Discussion: NURS 6512 Assessing the Ears, Nose, and Throat

Walden University Discussion: NURS 6512 Assessing the Ears, Nose, and Throat-Step-By-Step Guide

 

This guide will demonstrate how to complete the Walden University Discussion: NURS 6512 Assessing the Ears, Nose, and Throat assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for Discussion: NURS 6512 Assessing the Ears, Nose, and Throat                     

 

Whether one passes or fails an academic assignment such as the Walden University Discussion: NURS 6512 Assessing the Ears, Nose, and Throat depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for Discussion: NURS 6512 Assessing the Ears, Nose, and Throat                     

The introduction for the Walden University Discussion: NURS 6512 Assessing the Ears, Nose, and Throat is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for Discussion: NURS 6512 Assessing the Ears, Nose, and Throat                     

 

After the introduction, move into the main part of the Discussion: NURS 6512 Assessing the Ears, Nose, and Throat assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for Discussion: NURS 6512 Assessing the Ears, Nose, and Throat                     

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for Discussion: NURS 6512 Assessing the Ears, Nose, and Throat                     

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for Discussion: NURS 6512 Assessing the Ears, Nose, and Throat Included After Question

Discussion: NURS 6512 Assessing the Ears, Nose, and Throat

Discussion: NURS 6512 Assessing the Ears, Nose, and Throat

Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment. Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes, but would probably perform a simple strep test.

In this Discussion, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the Episodic/Focused SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

Case 1: Nose Focused Exam

Richard is a 50-year-old male with nasal congestion, sneezing, rhinorrhea, and postnasal drainage. Richard has struggled with an itchy nose, eyes, palate, and ears for 5 days. As you check his ears and throat for redness and inflammation, you notice him touch his fingers to the bridge of his nose to press and rub there. He says he’s taken Mucinex OTC the past two nights to help him breathe while he sleeps. When you ask if the Mucinex has helped at all, he sneers slightly and gestures that the improvement is only minimal. Richard is alert and oriented. He has pale, boggy nasal mucosa with clear thin secretions and enlarged nasal turbinates, which obstruct airway flow but his lungs are clear. His tonsils are not enlarged but his throat is mildly erythematous.

Case 2: Focused Throat Exam

Lily is a 20-year-old student at the local community college. When some of her friends and classmates told her about an outbreak of flu-like symptoms sweeping her campus over the past two weeks, Lily figured she shouldn’t take her three-day sore throat lightly. Your clinic has treated a few cases similar to Lily’s. All the patients reported decreased appetite, headaches, and pain with swallowing. As Lily recounts these symptoms to you, you notice that she has a runny nose and a slight hoarseness in her voice but doesn’t sound congested.

Case 3: Focused Ear Exam

Martha brings her 11-year old grandson, James, to your clinic to have his right ear checked. He has complained to her about a mild earache for the past two days. His grandmother believes that he feels warm but did not verify this with a thermometer. James states that the pain was worse while he was falling asleep and that it was harder for him to hear. When you begin basic assessments, you notice that James has a prominent tan. When you ask him how he’s been spending his summer, James responds that he’s been spending a lot of time in the pool.

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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 10 possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Week 5 Discussion”) with “Review of Case Study ___,” identifying the number of the case study you were assigned.

By Day 3

Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

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.

A Sample Answer For the Assignment: Discussion: NURS 6512 Assessing the Ears, Nose, and Throat

Title: Discussion: NURS 6512 Assessing the Ears, Nose, and Throat

Allergic rhinitis is an inflammation of the nasal membranes characterized by sneezing, nasal itching, nasal congestion, and rhinorrhea. It is triggered by reactions to airborne allergens such as dust, plant pollens, molds, animal dander, wool, and air pollutants (Bjermer et al., 2019). Clinical features of Allergic rhinitis include itching nose, eyes, ears, and palate, sneezing, rhinorrhea, postnasal drip, nasal congestion, loss of smell, headache, earache, excessive tearing, red eyes, eye swelling, fatigue, drowsiness, and malaise (Bjermer et al., 2019). Physical exam findings in allergic rhinitis include nasal crease, thin, watery nasal secretions, deviation or perforation of the nasal septum (Crisci & Ardusso, 2020). Besides, the patient may have mouth breathing, frequent sniffling or throat clearing, and dark circles under the eyes referred to as allergic shiners. Anterior rhinoscopy typically reveals swelling of the nasal mucosa and thin, clear secretions (Bjermer et al., 2019). The mucosa of the nasal turbinates may be swollen or boggy and have a pale, bluish-gray appearance.

Allergic rhinitis is the presumptive diagnosis based on pertinent positive subjective findings of itchy nose, eyes, palate, and ears, nasal congestion, sneezing, rhinorrhea, and postnasal drainage. Objective findings in line with Allergic rhinitis include dark circles around the eyes, excessive lacrimation, pale boggy nasal mucosa, clear thin secretions, and enlarged nasal turbinates obstructing airway flow.  Furthermore, the patient is allergic to pollen and dust mites which are documented triggers of Allergic rhinitis.

Vasomotor Rhinitis:

Vasomotor rhinitis refers to non-inflammatory rhinitis triggered by a change in temperature, odors, or humidity. It is thought to result from disturbed regulation of the parasympathetic and sympathetic systems whereby the parasympathetic system dominates, causing vasodilation and edema of the nasal vasculature (Crisci & Ardusso, 2020). The resulting symptoms include rhinorrhea, sneezing, congestion, headache, facial pressure, postnasal drip, coughing, and throat clearing. Physical exam findings in vasomotor rhinitis include boggy edematous mucosa with clear mucoid secretions (Crisci & Ardusso, 2020). In addition, mucosal injection and lymphoid hyperplasia involving the adenoids, tonsils, and lingual tonsils may be present. 

Pertinent positive findings consistent with vasomotor rhinitis include nasal congestion, sneezing, rhinorrhea, postnasal drainage, boggy nasal mucosa, clear thin nasal secretions, and throat clearing.

Common Cold:

Common cold is caused by Rhinoviruses, which mainly cause upper respiratory tract infections. Clinical features of Rhinovirus infection include nasal dryness or irritation and sore throat or throat irritation, which are often the initial symptoms (Jaume, Valls-Mateus & Mullol, 2020). Nasal discharge, nasal congestion, and sneezing then occur and intensify over 2-3 days. Other signs and symptoms include headache, facial and ear pressure, loss of sense of smell and taste, cough, hoarseness, post-tussive vomiting, irritability, and in some cases, low-grade fever.

Physical exam findings in the common cold include A red nose with a profuse and dripping nasal discharge. Nasal discharge may be clear and watery or mucopurulent with a yellow or green appearance (Jaume et al., 2020). Examination of the nose reveals nasal mucous membranes with a glistening, glassy appearance, usually without erythema or edema. In addition, mildly enlarged, non-tender cervical lymph nodes are present, and chest auscultation chest may reveal rhonchi (Jaume et al., 2020). Common cold is a differential diagnosis based on pertinent positive findings of postnasal discharge, rhinorrhea, nasal congestion, sneezing, throat clearing, and clear thin secretions.  

Influenza Infection

Influenza is a highly contagious airborne disease that occurs in seasonal epidemics. It manifests as an acute febrile illness with variable severity of systemic symptoms, ranging from mild fatigue to respiratory failure and death (Gaitonde, Moore & Morgan, 2019). Signs and symptoms of Influenza infection include fever, sore throat, nasal discharge, muscle pain, frontal or retro-orbital headache, weakness and severe fatigue, cough, tachycardia, and red, watery eyes (Gaitonde et al., 2019). Influenza is a differential diagnosis based on positive symptoms of nasal discharge, sneezing, and excessive lacrimation.

Acute Sinusitis

Sinusitis is characterized by inflammation of the paranasal sinuses lining. Acute Sinusitis presents with pain over the cheek, which radiates to the frontal region or teeth and increases with straining or bending down (Jaume et al., 2020). Symptoms include postnasal discharge, blocked nose, persistent coughing or pharyngeal irritation, facial pain, and a diminished sense of smell (Jaume et al., 2020). Physical exam findings include redness of the nose, cheeks, or eyelids and tenderness over the floor of the frontal sinus, purulent nasal secretions, purulent posterior pharyngeal secretions, mucosal erythema, and periorbital edema.

Pertinent positives consistent with Acute Sinusitis include nasal congestion, throat clearing, and postnasal drainage. However, the absence of facial pain or pressure and sinus tenderness symptoms makes Acute Sinusitis an unlikely primary diagnosis.

References

Bjermer, L., Westman, M., Holmström, M., & Wickman, M. C. (2019). The complex pathophysiology of allergic rhinitis: scientific rationale for the development of an alternative treatment option. Allergy, Asthma & Clinical Immunology, 15(1), 1-15. https://doi.org/10.1186/s13223-018-0314-1

Crisci, C. D., & Ardusso, L. (2020). A Precision Medicine Approach to Rhinitis Evaluation and Management. Current treatment options in allergy, 7(1), 93–109. https://doi.org/10.1007/s40521-020-00243-1

Gaitonde, D. Y., Moore, F. C., & Morgan, M. K. (2019). Influenza: Diagnosis and treatment. American family physician, 100(12), 751-758.

Greiwe, J. C., & Bernstein, J. A. (2019). Allergic and Mixed Rhinitis: Diagnosis and Natural Evolution. Journal of clinical medicine, 8(11), 2019. https://doi.org/10.3390/jcm8112019

Jaume, F., Valls-Mateus, M., & Mullol, J. (2020). Common Cold and Acute Rhinosinusitis: Up-to-Date Management in 2020. Current Allergy and asthma reports, 20(7), 28. https://doi.org/10.1007/s11882-020-00917-5

S. CC: “Chest pain”  HPI: The patient is a 65 year old AA male who developed sudden onset of chest pain, which began early this morning.  The pain is described as “crushing” and is rated nine out of 10 in terms of intensity. The pain is located in the middle of the chest and is accompanied by shortness of breath. The patient reports feeling nauseous. The patient tried an antacid with minimal relief of his symptoms.   Medications: Lisinopril 10mg, Omeprazole 20mg, Norvasc 5mg PMH: Positive history of GERD and hypertension is controlled FH: Mother died at 78 of breast cancer; Father at 75 of CVA.  No history of premature cardiovascular disease in first degree relatives. SH : Negative for tobacco abuse, currently or previously; consumes moderate alcohol; married for 39 years    Allergies: PCN-rash; food-none; environmental- none   Immunizations: UTD on immunizations, covid vaccine #1 1/23/2021 Moderna; Covid vaccine #2 2/23/2021 Moderna ROS    General–Negative for fevers, chills, fatigue Cardiovascular–Negative for orthopnea, PND, positive for intermittent lower extremity edema  Gastrointestinal–Positive for nausea without vomiting; negative for diarrhea, abdominal pain Pulmonary–Positive for intermittent dyspnea on exertion, negative for cough or hemoptysis   O. VS: BP 186/102; P 94; R 22; T 97.8; 02 96% Wt 235lbs; Ht 70”   General–Pt appears diaphoretic and anxious Cardiovascular–PMI is in the 5th inter-costal space at the mid clavicular line. A grade 2/6 systolic decrescendo murmur is heard best at the second right inter-costal space which radiates to the neck. A third heard sound is heard at the apex. No fourth heart sound or rub are heard. No cyanosis, clubbing, noted, positive for bilateral 2+ LE edema is noted. Gastrointestinal–The abdomen is symmetrical without distention; bowel sounds are normal in quality and intensity in all areas; a bruit is heard in the right para-umbilical area. No masses or splenomegaly are noted. Positive for mid-epigastric tenderness with deep palpation. Pulmonary— Lungs are clear to auscultation and percussion bilaterally   Diagnostic results: EKG, CXR, CK-MB (support with evidenced and guidelines)           A. Differential Diagnosis: 1) Myocardial Infarction (provide supportive documentation with evidence based guidelines). 2) Angina (provide supportive documentation with evidence based guidelines). 3) Costochondritis (provide supportive documentation with evidence based guidelines).   Primary Diagnosis/Presumptive Diagnosis: Myocardial Infarction

A.

Differential Diagnosis:

1) Myocardial Infarction (provide supportive documentation with evidence based guidelines).

2) Angina (provide supportive documentation with evidence based guidelines).

3) Costochondritis (provide supportive documentation with evidence based guidelines).

Primary Diagnosis/Presumptive Diagnosis: Myocardial Infarction

P. This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.