Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion

Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion

Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion

https://nursingessayscenter.com.com/assessing-the-heart-lungs-and-peripheral-vascular-system-nurs-6512-week-6-discussion/

Take a moment to observe your breathing. Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 DiscussionNotice the sensation of your chest expanding as air flows into your lungs. Feel your chest contract as you exhale. How might this experience be different for someone with chronic lung disease or someone experiencing an asthma attack?

In order to adequately assess the chest region of a patient, nurses need to be aware of a patient’s history, potential abnormal findings, and what physical exams and diagnostic tests should be conducted to determine the causes and severity of abnormalities.

In this Discussion, you will consider how a patient’s initial symptoms can result in very different diagnoses when further assessment is conducted.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the video case studies in this week’s Learning Resources titled Advanced health assessment and diagnostic reasoning. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.

To prepare:

With regard to the case study you were assigned:

• Review this week’s Learning Resources and consider the insights they provide.

• Consider what history would be necessary to collect from the patient.

• Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

• Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Discussion – Week 6”) with “Review of Case Study” identifying the number of the case study you were assigned.

By Day 3

Post a description of the health history you would need to collect from the patient in the case study you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

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Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition, and justify your reasoning.

Scenario 3

Vital signs:

Temperature: 100.9 oral

Respiratory rate: 20, labored

Heart rate: 82 BP right arm: 128/70

Oxygen saturation: 89% on room air

Weight: 210 lbs, stable

Skin: Warm, moist

Thorax and lungs: Thorax symmetrical; diminished breath sounds with rales and expiratory wheezes throughout; no rhonchi; wet,

productive cough noted during exam

Cardiovascular: Heart rate regular with good S1, S2; no S3 or S4; no murmur

Abdomen: Protuberant, with normoactive bowel sounds auscultated x4 quadrants

Peripheral vascular: No pedal edema; 2+ dorsalis pedis pulses bilaterally

Neurologic: Awake, alert, and oriented to person, place, and time

——————————————————————————————————————————-

Instructions: Your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to the Comprehensive SOAP Template/Exemplar on the attachments below.

Address all these in the SOAP Note:

1.     A description of the health history you would need to collect from the patient in the case study 3.

2.     Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion

3.     List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.

4. Final diagnosis and justify it.

REMINDER: Please make a SOAP NOTE for this case. Make your own patient’s data, applicable health history, review of systems, P.E., labs, etc. Incorporate the data from the case 2 in the SOAP note that you will do… This is not essay ok…. I need SOAP note (Nurse Practitioner/RN/MD  makes SOAP note)… Be guided with the templates/exemplar… Don’t copy paste. Formulate your own… Don’t forget to cite the Five different possible conditions (Differential diagnosis) and have Reference lists too.

Required Readings FOR Assessing the Heart, Lungs, and Peripheral Vascular System

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials SECTIONof your Syllabus.
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 13, ?Chest and Lungs? (pp. 260-293)

This chapter explains the physical exam process for the chest and lungs. The authors also include descriptions of common abnormalities in the chest and lungs.

Chapter 14, ?Heart? (pp. 294-331) Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion

The authors of this chapter explain the structure and function of the heart. The text also describes the steps used to conduct an exam of the heart.

Chapter 15, ?Blood Vessels? (pp. 332-349)

This chapter describes how to properly conduct a physical examination of the blood vessels. The chapter also supplies descriptions of common heart disorders. Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion
Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 8, ?Chest Pain? (pp. 81?96)

This chapter focuses on diagnosing the cause of chest pain and highlights the IMPORTANCE of first determining whether the patient is in a life-threatening condition. Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion It includes questions that can help pinpoint the type and severity of pain and then describes how to perform a physical examination. Finally, the authors outline potential laboratory and diagnostic studies. Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion

Chapter 11, ?Cough? (pp. 118-147)

A cough is a very common symptom in patients and usually indicates a minor health problem. This chapter focuses on how to determine the cause of the cough through asking questions and performing a physical exam.

Chapter 14, ?Dyspnea? (pp. 159?173)

The focus of this chapter is dyspnea, or SHORTNESS of breath. The chapter includes strategies for determining the cause of the problem through evaluation of the patient?s history, through physical examination, and through additional laboratory and diagnostic tests.

Chapter 26, ?Palpitations? (pp. 310-317)

This chapter describes the different causes of heart palpitations and details how the specific cause in a patient can be determined.

Chapter 33, ?Syncope? (pp. 390-397) Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion

This chapter focuses on syncope, or loss of consciousness. The authors describe the difficulty of ascertaining the cause, because the patient is usually seen after the loss of consciousness has happened. The chapter includes information on potential causes and the symptoms of each.
Sullivan , D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.
Chapter 6, “Outpatient Charting and Communications” (pp. 119?141)
Note: Download these Adult Examination Checklists and Physical Exam Summaries to use during your practice cardiac and respiratory examination. Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical exam summary: Blood vessels. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.

This Blood Vessels Physical Exam Summary was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Adult examination checklist: Guide for cardiovascular assessment. In Mosby’s guide to physical examination(7th ed.). St. Louis, MO: Elsevier Mosby.

This Adult Examination Checklist: Guide for Cardiovascular Assessment was published as a companion to Seidel’s guide to physical examination(8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Adult examination checklist: Guide for chest and lung assessment. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.

This Adult Examination Checklist: Guide for Chest and Lung Assessment was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical exam summary: Chest and lungs. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby.

This Chest and Lungs Physical Exam Summary was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2011). Physical exam summary: Heart. In Mosby’s guide to physical examination (7th ed.). St. Louis, MO: Elsevier Mosby. Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion

This Heart Physical Exam Summary was published as a companion to Seidel’s guide to physical examination (8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright Elsevier (2015). From https://evolve.elsevier.com/
McCabe, C., & Wiggins, J. (2010a). Differential diagnosis of respiratory disease part 1. Practice Nurse, 40(1), 35?41.
Retrieved from the Walden Library databases.

This article describes the warning signs of impending deterioration of the respiratory system. The authors also explain the features of common respiratory conditions.
McCabe, C., & Wiggins, J. (2010b). Differential diagnosis of respiratory diseases part 2. Practice Nurse, 40(2), 33?41.
Retrieved from the Walden Library databases.

The authors of this article specify how to identify the major causes of acute breathlessness. Additionally, they explain how to interpret a variety of findings from respiratory investigations.
SkillStat Learning, Inc. (2014). The 6 second ECG. Retrieved from http://www.skillstat.com/tools/ecg-simulator#/-home

This interactive website allows you to explore common cardiac rhythms. It also offers the Six Second ECG game so you can practice identifying rhythms.
University of Virginia. (n.d.). Introduction to radiology: An online interactive tutorial. Retrieved from http://www.med-ed.virginia.edu/courses/rad/index.html

This website provides an introduction to radiology and imaging. For this week, focus on cardiac radiography and chest radiology.
Required Media. Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion

Laureate Education. (Producer). (2012). Advanced health assessment and diagnostic reasoning. Baltimore, MD: Author.

Note: You will use the case studies presented in the media, Advanced Health Assessment and Diagnostic Reasoning, to complete this week’s Discussion.
Online media for Seidel’s Guide to Physical Examination

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapters 13, 14, and 15 that relate to the assessment of the heart, lungs, and peripheral vascular system. Refer to Week 4 for access instructions on https://evolve.elsevier.com/.
Optional Resources

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin?s diagnostic examination (9th ed.). New York, NY: McGraw Hill Medical.
Chapter 8, ?The Chest: Chest Wall, Pulmonary, and Cardiovascular Systems; The Breasts? SECTION 1, ?Chest Wall, Pulmonary, and Cardiovascular Systems,? pp. 302?433)

Note:Section 2 of this chapter will be addressed in Week 10. Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion

This section of Chapter 8 describes the anatomy of the chest wall, pulmonary, and cardiovascular systems. Section 1 also explains how to properly conduct examinations of these areas.

NURS 6512 Week 6 quiz

Question 1 On a CXR, which of the following is true of the diaphragm?

Question 2 The most helpful finding in determining left-sided heart failure is:

Question 3 Respiratory effort usually exhibited by the patient with cerebral brain damage is called:

Question 4 A third heart sound is created by:

Question 5 Electrical activity recorded by the electrocardiogram (ECG) tracing that denotes the spread of the stimulus through the atria is the:

Question 6 The amplitude of pulses is recorded on a(n):

Question 7 Chronic obstructive pulmonary disease, pericarditis, and pericardial effusion are most often associated with:

Question 8 A bounding pulse in an infant may be associated with:

Question 9 Conduction system impairment should be suspected if an irregular heartbeat is:

Question 10 The spread of the impulse through the ventricles (ventricular depolarization) is depicted on the ECG as the: Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion

Question 11 In infants or small children, a capillary refill time of 4 seconds:

Question 12 Thrombosis of a leg vein should be suspected if the patient feels calf pain:

Question 13 A 34-year-old man is being seen for complaints of dull pain between the shoulder blades that is more intense with deep breathing and coughing. Upon auscultation of the chest you suspect that you will hear:

Question 14 Heart position can vary depending on body habitus. In a short, stocky individual, you would expect the heart to be located:

Question 15 The level at which the jugular venous pulse is visible gives an indication of:

Question 16 Which of the following statements is most accurate in describing hepatic jugular reflux?

Question 17 Purkinje fibers are located in the:

Question 18 As you take vital signs on Mr. B., age 78, you note that his respirations are 40 per minute. He has been resting and his mucosa is pink. Concerning Mr. B. s respirations, you would: Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion

Question 19 Systolic hypertension in the adult is generally defined as pressure in excess of:

Question 20 In barrel chest, the ratio of anteroposterior diameter to transverse (lateral) diameter is: Assessing the Heart, Lungs, and Peripheral Vascular System: NURS 6512 Week 6 Discussion