NURS 6512 Week 3 Case Study Assignment: Differential Diagnoses and Diagnostic Testing

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NURS 6512 Week 3 Case Study Assignment: Differential Diagnoses and Diagnostic Testing – Step-by-Step Guide

The first step before starting to write the NURS 6512 Week 3 Case Study Assignment: Differential Diagnoses and Diagnostic Testing, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for NURS 6512 Week 3 Case Study Assignment: Differential Diagnoses and Diagnostic Testing

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility. Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for NURS 6512 Week 3 Case Study Assignment: Differential Diagnoses and Diagnostic Testing

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for NURS 6512 Week 3 Case Study Assignment: Differential Diagnoses and Diagnostic Testing

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for NURS 6512 Week 3 Case Study Assignment: Differential Diagnoses and Diagnostic Testing

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for NURS 6512 Week 3 Case Study Assignment: Differential Diagnoses and Diagnostic Testing

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for NURS 6512 Week 3 Case Study Assignment: Differential Diagnoses and Diagnostic Testing

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

NURS 6512 Week 3 Case Study Assignment: Differential Diagnoses and Diagnostic Testing Instructions

When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools to help in understanding a patient’s condition. In turn, beginning with a differential diagnosis supports the process of further applying information to narrow the possibilities of what the condition may be and working to arrive at the most accurate diagnosis for planning treatment.  

For this Case Study Assignment, you will determine the physical exams and diagnostic tests that would be most appropriate for gaining information and better understanding of your patient’s condition. Then, based on your analysis, you will formulate a differential diagnosis for the patient. Have a look at NURS 6512 Week 4 Assignment I-Human Patients Case Study: Evaluating And Managing Integumentary Conditions.

Our focus this week is on Differential Diagnosis and Diagnostic Testing

The first step you should take as a provider to properly diagnose a patient’s condition is to begin listing all the possible diagnosis.   This list of potential diagnosis is considered differential diagnosis.  It is from this list you will begin to include / exclude diagnosis until you reach the one you will develop your treatment plan for. You basically become a detective in identifying possibilities and then look at symptoms, labs, and diagnostics to reach your conclusion.    The more experienced and knowledgeable you are the better your list of potential diagnosis will be.   Please be sure to review the Walden generated required media to review this topic.

The second topic this week is Diagnostic testing. As a provider, you must take the next step in utilizing tests to assist in identifying the diagnosis and then monitoring your treatment plan for effectiveness. You need to understand what test are valid, reliable, and valuable in clinical practice.

  •  Case Study Assignment

Miss Washington is a 71 y/o female who presents with a new leg ulcer that appeared after a fall 1 week ago. The patient is coughing and wheezing. She tells you that “I’m feeling terrible.” Vital signs appear stable with no fever.

  • To prepare:

Review this week’s Learning Resources. 

  • Review the details of the patient case study. 
  • Consider what physical exams and diagnostic tests would be most appropriate to gather more information about the patient’s condition. 
  • Reflect on how the results would be used to make a diagnosis. 
  • Identify three to five (3–5) possible conditions that may be considered in a differential diagnosis for the patient. 

Assignment: Diagnostic Reasoning 

Include the following: 

  • Identify the patient’s chief complaint. 
  • Identify what physical exams and diagnostic tests would be most appropriate to gather more information about the patient’s condition. Be specific and explain your reasoning. 
  • Explain how the results would be used to make a diagnosis. 

Identify three to five (3–5) possible conditions that may be considered in a differential diagnosis for the patient. Explain your thinking. 

NURS 6512 Week 3 Case Study Assignment: Differential Diagnoses and Diagnostic Testing Example

Chief Complaint

Leg ulcer following a fall one week ago, accompanied by coughing, wheezing, and feeling unwell.

Physical Exams

A thorough physical examination of the leg ulcer is essential to assess its size, depth, signs of infection such as redness, warmth, swelling, and purulent discharge, and the condition of the surrounding tissue. Palpation of the affected area can help determine the presence of tenderness or fluctuance, which may indicate an abscess or cellulitis.

A vascular assessment, including checking pulses in the affected leg, is crucial to rule out compromised circulation, especially in an older adult. Auscultation of the lungs should be performed to evaluate the cause of the patient’s coughing and wheezing and to identify potential abnormalities such as crackles or wheezing that may indicate respiratory infection, asthma, or chronic obstructive pulmonary disease.

Diagnostic Tests

Wound swab cultures and sensitivity testing would be appropriate to identify any leg ulcer infection and guide antibiotic therapy. Blood tests, including a complete blood count, can detect leukocytosis, suggesting systemic infection or inflammation, while C-reactive protein or erythrocyte sedimentation rate can measure the severity of inflammation.

Imaging, such as an X-ray of the affected leg, may be necessary to rule out osteomyelitis if there are signs of deep tissue infection. Pulmonary function tests or a chest X-ray can help evaluate the underlying cause of the cough and wheezing and identify conditions like pneumonia or an exacerbation of a chronic respiratory condition. These tests provide comprehensive insights into the patient’s condition and help to direct treatment effectively.

Making a Diagnosis

The results from the physical exams and diagnostic tests would clarify the underlying causes of the patient’s symptoms and guide treatment decisions. Examination findings, such as signs of infection in the leg ulcer or impaired blood flow, would help identify whether the wound is healing properly or complicated by conditions like cellulitis or peripheral artery disease.

Diagnostic test results, including wound cultures, would pinpoint specific pathogens to guide antibiotic therapy, while blood tests indicating elevated inflammatory markers or leukocytosis would confirm systemic infection or inflammation. Imaging studies, such as an X-ray, could rule out osteomyelitis in the leg or reveal pneumonia or other respiratory conditions contributing to the cough and wheezing. These combined findings would provide a comprehensive picture of the patient’s condition, ensuring accurate diagnosis and tailored treatment.

Differential Diagnosis

Infected Leg Ulcer

An infected leg ulcer is a likely condition, considering the recent fall and the presence of a wound. Symptoms such as redness, warmth, swelling, and purulent discharge suggest a localized infection. The patient’s statement about feeling terrible may indicate systemic involvement, such as an immune response to the infection. Infections in older adults can escalate quickly due to potential comorbidities or a weakened immune system (Garcia et al., 2021).

The presence of coughing and wheezing may further indicate that the infection has systemic implications, complicating the clinical picture. Given the patient’s age, attention to the wound’s characteristics, such as size, depth, and surrounding tissue condition, is essential to understanding the severity and potential complications of the ulcer. Proper evaluation of the wound is critical to determining the next steps in care.

Chronic Obstructive Pulmonary Disease (COPD) Exacerbation

Chronic obstructive pulmonary disease exacerbation can explain the patient’s respiratory symptoms, particularly coughing and wheezing. Exacerbations are often caused by environmental triggers or infections, leading to increased airway inflammation and mucus production. Respiratory symptoms may be more severe in older adults due to reduced lung function over time.

Wheezing indicates airway obstruction, while the patient’s feeling of being unwell may suggest compromised oxygen exchange (Naqvi & Choudhry, 2020). COPD exacerbations can also create additional strain on the cardiovascular system, leading to further fatigue and discomfort. The connection between chronic lung conditions and systemic health often highlights the complex interplay of symptoms. Evaluating the patient’s history of respiratory illnesses and current presentation can provide a more comprehensive understanding of the potential issues at play.

Peripheral Artery Disease (PAD)

Peripheral artery disease may complicate the healing of the patient’s leg ulcer. This condition is common in older adults and involves reduced blood flow to the extremities due to atherosclerosis. Impaired circulation can lead to delayed wound healing and increased susceptibility to infections. PAD often presents with symptoms such as cool skin, diminished hair growth, and weakened pulses in the affected area (Golledge, 2022).

The presence of a non-healing ulcer raises concerns about the adequacy of blood flow to the lower extremity. While PAD primarily affects the vascular system, it can have systemic implications, as inadequate circulation may contribute to fatigue and discomfort. The patient’s presentation of a non-healing ulcer alongside other symptoms underscores the importance of considering PAD in the differential diagnosis.

Pneumonia

Pneumonia is another condition that may explain the patient’s respiratory symptoms, including coughing and wheezing. While fever is a common sign of pneumonia, older adults often exhibit atypical presentations, such as generalized malaise or weakness. Pneumonia is typically caused by bacterial or viral infections, leading to lung inflammation and fluid buildup. This condition may be more likely if the patient has limited mobility after the fall, as immobility can increase the risk of respiratory complications.

Wheezing and coughing are indicative of airway irritation or obstruction, while the patient’s subjective feeling of being terrible suggests the systemic effects of the illness (Naqvi & Choudhry, 2020). Pneumonia often impacts overall energy levels and respiratory function, particularly in vulnerable populations like older adults with potential underlying health issues.

References

Garcia, T. D. F., Borges, E. L., Junho, T. O. D. C., & Spira, J. A. O. (2021). Microbiological profile of leg ulcer infections: Review study. Revista Brasileira de Enfermagem, 74(3), e20190763. https://doi.org/10.1590/0034-7167-2019-0763

Golledge, J. (2022). Update on the pathophysiology and medical treatment of peripheral artery disease. Nature Reviews Cardiology, 19(7), 456–474. https://doi.org/10.1038/s41569-021-00663-9

Naqvi, S. Z. H., & Choudhry, M. A. (2020). An automated system for classification of chronic obstructive pulmonary disease and pneumonia patients using lung sound analysis. Sensors, 20(22), 6512. https://doi.org/10.3390/s20226512