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.

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.

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.

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.

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.

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