the work your own.  At least 2 of your references must be obtained from Foley library.  Please review APA 6^th edition of appropriate citation of references. Plagiarism will not be tolerated.  Poor grammar and spelling errors will result in point deduction. No more than 10-11 pages maximum (not counting reference page). The instructions are in an outline format, but you do not have to use this outline to submit your work.  The outline will guide you through everything that I am looking for you to cover.

This assignment should not be in APA format (although your references should be).  Instead, please use the numbers 1 to 5 to separate out each of the categories below, answering each of the areas within each heading.  If you do cite a reference, then please do give credit as an in-text reference (Author, year). When completing this assignment please give your responses in the same sequence as the outline below.   If you do not submit with your answers below the heading of each area, it will be returned to you to be resubmitted with a late penalty.  References should be in APA format for your last page of the assignment. 

To Submit:  Click into “Turn it in.”  It will guide you through the process step by step.  Make sure your first & last name are on the top of the document. “Turn it in” is in the same area you found the mid-term case.  It is an easy process (even I was able to do it).  If you have difficulty you can always email:  atasupport@gonzaga.edu

The midterm is due by Sunday October 25 @ 11:59 PM PST & the final is due by Sunday November 29 @ 11:59 PM. 

1. Differential Diagnosis Table
   1. Complete a differential diagnosis table for this patient (see below)
      1. A differential diagnosis list is a list of all the possible diagnoses this patient could have based on the symptoms the patient presents with, the available history and the physical exam. Examine what you know about this patient, and consider the pathophysiology as you make your list of possible diagnoses.
      2. You should be able to generate a list of at least 4-5 possibilities, though there is space for more if you would like.

• Put them in a list of most likely being number 1, to less likely.
  1. Your number one diagnosis is the one you think this patient has, given the history and physical exam. This is the most likely diagnosis given that there are more clinical manifestations and findings in the history and exam that support this diagnosis.
  2. Include any differential that you think is appropriate for this patient, given the information you have, but make sure it is in the order of most likely.
  3. Be specific in your possible diagnosis. Do not use generic diseases or diagnoses.  If there are more than one type of a disease, list each separately, as likely the pathophysiology is different.

 

Possible Diagnosis (listed in order of likelihood)	Signs and Symptoms seen in This patient that make you consider this as a diagnosis
NEUROPATHIES PAGE 583 Neurophathy (peripheral neuropathy) (neurology	https://my.clevelandclinic.org/health/diseases/14737-neuropathy
Spinal tumors/infection	https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Tumors
Diabetes
Peripheral artery disease	Smoking, over 50, leg numbness or weakness, painful with activities
Pernicious anemia/iron deficiency anemia	https://thearbor.com/can-alcohol-cause-anemia/ low RBC, iron
Stomach flu	Vomiting, fever
1. Multiple sclerosis
2. Back Pain
3. Diabetes
4.Peripheral neuropathy
5.Viral Gastroenteritis
6.Food poinsoning
7. Musculoskeletal	Legs weakness
8.Spinal cord cancer
9.Anemia	Weakness, Fatigue (alcohol consumption, low iron diets…)

MYELOPATHY AND CAUDA EQUINA SYNDROME

 

https://www.youtube.com/watch?v=iqDz9ixXILs

 

2. Most Likely Diagnosis: Multiple Sclerosis
   1. Expand upon your most likely diagnoses (#1 from your list above).
      1. Define the pathological condition, disease or syndrome. (Make sure you include a reference for your definition).

–

1. Explain why the pathology is a possibility for this patient.
   1. Why do the clinical manifestations this patient has make you consider the pathophysiological problem?

 

2. Explain each clinical manifestation or abnormal finding in the case with a reason for why it matters in the diagnosis you are considering. Explain the relationship of these signs and symptoms to the pathophysiology

 

 

3. What other information would you need to know to help with this diagnosis?

-Additional information:

• Emphasize and discuss the pathophysiology of this diagnosis.
  1. What causes it?

 

2. How does it develop?

 

 

3. What role does genetics have in the development of the disorder, if at all?

 

4. Discuss all the body organ (s) or system affected by the disease.

 

 

5. How are normal anatomy and physiology altered?

 

6. How is normal body function compromised?

 

 

7. What are the potential complication or sequelae of the disease process?

 

1. Who is at risk for developing this pathological condition?
   1. Why are persons at risk?

 

2. How can it be prevented?

 

 

3. Explain how this risk is present for this patient.

 

3. Second Most Likely Diagnosis
   1. Expand upon your most likely diagnoses (#2 from your list above).
      1. Define the pathological condition, disease or syndrome. (Make sure you include a reference for your definition).

 

1. Explain why the pathology is a possibility for this patient.
   1. Why do the clinical manifestations this patient has make you consider the pathophysiological problem?

 

2. Explain each clinical manifestation or abnormal finding in the case with a reason for why it matters in the diagnosis you are considering. Explain the relationship of these signs and symptoms to the pathophysiology

 

 

3. What other information would you need to know to help with this diagnosis?

 

• Emphasize and discuss the pathophysiology of this diagnosis.
  1. What causes it?

 

2. How does it develop?

 

 

3. What role does genetics have in the development of the disorder, if at all?

 

4. Discuss all the body organ (s) or system affected by the disease.

 

 

5. How are normal anatomy and physiology altered?

 

6. How is normal body function compromised?

 

 

7. What are the potential complication or sequelae of the disease process?

 

1. Who is at risk for developing this pathological condition?
   1. Why are persons at risk?

 

2. How can it be prevented?

 

 

3. Explain how this risk is present for this patient.

 

4. Third Most Likely Diagnosis
   1. Expand upon your most likely diagnoses (#3 from your list above).
      1. Define the pathological condition, disease or syndrome. (Make sure you include a reference for your definition).

 

1. Explain why the pathology is a possibility for this patient.
   1. Why do the clinical manifestations this patient has make you consider the pathophysiological problem?

 

2. Explain each clinical manifestation or abnormal finding in the case with a reason for why it matters in the diagnosis you are considering. Explain the relationship of these signs and symptoms to the pathophysiology

 

 

3. What other information would you need to know to help with this diagnosis?

 

• Emphasize and discuss the pathophysiology of this diagnosis.
  1. What causes it?

 

2. How does it develop?

 

 

3. What role does genetics have in the development of the disorder, if at all?

 

4. Discuss all the body organ (s) or system affected by the disease.

 

 

5. How are normal anatomy and physiology altered?

 

6. How is normal body function compromised?

 

 

7. What are the potential complication or sequelae of the disease process?

 

1. Who is at risk for developing this pathological condition?
   1. Why are persons at risk?

 

2. How can it be prevented?

 

 

3. Explain how this risk is present for this patient.

 

 

5. How might you counsel/educate this patient, based on these top 3 diagnoses?

 

-What might this patient expect to encounter as a result of these pathophysiological issues? 

Keep in mind that you will be giving the patient instructions at the level of an Advanced Practice nurse. 

Education & counseling is one area we excel in as NP’s. 

You should given patient & families education regarding their diagnosis, what the diagnosis means for them long-term,

what is their overall prognosis or chances of full recovery,

what the patient can expect as far as further testing,

how the disease process is treated, pro’s & con’s of treatment etc…Consider yourself in the provider role.

 

6. Reference page (in APA format).

References

https://www.mayoclinic.org/diseases-conditions/spinal-cord-tumor/symptoms-causes/syc-20350103