Diagnosis and Assessment in a Clinical SettingGiven the information provided in the subjective portion of the note, the clinician would want to find out if the patient has ever engaged in anal intercourse. If the patient has engaged in such intercourse, the clinician would want to know how many partners she’s had in this regard and when was the last incidence of anal intercourse. The clinician would also want to find out if the patient used protection when engaging this form of intercourse. Getting the total number of partners that this woman has had over the past year might shed some light on the situation as well. Additionally, it might be worth asking if the patient has made an obvious changes in personal hygiene or underwear. For example, the sudden usage of baby wipes in the vaginal or anal area has been found to cause irritation in some cases. Likewise, wearing underwear or thongs made out of material that can cause irritation, such as latex or polyester, which prevents proper ventilation to the skin can also cause irritation. Hence, asking the patient if she’s made an sudden changes in dress, or personal hygiene are necessary. Furthermore, asking about the last bowel movement the patient had would be valuable information, as well as asking about the nature of her bowel movements. Does the patient strain or have difficult or leaky bowel movements? Does...
The bumps should be swabbed along with a swab taken of the anus area, and a microscopic examination should be conducted (nih.gov). For example, herpes sores often break and ooze a fluid. If this is in fact a herpes outbreak, the bumps might not be at the stage where they yet break and emit a fluid. Conducting a swab might also help one determine if these bumps are the telltale sores or fever blisters that are often red, white or clear, that forms on the genitalia. Testing the area to determine if it looks swollen would also help in determining a diagnosis. Assessing if the sores are appearing in clusters or groups is also important to note down for the patient’s file; alternatively, the sores or bumps might be manifesting in a more individualized manner. A clinician who has experience in diagnosing herpes should be able to tell if these are the bumps commonly associated with herpes; even if they are not yet emitting a fluid, an experienced clinician can generally tell if that will eventually happen. “The sores will burst and the fluid will begin to discharge, leading to the formation of wet ulcers. Just like cold sores,…
However, the screening of patients for these conditions necessitates the inclusion of brief screening questions into a health systems review at the medical visit because patients may be embarrassed or unwilling to show concerns or talk about their mental distress or health. The inclusion of the questions into the health systems review can help to facilitate early discovery and intervention and communicating to patients about concerns on their overall
This leaves many veterans prone to the condition known as Post-Traumatic Stress Disorder (PTSD). This may be characterized as "an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat." (NIMH, 1) in the particular case of this discussion,
patients undergoing mechanical ventilation contract Ventilator Associated Pneumonia (VAP). This acute medical condition always results in increased death rates and associated medical costs among patients. This article reviews several literatures that try to enlighten masses on the diagnosis, medical treatments and VAP prevention methods. In addition, this article outlines recommendations medical practitioners can implement in their daily practices to curb VAP and offers an insight on controversies that usually
Patient Sexual Orientation on Diagnosis Since DSM-IV Since the creation of DSM-IV as a diagnostic tool, whether or not a patient is homosexual has affected their diagnosis. Whether or not this should be so is a discussion for another day, but why it is so is a more pressing question which needs to be answered. Concerns that many people are not getting the proper clinical diagnosis simply because they have
Patient Overview -- Mr. C. is a 52-year-old business executive with indigestion that an entire roll of TUMS did not help. Initially he blamed this on his lunchtime pizza, but his staff convinced him to go to the ER where he presented epigastric pain. An EKG was done indicating ST segment elevation. Additionally, the pain remained unrelieved after three sublingual nitroglycerine tablets. Three doses of morphine sulfate given intravenously
Practice-Specific Concepts The nursing practice is a profession that is based on conceptual and theoretical models that help in guiding patient safety and quality initiatives. The use of conceptual and theoretical models is an important part in nursing practice that is applied across the various disciplines in this profession. As a clinical nurse specialist, nursing conceptual and theoretical models play a crucial role in achieving the specific goal of identifying,
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