To answer this week’s discussion questions will require that you read the articles on dual processing theory and reducing diagnostic errors ATTACHED. You are expected to apply the course readings mentioned below .YOU WILL NOT BE ABLE TO ANSWER THIS WEEK’S DISCUSSION QUESTION WITHOUT READING THE ASSIGNED ARTICLES.
Djulbegovic et al. (2012)
Monteiro et al., (2019)
Tsalatsanis et al., (2015)
Chief Complaint: “Pain in Right Side” A 40-year-old man presents to his primary care provider (PCP) with right upper quadrant (RUQ) pain for 2 days. The pain is described as “sore” and rated 4 on 1 to 10 pain scale. The pain is intermittent and not worsening. He reports food does not seem to make it better or worse. No nausea or vomiting or diarrhea or constipation are reported.
Vital signs: heart rate, 75; blood pressure, 122/78; respiration rate, 15; afebrile.
Examination: No acute distress. Abdomen: mildly tender on palpation at RUQ; no masses, hepatomegaly or splenomegaly.
Diagnosis: Gallbladder disease.
Plan: Abdominal ultrasound with reflexive cholescintigraphy (hepatobiliary iminodiacetic acid) scan within 1 week. Patient instructed to call provider if worsening symptoms occur. He is also told to avoid any fatty foods or alcohol consumption. The patient is agreeable to plan.
Follow-up: Two days after the initial visit, the patient calls his PCP with worsening RUQ pain. Ultrasound imaging was scheduled for later that day. Patient then started having shortness of breath while at home and went to the local emergency department (ED). Computed tomography angiography of the chest revealed a right-sided pulmonary embolism. Patient did not have any family history of clotting disorders and no recent surgery, immobilization, or travel. Patient had been on testosterone injections for several years for low testosterone levels, and this was not updated in his medical record at his PC
Chief Complaint: “Fever and Sleepy” A 3-year-old girl presents with her mother to a walk-in clinic with fever, nasal drainage, and fatigue for 2 days. She was observed hiding her head into her mother’s chest during the examination.
Presentation occurred during flu season. The clinician had 6 positive flu tests that day, all with similar symptoms, but most including a cough.
Vital signs: heart rate, 125; respiration rate, 20; blood pressure, 100/72; temperature, 100.8F.
Examination: Lungs clear, heart rate regular, no murmur. Head, eyes, ears, nose, and throat: normocephalic, conjunctivae clear, tympanic membrane without bulging or redness, pharynx normal, nares normal with clear drainage, tonsils 1þ, no erythema or exudate. Patient did not want to look at the clinician in a brightly lit room. The patient was lethargic and had limited tearing when crying. Rapid flu test: Negative.
Diagnosis: Presumptive seasonal influenza.
Plan: Supportive care, including encouraging fluids, Over the counter acetaminophen for fever, and age-appropriate antiviral medication for the flu was prescribed.
Follow-up: Parents were unable to keep her fever down over the next 1 day, and she progressively became more lethargic. Patient was taken to the ED, and a diagnosis of viral meningitis and dehydration was made. Patient spent several days in the hospital, but did completely recover.
All discussion posts must be minimum 250 words, references must be cited in APA format 7th Edition, and must include minimum of 2 scholarly resources published within the past 5-7 years.
ONE PAGE TO ANSWER THE 2 CASES ABOVE
NO PLAGIARISM, NEED BE ORIGINAL WORK
REFERENCES IN APA, AND NEED IN TEXT CITATIONS.
DUE DATE JULY 19,2023 NO LATER
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