Clinical Decision

Endocrine Chief Complaint: A 35-year-old female presents for a follow-up visit for poorly controlled type 2 diabetes.

HPI: The patient reports feeling fatigued and experiencing increased thirst and frequent urination over the past two months. Her blood glucose readings have been consistently high, despite adherence to her current medication regimen. She has a history of hypertension and obesity.

ROS: Positive for polyuria, polydipsia, and fatigue. Negative for chest pain, shortness of breath, abdominal pain, and visual changes.Physical Exam Results: BP 140/90 mmHg, HR 82 bpm, BMI 32 kg/m². General: Alert and oriented. HEENT: No abnormalities.

Cardiovascular: Regular rate and rhythm, no murmurs. Respiratory: Clear to auscultation bilaterally. Abdomen: Soft, non-tender, no hepatosplenomegaly. Extremities: No edema.Lab Results: HbA1c 9.5%, fasting glucose 180 mg/dL, creatinine 0.9 mg/dL, eGFR > 60 mL/min.

Consult Note: Endocrinologist recommends intensifying the diabetes management plan and starting a GLP-1 receptor agonist.Medications Ordered: Metformin 1000 mg BID, Lisinopril 10 mg daily.

Instructions: Based on the complete encounter, write out your medical decision making. What were you concerned with, what did you order and why, what did you find, and what are you doing about what you found?  Include at least one current clinical guideline as a scholarly reference in APA format.

Submission Details:

  • Submit your document to the submissions area by the assigned due date.
  • Be sure to include your name, student number, and the date of submission on your document.
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Clinical Decision

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

Lucy James is a 27-year-old female patient who presents with RLQ abdominal pain that comes and goes but has gotten worse over the last couple of day. She has vomited twice today and had several bouts of diarrhea as well.  Her period is a couple of days late, but she states that she is usually not regular. However, a quick urine HCG in clinic results with a faint positive. 

Caroline Andress is a 38-year-old female patient complaining of lower abdominal pain, mainly in the LLQ. Upon palpation you found a palpable left adnexal mass, and the patient responded with guarding and expression of pain to palpation of the left adnexal area. Cervical motion tenderness is noted during the pelvic exam. In clinic urine HCG is negative. The patient reports that her LMP was three weeks ago. No vaginal discharge or other anomalies are noted. Is this simple ovulatory pain, or is something more serious going on?

Megan Peters is your third patient of the day. She is a 25-year-old female who is 33 weeks pregnant and presents with a severe headache. She is wearing a dress with sandals, and it is obvious that her ankles and feet are extremely edematous. Her vital signs are as follows: B/P 162/102, HR 89, Resp 19, Temp 37.2, O2 sat 98% on RA. What is the first issue that comes to mind?

Sherise Benjamin is a 22-year-old female patient who presents with lower abdominal pain and a yucky looking vaginal discharge. When asked about sexual activity and protection she states, “Yea, I date a lot. I always have condoms in my purse, but you know how it is. Sometimes in the heat of the moment I just forget to get one out. Do you think this pain has something to do with sex?”  

Your last patient of the day is a 14-year-old male named Enrique Hermanez. About 30 minutes ago he slid into home plate scoring a dramatic, game winning home run. He said, “When I tried to stand up it felt like I had been kicked in the scrotum. This is the worst pain I have ever felt. I just sat back down and yelled for my dad to come and get me.” The patient rates his pain at 10/10 and keeps trying to hold back tears. 

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Ectopic Pregnancy
  • Ovarian Torsion
  • Pelvic Inflammatory Disease (PID)
  • Preeclampsia/Eclampsia
  • Testicular Torsion
  • Appendicitis
  • Ovarian Cyst Rupture

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

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Clinical Decision

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

Mitch Freese’ is a 56-year-old male patient brought to the clinic by his wife. About an hour ago he started talking in garbled language and began stumbling around the house. His wife first thought that he had started drinking early today, but he does not smell of alcohol, and his wife said that the new bottle of gin is full and still sealed. His right side has a bit of a slumped appearance, but you only saw him walk a few steps. 

Jermaine Edwards is a 17-year-old linebacker on the local Raging Rhinos football team. Some of the team members were in a pickup game against some other local footballers this afternoon without the proper gear and Jermaine took an elbow to the head. Immediately after the injury Jermaine was confused and lost consciousness for about 3 minutes. A nurse at the park timed it. When he regained consciousness, it took him a few minutes to remember his name, but then he seemed o.k. The nurse insisted that he be seen. They called Jermaine’s mom, and she gave permission for a buddy to drive him to your clinic. During the drive he lost consciousness again but regained consciousness about a minute later. Then he threw up in his buddy’s truck. 

Emma Taylor, a 19-year-old female student at the local university, was your third patient of the day. A couple of her suite mates have been sick, and she started feeling poor last night. She has a horrible headache; her neck is stiff and has positive gaze nystagmus. She is frightened and states several times that something is wrong with her. 

Hazel Ruth is a 34-year-old female patient who is 23 weeks pregnant with her first child. She was brought in by her husband who states that she had what he thought was a seizure about 20 minutes ago while taking a nap on the couch. He states that she got stiff and then wiggled a lot, then repeated the process over and over for more than 10 minutes. He knew about the time because the change started just as sports center came on and he looked at the clock when he picked her up to carry her to the car. 

You hear your last patient, Andrew Owens, several minutes before you see him. This 39-year-old came into the clinic lobby screaming something intelligible about aliens and needing to have a probe removed before he morphed into another species. His son drove him to the clinic and is frantically trying to calm him, but his arms and legs are flailing about while he periodically bends over to feel his belly. He is quickly brought into triage and your nurse comes to get you urgently. 

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Acute Psychosis
  • Meningitis
  • Status Epilepticus
  • Stroke (CVA)
  • Subarachnoid Hemorrhage
  • Concussion with loss of consciousness
  • Schizophrenia

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

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Clinical Decision

Chief Complaint, HPI, Physical Exam Results, and Diagnostic Results

 

Cardiovascular Chief Complaint: A 65-year-old female presents with intermittent chest pain.

HPI: The patient reports that the chest pain started one month ago. The pain is described as a pressure-like sensation located in the center of her chest and radiates to her left arm. The pain typically occurs with exertion and is relieved by rest. She rates the pain as 5/10 at its worst. She has a history of hypertension and hyperlipidemia, managed with medication. She is a former smoker with a 20-pack-year history.

Physical Exam Results: Vital signs are within normal limits. Cardiovascular examination reveals a regular rhythm with no murmurs, rubs, or gallops. There is no jugular venous distention or peripheral edema. Respiratory examination is unremarkable.Diagnostic Results: ECG shows ST-segment depression in leads V5 and V6. Troponin levels are normal. A stress test reveals ischemic changes during exercise.

Instructions: Based on the chief complaint, HPI, physical exam results, and diagnostic results, what referrals are you going to make, and what medications are you going to order? List at least one referral and two medications and justify their relevance.  Include at least one current clinical guideline as a scholarly reference in APA format.

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Clinical Decision

Clinical Decision-Making Assignment

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

Nicholas Angello arrived at the clinic with complaints of weight loss, fatigue, and unexplained bruising. This 37-year-old male patient has always been active and full of energy, but for the last month or so he states that everything has changed. He denies changing his diet or taking any medications. He denies any undue stress or other known changes in his life.  His wife says that his color looks paler than usual and that he keeps complaining of aches and pain that has never been there before.  

Sarah Lemsley has been undergoing chemotherapy for metastatic breast cancer but has been handling the side effects well, and her body is responding well to the treatment. This 48-year-old, female patient arrived at the clinic with a complaint of general malaise, body aches, and mild cold symptoms. She believes that she may have the flu. She has been taking Tylenol (last dose 2 hours ago) because she has been so achy. You test for COVID-19 and FLU A/B and both are negative. So, you run a CBC with the following results: Total WBC  2100, Neutrophils 25%, Bands 12%, Lymphocytes 58%, Monocyte 1%, Eosinophil 2%, Basophil 2%, PLT 157,000, RBC 2.28, Hgb 7.8, HCT 23.7. Vital signs: B/P 114/78, HR 101, Temp 38.1, Resp 24, O2 sat 96% on RA. 

Thirteen-year-old Trey James arrived at the clinic a few minutes ago and the triage nurse summoned you to triage. Trey is coughing, his respiratory rate is 28 and his oxygen sat is 93%. He was playing soccer in a field with his friends and suddenly started to scratch his right leg. He looked down to see his leg swelling and watched as a raised rash appeared to climb up his body. His buddy brought him to the clinic in his truck and called Trey’s mom to meet him at the clinic. Now Trey is in a tripod position in triage, and his lips appear discolored.  

Alexander Richards, a 50-year-old male, presented to the clinic with complaint of headache, abdominal pain, visual disturbances, and recurrent epistaxis for the last four days. When lifting his shirt to auscultate lungs, you notice that he has petechiae and purpura diffusely on his back. Further examination finds more petechiae and purpura on his chest and abdomen.  

Mitchell Harcort is a 24-year-old male who presented to the clinic with complaint of right flank/RUQ pain and blood in his urine. Mr. Harcort was a featured participant in the mixed martial arts competition held two nights ago. Although he expected to have bruising from the event, he also states that more bruises have popped up since then. He also states that he just doesn’t feel right. As you examine Mr. Harcort you see petechiae and purpura on his back and a large area of ecchymosis over his liver. When asked about it, the patient said, “Oh, yea, my opponent connected with a wicked kick to my right flank. It almost took me down, but I rebounded.” After speaking, he coughed, grabbed a Kleenex, and showed you a tissue containing pink and red sputum. At this moment you also notice that his sclera are yellow.  

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Acute Leukemia
  • Anaphylaxis
  • Disseminated Intravascular Coagulation (DIC)
  • Neutropenic Fever
  • Thrombotic Thrombocytopenic Purpura (TTP)
  • Macrocytic Anemia
  • Polycythemia Vera (PV)

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

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Clinical Decision

Clinical Decision-Making Assignment

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

Adam Kerenski checked in at the triage desk holding an emesis bag. He is breathing heavily and irregularly and states that his stomach hurts. His wife entered a few minutes later after parking the car and stated that he is just not himself. She says, “he is not thinking right and not acting like himself at all.” Mr. Kerenski thinks that he has a stomach bug, but his wife thinks it might be his sugar. He has refused to check it. Mrs. Kerenski tells the nurse that he has urinated multiple times and can’t get enough to drink. A quick blood glucose check in triage shows 430 mg/dL. 

Missy Federle is a 40-year-old female patient who arrived at the emergency department with a complaint of heart palpitations, diarrhea, and fever. Her 17-year-old son is accompanying her, and he stated that she is not acting like herself. Her vital signs in triage were charted as B/P 160/102, HR 110, Resp 24, Temp 39.1, O2 sat 95% on RA, BG 110 mg/dL. 

Christina Charmeuse is the third patient on your roster. She is a 38-year-old female who was wheeled in by her husband. Ms. Charmeuse presented with her head and shoulders slumped in the wheelchair. Her husband stated that the patient’s mother passed away yesterday morning in a tragic car wreck, and that after the initial shock she started feeling very weak. In the night, Ms. Charmeuse began having nausea and vomiting and talking nonsense. She had difficulty waking up this morning. So, he took her to the hospital. Her medical history includes two c-sections, Addison’s disease, and familial hypercholesterolemia. Vital signs in triage: B/P 95/56, HR 108, Resp 31, Temp 38.1, O2 sat 97% on RA, BG 61mg/dL

Frederick Wingston arrived at the emergency department being assisted by his daughter and son-in-law. Mr. Wingston is a 73-year-old male patient who was discharged from the hospital 5 days ago after inpatient treatment for Covid-19. Since his discharge he has experienced increased coughing, purulent sputum, and fever. Since yesterday afternoon, he has been dizzy, unable to ambulate on his own, and has wet himself repeatedly. This morning, he does not know his own name and has been acting erratically. His daughter thinks that he has passed out a couple of times but cannot be sure because of his altered mental status. Mr. Wingston has comorbid DMII, and hyperlipidemia. You auscultate his lung fields and hear decreased lung sound in the RLL with rhonchi in the RML, and notice extremely dry mucous membranes, but something else is going on too. Vital signs: B/P 98/58, HR  99, Temp 38.6, Resp 28, O2 Sat 94% on RA, BG 702 mg/dL

Keiko Tanak, a 23-year-old female, presented to the emergency department being supported by her father. She appears diaphoretic and is having difficulty walking in a straight line. Her father states that he found her this morning behind the wheel of her car and brought her to the hospital. She was out most of the night celebrating her best friend’s engagement. Her father states that she is not usually much of a drinker, but he could smell alcohol on her breath when he opened the car door. Ms. Tanak is not oriented and will only mumble that her head hurts and that she is hungry. Her vital signs were charted from triage: B/P 110/68, HR 102, Resp 18, Temp 37.2, O2 Sat 99% on RA, BG 48 mg/dL. 

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Adrenal Crisis
  • Diabetic Ketoacidosis (DKA)
  • Hyperosmolar Hyperglycemic State (HHS)
  • Hypoglycemia
  • Thyroid Storm
  • Hypothyroidism
  • Hyperthyroidism

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

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Clinical Decision

Chief Complaint, HPI, and Physical Exam Results

 

Musculoskeletal Chief Complaint: A 50-year-old male presents with knee pain.

HPI: The patient reports that the pain began a week ago after twisting his knee while playing basketball. The pain is localized to the medial aspect of the knee and is aggravated by weight-bearing activities. He rates the pain as 6/10. There is occasional swelling but no locking or giving way of the knee. He has been taking ibuprofen with partial relief.

Physical Exam Results: Inspection reveals mild swelling and no deformity. Palpation reveals tenderness over the medial joint line. The range of motion is limited due to pain, particularly in flexion. McMurray’s test is positive for medial meniscus injury. There are no signs of ligament instability.

Instructions: Based on the chief complaint, HPI, and physical exam results, what diagnostics are you going to order? List at least three diagnostics and justify their relevance.  Include at least one current clinical guideline as a scholarly reference in APA format.

Submission Details:

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Clinical Decision

Clinical Decision-Making Assignment

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

The musculoskeletal system has so much to offer. Issues can range from a simple strained muscle to life threatening issues that cannot be missed. How will we know the difference? This week we will ponder just that.

Your first patient of the week is William Gardner, a 56-year-old male. William has a history of osteoarthritis and has had two bouts of gout over the last 5 years. He states that his right knee, the one that the orthopedics clinic replaced 11 months ago, is excruciating to move. He was doing some yard work about a week ago and got a cut on his knee, but he cleaned it out well and put a Band-Aid on it. So, he does not think the two are related. His right knee is swollen, and he can’t really bear weight on it.

Jerri Bennett is your next patient. She is an 11-year-old girl who broke her left tibia playing soccer 3 days ago. Yesterday, the ortho clinic put her in a purple cast and everything seemed fine. However, this morning her left lower leg is hurting and the toes on her left foot feel numb. Her left nail beds are pale, but the right sided capillary refill is measured at <3 seconds. 

Audra Buxbaum, a 29-year-old female, was in a car wreck 2 weeks ago. She didn’t go to the ED to be checked out because she doesn’t have insurance, but she had to come to the clinic today because the pain just keeps getting worse, and now she can’t seem to keep from wetting her pants. “How embarrassing,” she stated, “I’m too young for things like this to happen. My legs are kind of numb and tingly, and I can’t even tell that I have to urinate until it’s too late. Please help me.” 

Henry Bixby, a 52-year-old male, arrives at the clinic with complaint of intense leg pain and dark colored urine. Mr. Bixby recently joined a gym and has been working on getting back in shape. He is proud of the progress that he has made in the last month. He also recently found out that he has hypertension and high cholesterol, for which his PCP has given him carvedilol and simvastatin. He thinks that he may have just strained his leg muscles. He rates the pain at 7/10 and states that it has been over a week since he has worked on his legs. The pain in his legs keeps getting worse even though he has focused on his arms and back. 

Serena Esmeraldi is the last patient of the day who complains of intense pain in her right lower leg. Mrs. Esmeraldi is a 72-year-old, female resident from Peaceful Pines Retirement Community. Five or six days ago she was taking a walk on the grounds with her boyfriend and stepped on a nail that penetrated her shoe. She did not know that it was there until she crossed her legs while sitting on the bench, and Steven saw it poking out of her shoe. She reached up and pulled it out but forgot about it until her leg started hurting. Mrs. Esmeraldi states that her diabetes makes it hard for her to feel her feet. This morning, she awoke to a swollen right foot, ankle, and lower leg with a constant dull pain in her leg and ankle, and the community director suggested that she be seen immediately. She thinks that she might need a tetanus shot or some penicillin. 

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Acute Osteomyelitis
  • Cauda Equina Syndrome
  • Compartment Syndrome
  • Rhabdomyolysis
  • Septic Arthritis
  • Bursitis
  • Tendinitis

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

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Clinical Decision

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

This week we will examine the largest organ in the body, the skin. It is extremely important to understand the characteristics of various skin issues. Is that a macule or a papule? Is this anomaly diffuse, acral, follicular, or dermatomal? The vocabulary matters and knowing the differences between types of lesions could be the difference between can’t miss – won’t miss and “oops, I missed it.”

Carl Rosen is your first patient of the day. A 23-year-old male, Carl arrives at the clinic with a complaint of a rash. His left thigh, as he describes it, is red, puffy, and hurts to the touch. He thinks that he was bitten by a bug yesterday while hiking, but by this morning the area was much bigger and is still very painful. The area has an irregular border, is warm to the touch, and has an orange peel texture. 

Cynthia Reynolds is a 41-year-old female patient whose complaint is a painful rash. It started a couple of days ago with pain in her right forearm, then last night she started to see swelling and shiny redness in the painful area. This morning there are a couple of blisters in the area, and she cannot stand to touch anywhere around the area. It also has started to appear bruised, and Cynthia complains that she feels fatigued and achy, like she has the flu. 

Myra Alexander, a 68-year-old female, is your third patient of the day. She has a rash on her left upper back and her left breast that are painful. She noticed the discomfort on her back 2 days ago, but did not realize that she had a rash until her husband mentioned seeing it. This morning, she noticed a similar rash on her breast and states that she cannot stand to have clothing touch the areas. The rash looks like little red blisters that are clustered, poorly formed lines. 

Adnan Rafiq a 33-year-old male is the fourth patient of the day. 18 days ago he was hospitalized after presenting to the emergency department with a seizure that caused a fall and extensive damage to his right knee. During the hospitalization he received IV lamotrigine and post operative antibiotics. He is healing well from his surgery and has had no further seizure activity. However, today he presents with a blistering rash that has appeared on his chest, back, arms, and legs. This issue began 3 days ago with a sore throat, a low-grade fever, malaise, and muscle aches. He thought he had the flu, but it is obviously more than a simple virus. 

Your last patient of the day states that her husband saw a spot on her back and told her to come to have it inspected. She states that because she has brown skin, she does not think that she could be susceptible to anything serious from sun exposure. Jamila Coates, a 48-year-old female, shows you a lesion on her back with irregular borders measuring 1.4 cm x 1.2 cm. The lesion reflects several colors from the patient’s natural skin color to several shades darker and lighter. The lesion is raised, and the patient said that it started to bleed a couple days ago when she bumped it trying to unlatch her bra. 

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Cellulitis
  • Herpes Zoster
  • Melanoma
  • Necrotizing Fasciitis
  • Stevens-Johnson Syndrome / Toxi Epidermal Necrolysis
  • Lichen Planus

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

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Clinical Decision

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

This week we will examine the largest organ in the body, the skin. It is extremely important to understand the characteristics of various skin issues. Is that a macule or a papule? Is this anomaly diffuse, acral, follicular, or dermatomal? The vocabulary matters and knowing the differences between types of lesions could be the difference between can’t miss – won’t miss and “oops, I missed it.”

Carl Rosen is your first patient of the day. A 23-year-old male, Carl arrives at the clinic with a complaint of a rash. His left thigh, as he describes it, is red, puffy, and hurts to the touch. He thinks that he was bitten by a bug yesterday while hiking, but by this morning the area was much bigger and is still very painful. The area has an irregular border, is warm to the touch, and has an orange peel texture. 

Cynthia Reynolds is a 41-year-old female patient whose complaint is a painful rash. It started a couple of days ago with pain in her right forearm, then last night she started to see swelling and shiny redness in the painful area. This morning there are a couple of blisters in the area, and she cannot stand to touch anywhere around the area. It also has started to appear bruised, and Cynthia complains that she feels fatigued and achy, like she has the flu. 

Myra Alexander, a 68-year-old female, is your third patient of the day. She has a rash on her left upper back and her left breast that are painful. She noticed the discomfort on her back 2 days ago, but did not realize that she had a rash until her husband mentioned seeing it. This morning, she noticed a similar rash on her breast and states that she cannot stand to have clothing touch the areas. The rash looks like little red blisters that are clustered, poorly formed lines. 

Adnan Rafiq a 33-year-old male is the fourth patient of the day. 18 days ago he was hospitalized after presenting to the emergency department with a seizure that caused a fall and extensive damage to his right knee. During the hospitalization he received IV lamotrigine and post operative antibiotics. He is healing well from his surgery and has had no further seizure activity. However, today he presents with a blistering rash that has appeared on his chest, back, arms, and legs. This issue began 3 days ago with a sore throat, a low-grade fever, malaise, and muscle aches. He thought he had the flu, but it is obviously more than a simple virus. 

Your last patient of the day states that her husband saw a spot on her back and told her to come to have it inspected. She states that because she has brown skin, she does not think that she could be susceptible to anything serious from sun exposure. Jamila Coates, a 48-year-old female, shows you a lesion on her back with irregular borders measuring 1.4 cm x 1.2 cm. The lesion reflects several colors from the patient’s natural skin color to several shades darker and lighter. The lesion is raised, and the patient said that it started to bleed a couple days ago when she bumped it trying to unlatch her bra. 

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Cellulitis
  • Herpes Zoster
  • Melanoma
  • Necrotizing Fasciitis
  • Stevens-Johnson Syndrome / Toxi Epidermal Necrolysis
  • Lichen Planus

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

/by

Clinical Decision

THIS ASSIGNMENT WILL BE UPLOADED IN TURN IT IN SO PLEASE DO MANAGE CAREFULLY THE AI USAGE

Clinical Decision-Making Assignment

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

Oh, that belly. Where do we start? There is so much to know and so much to assess, but we cannot be distracted by six-pack abs that are difficult to palpate or by an abundance of adipose that is equally difficult to palpate.

Your first patient for this week is Vernoica Perkins, 19-year-old female, who complains of stomach pain. Her period is due tomorrow, but she says that she has never had cramps like this before. They started at her belly button, and now they are worse toward her right hip bone. She is nauseous and has had diarrhea twice this morning. She rates her pain at 7 or 8 out of 10. Her vital signs are as follows: B/P 129/83, HR 104, Resp 22, O2 on RA 98%, Temp 38.2. 

Margerie Schmidt, a 55-year-old female, is your second patient. Her complaint is of right sided back, stomach pain, and shoulder pain. She says, “I mean…I’ve been cleaning out closets, but I don’t think I pulled anything. It didn’t start hurting until I started eating the barbeque at the church social on Sunday. Since then, it has been hurting, especially when I eat.” She rates her pain at 6/10 all the time, but sometimes it surges to 9/10. 

The third patient of the day came in looking pale with an emesis basin in his hand. Trey Ziffer, 21-year-old male, stated that he was at a fraternity retreat this weekend, and woke up today with nausea, vomiting, and left sided abdominal pain. “Yes, I drank way too much this weekend, but who hasn’t?  It is certainly not the first time, nor will it be the last. Ya feel me?” Trey said. Vital signs: B/P 84/58, HR 104, Resp 27, Temp 37.4, O2 on RA 99%. “I feel wicked bad, and I…” Trey didn’t finish his sentence because he had to vomit again.

Up next was Harvey Bingerber, a 63-year-old male who came into the clinic clutching his abdomen with a stooped posture. He states that he has been constipated for the last week, but yesterday things got serious. He is bloated, can’t zip his pants, he is nauseous, he has offensive halitosis, and his belly is “killing him.” His wife gave him MiraLAX, Pepto-Bismol, and some other white stuff, but nothing has helped. 

Your last patient for the day prefers to stand instead of sitting down. She is so uncomfortable that she cannot sit still. Iela Christon, a 27-year female, complains of frequency, urgency, low back pain, fatigue, and general malaise.  Her vitals are as follows: B/P 128/82, HR 88, Resp 17, O2 on RA 97%, Temp 38.5. Her quick dip UA has the following results: pH – 7.2, Specific Gravity – 1.030, Glucose – neg, Protein – 30mg/dl, Bilirubin – neg, Urobilinogen – neg, Blood – ca 50, Ketone – neg, Nitrite – ++, Leukocytes – ca 500, Ascorbic Acid – neg, Clarity – Turbid, Color – Amber/Brown. 

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Acute Appendicitis
  • Acute Cholecystitis
  • Acute Pancreatitis
  • Acute Pyelonephritis
  • Bowel Obstruction
  • Irritable Bowel Syndrome
  • Ectopic Pregnancy

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

Submission Details

  • Submit your document to the submissions area by the assigned due date.
  • Be sure to include your name, student number, and the date of submission on your document.
/by

Clinical Decision

Due March 5 at 11:59 PM

Clinical Decision-Making Assignment

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

Oh, that belly. Where do we start? There is so much to know and so much to assess, but we cannot be distracted by six-pack abs that are difficult to palpate or by an abundance of adipose that is equally difficult to palpate.

Your first patient for this week is Vernoica Perkins, 19-year-old female, who complains of stomach pain. Her period is due tomorrow, but she says that she has never had cramps like this before. They started at her belly button, and now they are worse toward her right hip bone. She is nauseous and has had diarrhea twice this morning. She rates her pain at 7 or 8 out of 10. Her vital signs are as follows: B/P 129/83, HR 104, Resp 22, O2 on RA 98%, Temp 38.2. 

Margerie Schmidt, a 55-year-old female, is your second patient. Her complaint is of right sided back, stomach pain, and shoulder pain. She says, “I mean…I’ve been cleaning out closets, but I don’t think I pulled anything. It didn’t start hurting until I started eating the barbeque at the church social on Sunday. Since then, it has been hurting, especially when I eat.” She rates her pain at 6/10 all the time, but sometimes it surges to 9/10. 

The third patient of the day came in looking pale with an emesis basin in his hand. Trey Ziffer, 21-year-old male, stated that he was at a fraternity retreat this weekend, and woke up today with nausea, vomiting, and left sided abdominal pain. “Yes, I drank way too much this weekend, but who hasn’t?  It is certainly not the first time, nor will it be the last. Ya feel me?” Trey said. Vital signs: B/P 84/58, HR 104, Resp 27, Temp 37.4, O2 on RA 99%. “I feel wicked bad, and I…” Trey didn’t finish his sentence because he had to vomit again.

Up next was Harvey Bingerber, a 63-year-old male who came into the clinic clutching his abdomen with a stooped posture. He states that he has been constipated for the last week, but yesterday things got serious. He is bloated, can’t zip his pants, he is nauseous, he has offensive halitosis, and his belly is “killing him.” His wife gave him MiraLAX, Pepto-Bismol, and some other white stuff, but nothing has helped. 

Your last patient for the day prefers to stand instead of sitting down. She is so uncomfortable that she cannot sit still. Iela Christon, a 27-year female, complains of frequency, urgency, low back pain, fatigue, and general malaise.  Her vitals are as follows: B/P 128/82, HR 88, Resp 17, O2 on RA 97%, Temp 38.5. Her quick dip UA has the following results: pH – 7.2, Specific Gravity – 1.030, Glucose – neg, Protein – 30mg/dl, Bilirubin – neg, Urobilinogen – neg, Blood – ca 50, Ketone – neg, Nitrite – ++, Leukocytes – ca 500, Ascorbic Acid – neg, Clarity – Turbid, Color – Amber/Brown. 

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Acute Appendicitis
  • Acute Cholecystitis
  • Acute Pancreatitis
  • Acute Pyelonephritis
  • Bowel Obstruction
  • Irritable Bowel Syndrome
  • Ectopic Pregnancy

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

Submission Details

  • Submit your document to the submissions area by the assigned due date.
  • Be sure to include your name, student number, and the date of submission on your document.
/by

Clinical Decision

Due March 5 at 11:59 PM

Clinical Decision-Making Assignment

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

Oh, that belly. Where do we start? There is so much to know and so much to assess, but we cannot be distracted by six-pack abs that are difficult to palpate or by an abundance of adipose that is equally difficult to palpate.

Your first patient for this week is Vernoica Perkins, 19-year-old female, who complains of stomach pain. Her period is due tomorrow, but she says that she has never had cramps like this before. They started at her belly button, and now they are worse toward her right hip bone. She is nauseous and has had diarrhea twice this morning. She rates her pain at 7 or 8 out of 10. Her vital signs are as follows: B/P 129/83, HR 104, Resp 22, O2 on RA 98%, Temp 38.2. 

Margerie Schmidt, a 55-year-old female, is your second patient. Her complaint is of right sided back, stomach pain, and shoulder pain. She says, “I mean…I’ve been cleaning out closets, but I don’t think I pulled anything. It didn’t start hurting until I started eating the barbeque at the church social on Sunday. Since then, it has been hurting, especially when I eat.” She rates her pain at 6/10 all the time, but sometimes it surges to 9/10. 

The third patient of the day came in looking pale with an emesis basin in his hand. Trey Ziffer, 21-year-old male, stated that he was at a fraternity retreat this weekend, and woke up today with nausea, vomiting, and left sided abdominal pain. “Yes, I drank way too much this weekend, but who hasn’t?  It is certainly not the first time, nor will it be the last. Ya feel me?” Trey said. Vital signs: B/P 84/58, HR 104, Resp 27, Temp 37.4, O2 on RA 99%. “I feel wicked bad, and I…” Trey didn’t finish his sentence because he had to vomit again.

Up next was Harvey Bingerber, a 63-year-old male who came into the clinic clutching his abdomen with a stooped posture. He states that he has been constipated for the last week, but yesterday things got serious. He is bloated, can’t zip his pants, he is nauseous, he has offensive halitosis, and his belly is “killing him.” His wife gave him MiraLAX, Pepto-Bismol, and some other white stuff, but nothing has helped. 

Your last patient for the day prefers to stand instead of sitting down. She is so uncomfortable that she cannot sit still. Iela Christon, a 27-year female, complains of frequency, urgency, low back pain, fatigue, and general malaise.  Her vitals are as follows: B/P 128/82, HR 88, Resp 17, O2 on RA 97%, Temp 38.5. Her quick dip UA has the following results: pH – 7.2, Specific Gravity – 1.030, Glucose – neg, Protein – 30mg/dl, Bilirubin – neg, Urobilinogen – neg, Blood – ca 50, Ketone – neg, Nitrite – ++, Leukocytes – ca 500, Ascorbic Acid – neg, Clarity – Turbid, Color – Amber/Brown. 

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Acute Appendicitis
  • Acute Cholecystitis
  • Acute Pancreatitis
  • Acute Pyelonephritis
  • Bowel Obstruction
  • Irritable Bowel Syndrome
  • Ectopic Pregnancy

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

Submission Details

  • Submit your document to the submissions area by the assigned due date.
  • Be sure to include your name, student number, and the date of submission on your document.
/by

Clinical Decision

Due March 5 at 11:59 PM

Clinical Decision-Making Assignment

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

Oh, that belly. Where do we start? There is so much to know and so much to assess, but we cannot be distracted by six-pack abs that are difficult to palpate or by an abundance of adipose that is equally difficult to palpate.

Your first patient for this week is Vernoica Perkins, 19-year-old female, who complains of stomach pain. Her period is due tomorrow, but she says that she has never had cramps like this before. They started at her belly button, and now they are worse toward her right hip bone. She is nauseous and has had diarrhea twice this morning. She rates her pain at 7 or 8 out of 10. Her vital signs are as follows: B/P 129/83, HR 104, Resp 22, O2 on RA 98%, Temp 38.2. 

Margerie Schmidt, a 55-year-old female, is your second patient. Her complaint is of right sided back, stomach pain, and shoulder pain. She says, “I mean…I’ve been cleaning out closets, but I don’t think I pulled anything. It didn’t start hurting until I started eating the barbeque at the church social on Sunday. Since then, it has been hurting, especially when I eat.” She rates her pain at 6/10 all the time, but sometimes it surges to 9/10. 

The third patient of the day came in looking pale with an emesis basin in his hand. Trey Ziffer, 21-year-old male, stated that he was at a fraternity retreat this weekend, and woke up today with nausea, vomiting, and left sided abdominal pain. “Yes, I drank way too much this weekend, but who hasn’t?  It is certainly not the first time, nor will it be the last. Ya feel me?” Trey said. Vital signs: B/P 84/58, HR 104, Resp 27, Temp 37.4, O2 on RA 99%. “I feel wicked bad, and I…” Trey didn’t finish his sentence because he had to vomit again.

Up next was Harvey Bingerber, a 63-year-old male who came into the clinic clutching his abdomen with a stooped posture. He states that he has been constipated for the last week, but yesterday things got serious. He is bloated, can’t zip his pants, he is nauseous, he has offensive halitosis, and his belly is “killing him.” His wife gave him MiraLAX, Pepto-Bismol, and some other white stuff, but nothing has helped. 

Your last patient for the day prefers to stand instead of sitting down. She is so uncomfortable that she cannot sit still. Iela Christon, a 27-year female, complains of frequency, urgency, low back pain, fatigue, and general malaise.  Her vitals are as follows: B/P 128/82, HR 88, Resp 17, O2 on RA 97%, Temp 38.5. Her quick dip UA has the following results: pH – 7.2, Specific Gravity – 1.030, Glucose – neg, Protein – 30mg/dl, Bilirubin – neg, Urobilinogen – neg, Blood – ca 50, Ketone – neg, Nitrite – ++, Leukocytes – ca 500, Ascorbic Acid – neg, Clarity – Turbid, Color – Amber/Brown. 

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Acute Appendicitis
  • Acute Cholecystitis
  • Acute Pancreatitis
  • Acute Pyelonephritis
  • Bowel Obstruction
  • Irritable Bowel Syndrome
  • Ectopic Pregnancy

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

Submission Details

  • Submit your document to the submissions area by the assigned due date.
  • Be sure to include your name, student number, and the date of submission on your document.
/by

Clinical Decision

Due March 5 at 11:59 PM

Clinical Decision-Making Assignment

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

Oh, that belly. Where do we start? There is so much to know and so much to assess, but we cannot be distracted by six-pack abs that are difficult to palpate or by an abundance of adipose that is equally difficult to palpate.

Your first patient for this week is Vernoica Perkins, 19-year-old female, who complains of stomach pain. Her period is due tomorrow, but she says that she has never had cramps like this before. They started at her belly button, and now they are worse toward her right hip bone. She is nauseous and has had diarrhea twice this morning. She rates her pain at 7 or 8 out of 10. Her vital signs are as follows: B/P 129/83, HR 104, Resp 22, O2 on RA 98%, Temp 38.2. 

Margerie Schmidt, a 55-year-old female, is your second patient. Her complaint is of right sided back, stomach pain, and shoulder pain. She says, “I mean…I’ve been cleaning out closets, but I don’t think I pulled anything. It didn’t start hurting until I started eating the barbeque at the church social on Sunday. Since then, it has been hurting, especially when I eat.” She rates her pain at 6/10 all the time, but sometimes it surges to 9/10. 

The third patient of the day came in looking pale with an emesis basin in his hand. Trey Ziffer, 21-year-old male, stated that he was at a fraternity retreat this weekend, and woke up today with nausea, vomiting, and left sided abdominal pain. “Yes, I drank way too much this weekend, but who hasn’t?  It is certainly not the first time, nor will it be the last. Ya feel me?” Trey said. Vital signs: B/P 84/58, HR 104, Resp 27, Temp 37.4, O2 on RA 99%. “I feel wicked bad, and I…” Trey didn’t finish his sentence because he had to vomit again.

Up next was Harvey Bingerber, a 63-year-old male who came into the clinic clutching his abdomen with a stooped posture. He states that he has been constipated for the last week, but yesterday things got serious. He is bloated, can’t zip his pants, he is nauseous, he has offensive halitosis, and his belly is “killing him.” His wife gave him MiraLAX, Pepto-Bismol, and some other white stuff, but nothing has helped. 

Your last patient for the day prefers to stand instead of sitting down. She is so uncomfortable that she cannot sit still. Iela Christon, a 27-year female, complains of frequency, urgency, low back pain, fatigue, and general malaise.  Her vitals are as follows: B/P 128/82, HR 88, Resp 17, O2 on RA 97%, Temp 38.5. Her quick dip UA has the following results: pH – 7.2, Specific Gravity – 1.030, Glucose – neg, Protein – 30mg/dl, Bilirubin – neg, Urobilinogen – neg, Blood – ca 50, Ketone – neg, Nitrite – ++, Leukocytes – ca 500, Ascorbic Acid – neg, Clarity – Turbid, Color – Amber/Brown. 

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Acute Appendicitis
  • Acute Cholecystitis
  • Acute Pancreatitis
  • Acute Pyelonephritis
  • Bowel Obstruction
  • Irritable Bowel Syndrome
  • Ectopic Pregnancy

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

Submission Details

  • Submit your document to the submissions area by the assigned due date.
  • Be sure to include your name, student number, and the date of submission on your document.
/by

Clinical Decision

Chief Complaint and HPI

 

GI/GU Chief Complaint: A 30-year-old female presents with lower abdominal pain.

HPI: The patient reports that the pain started two days ago and is located in the right lower quadrant. She describes the pain as sharp and rates it 7/10. The pain is constant but worsens with movement. She has experienced nausea but no vomiting. She denies changes in bowel habits but mentions a slight increase in urinary frequency. Her last menstrual period was three weeks ago, and she is sexually active with one partner, using condoms for contraception.

Instructions: Based on the chief complaint and HPI, what physical exams are you going to perform? List at least five physical exam components and justify their relevance.  Include at least one current clinical guideline as a scholarly reference in APA format.

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Clinical Decision

Chief Complaint

 

Respiratory Chief Complaint: Ryan Davidson, a 45-year-old male presents with a persistent cough for the past three weeks.

Instructions: Based on the chief complaint, what questions are you going to ask the patient to inform your HPI? List at least 5 questions.

Submission Details:

  • Submit your document to the submissions area by the assigned due date.
  • Be sure to include your name, student number, and the date of submission on your document.
/by

Clinical Decision

Clinical Decision-Making Assignment

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

 Marla Carico, 62-year-old female, arrived at the clinic a few moments ago with complaint of upper back pain and nausea. She started feeling nauseous this morning and her back started hurting a few minutes later. She denies any injury. It all happened while she was drinking her morning coffee while watching her usual morning T.V. shows. Now she feels weak and expresses that she just feels like something is not right.  

Randall Smitters, 43-year-old male, presents with complaint of cough, shortness of breath, and pain in his left chest. He denies pain in his neck or left arm. He is not diaphoretic or nauseous. In his review of symptoms, the nurse also noted that he has had pain in his right leg, but he thinks that he must have pulled a muscle.   

Che Yashimoto, 57-year-old male, complains of intense pain in his stomach, just below his rib cage. He states that he bent over to tie his shoes about 20 minutes ago and felt like something ripped in his belly. He is visibly fearful, appears pale for his ethnicity, and is very weak. 

Melissa Parker, 45-year-old female, visits the clinic with complaint of sudden swelling in her ankles. She states that the onset was a couple of days ago. Since then, she has had to sleep in her recliner because she can’t breathe when she lays down in her bed. She feels short of breath when she tries to do any of her normal household activities.  

Wendel Rhinehart, 29-year-old male, had a couple of teeth that gave him problems for months. He finally went to the dentist and found that he needed bilateral root canals and antibiotics to clear up the infections. However, the systemic fever, chills, and fatigue that he thought was caused by his gum infections wouldn’t seem to clear up. He comes to the clinic today thinking he just needs another round of the antibiotics, but you know that something else is going on. Since this all began, Wendel has lost 11.5 lbs., you notice petechia on his bilateral arms and hear a loud mitral murmur on auscultation of his chest.

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    

  • Acute Heart Failure,
  • Dissection of a Thoracic or Abdominal Aneurysm
  • Endocarditis,
  • Myocardial Infarction
  • Pulmonary Embolism
  • Cholecystitis
  • Pneumonia

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

 

 

These books can be used as a resource as you complete your assignment this week.

  • Cash, J. (2024). Family practice guidelines. Springer Publishing Company, LLC
  • Domino, F. (2025). The 5-minute clinical consult 2025 (33rd ed.). Wolters Kluwer
  • Goolsby, M., & Grubbs, L. (2023). Advanced assessment: Interpreting findings and formulating differential diagnoses (5th ed.). F.A. Davis Company

 

 

/by

Clinical Decision

Clinical Decision-Making Assignment

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patient’s presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

A 62-year-old  patient arrives at your clinic with complaint of a horrible headache over her left temple that started this morning. She has a history of migraines, but something feels different this time. What will you consider? What will you ask? What will you assess? 

A 52-year-old  male patient complains of a headache with blurry vision in his right eye that started a few days ago. His eye appears red and the right cornea is moderately edematous. He says that his allergies sometime cause eye pain and swelling, but this is different. Does this sound like an emergency?

A 31-year-old  female was coaching softball this morning with her daughter’s team and a foul ball hit her just above her left ear. When it happened, she saw a flash of light and now has an area in her left eye that appears dark. She has a bruise and a raised area on her head that is sore. However, she never lost consciousness and nothing really hurts except for the impact spot. The rest of her vision seems fine. She just wants to go home and see her eye doctor tomorrow. What will be your response?

An 14-year-old d male has a sore throat that has kept him from eating, and his mom has had to force him to drink water over the last day and a half.  He is in middle school where students are always sick with one thing or another. His right tonsil is bigger than his left one, and his uvula is stuck to the right tonsil. Both tonsils are erythematous, with visible exudate and petechia on bilateral tonsillar pillars. It looks like strep and smells like strep, but it is something more?

The 13-year-old male patient arrives being carried by his father. He was found like this propped up in his bed this morning. He is quiet and stares forward with mouth open. He has refused to eat or drink and wants to be held upright all the time. His mom has wiped the drool away from his mouth twice in the last 5 minutes. Is this strep too? Something simple? Or is this a life-threatening emergency?

Each of the above patients represents one of the following diagnoses:

  • Acute Closed-Angle Glaucoma
  • Epiglottitis
  • Peritonsillar Abscess
  • Retinal Detachment
  • Temporal Arteritis
  • Ocular Migraine
  • Tonsillitis

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.    Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.

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