(Heart disease, or Causes and effects of heart attacks)

Review Chapters 1 and 2 of Bates’ Guide to Physical Examination and History Taking and the condition or disorder you selected in DQ 1.

Imagine a patient comes into your office with your selected condition or disorder. What elements in the patient history and physical exam would indicate the patient has the selected condition or disorder?

Select two differential diagnoses that could be applied to this patient. How did you arrive at the two differential diagnoses? Include history and physical examination findings that would support each of the two alternative diagnoses.

Select one nose, mouth, or neck condition or disorder. Summarize/Discuss the clinical characteristics and identify the appropriate laboratory, imaging, and other diagnostic and screening tools that apply to this condition or disorder.

Explain why you selected these tests or tools as being appropriate to this process? Support your summary and recommended plan with a minimum of two peer-reviewed references in addition to the course materials.

W1 DQ-2

Refer to “The Medical H and P” and “How to Create a Differential Diagnosis” videos in this topic. Discuss your observations. What questions did the videos raise for further exploration? Explain what else would you have added to the examination and patient interaction activities.

After watching the videos, I have learned the importance of using the patient history and physical as a basis for selecting relevant diagnostic testing, which leads to a timely and accurate diagnosis. This process protects the patients from the risks of unnecessary testing and is cost-effective. The videos are very helpful in breaking down step-by-step the process for bedside differential diagnosis. The videos also show that it is easy to get lost in certain diagnostics and diagnosis as well as the bias we may develop (Strong 2013). As the healthcare field continues to evolve, it is critical to include patients as active participants in their own healthcare, which begins by listening closely to their concerns through eliciting a comprehensive patient history. The data collected during the history will in turn lead to a focused and skilled physical exam, which will ultimately form the basis for selective testing and an improved diagnostic process (Bickley, Szilagyi, & Bates, 2017). A “differential diagnosis” is distinguishing a condition as the potential cause of a patient’s illness via process of elimination. Because the ultimate diagnosis is unknown at the time of assessment, it’s important for clinicians to consider multiple conditions that may cause similar observable symptoms and follow a process of elimination to rule them out. When a clinician considers differential diagnoses in determining a patient’s condition, they’re using what they know about pathophysiology and applying it with their assessment findings and the patient’s history. Although this process may not arrive at a concrete diagnostic certainty, it’s infinitely useful in narrowing the field of potential choices and zeroing in on needed treatments (Kaiser, 2016).

As Nurse practitioners, it is our role to refine and promote history and physical as a basis for the judicious selection of testing procedures, which will ultimately improve the diagnostic process. The end result will be to offer evidence-based and cost-effective care to patients within a reasonable time frame while also including patients as active participants in their own care.