NURS663B Primary Care Adult and Geriatric Patient Theory Week 4 Discussion

NURS663B Primary Care Adult and Geriatric Patient Theory

Week 4 Discussion

Select one of the following case studies to address. In the subject line of your post, please identify which prompt you are responding to, for example,  #1 45-year-old woman, intermittent fevers.

Discuss what questions you would ask the patient, what physical exam elements you would include, what further testing you would want to have performed, differential and working diagnosis, treatment plan, including inclusion of complementary and OTC therapy, referrals, and other team members needed to complete patient care.

In your peer replies, please reply to at least one peer who chose a different case study.

Case Studies

1. Jenny G., a 48-year-old recovering intravenous (IV) drug abuser, presents with general malaise, anorexia, abdominal pain, and slight jaundice. She is currently staying in a women’s shelter and is looking for a job. She is divorced with two grown children whom she hasn’t been in contact with for years. She returns to your office for her lab results. You note that her ALT is elevated, and that her Hepatitis A and C antibodies are positive.

2. Mrs. J., age 42, has been married for 20 years to a high school teacher. She has 16-year-old twins who are in high school. She is coming in for a routine physical, because she said over the phone that she has no energy and has lost some weight. She also thinks she has had a temperature for several days. She has the following physical exam findings: temperature, 101°F; weight loss of 10 lbs. since her previous visit last year; flu-like symptoms; nonproductive cough; bilateral lymphadenopathy in cervical and supraclavicular nodes; and decreased breath sounds in bilateral bases.

3.  Michael, a 33-year-old realtor, comes to your offices with a severe rash that he has had for the past two days that started on his stomach and has now spread to his arms and trunk, and is spreading to his face. He denies shortness of breath, but states that his lips and throat feels itchy. He took several doses of Benadryl without any relief. He denies any new foods or medications or environmental exposures. On examination you notice diffuse, generalized urticarial rash. Vital signs are stable.