LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM

Walden University LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM-Step-By-Step Guide

 

This guide will demonstrate how to complete the Walden University LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM 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 LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM                     

 

Whether one passes or fails an academic assignment such as the Walden University LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM 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 LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM                     

The introduction for the Walden University LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM 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 LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM                     

 

After the introduction, move into the main part of the LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM 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 LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM                     

 

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 LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM                     

 

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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Additional Subjective Information

Additional subjective information should be obtained from TS. Firstly, information about the character of her urine should be obtained. This includes information such as the smell and color of the urine. Bloodstained urine could indicate bladder problems while urine with a strong smell could imply that TS has a urinary tract infection. The nurse should also ask for information about the presence or absence of abnormal vaginal discharge. For instance, yellow or purulent vaginal discharge would indicate sexually transmitted infections. The character of TS’s symptoms should also be obtained. This includes seeking information on the factors that precipitate or alleviate her urinary symptoms. She should be asked about any activity that worsens or relieves her symptoms (Kaur & Kaur, 2021). The nurse should also assess her current level of pain using the pain rating scale. Pain rating could indicate the severity of her condition.

            The nurse should also ask TS about her sexual habits. This includes sexual preferences and the use of protection when engaging in sexual intercourse. The information would help the nurse rule out causes such as sexually transmitted infections. Additional sexual-related information that should be obtained includes the use of contraceptives, the last menstrual period, and menstrual cycle problems. The nurse should also obtain information about any history of recurrent urinary tract infections. This would help determine if she has chronic urinary tract infections. Similarly, information about the history of sexually transmitted infections should be obtained to rule them out in her case. Information about her partner’s history of sexually transmitted infections and testing should also be obtained to rule out a risk of STD transmission. Information about TS’s social history is also needed. This includes data about smoking, dietary practices, and alcohol use (Bono et al., 2024). The nurse should also rule out the potential of heredity of TS’s problem. Information about a family history of health problems such as kidney disease or symptoms that TS has should be obtained.

LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM

LAB ASSIGNMENT ASSESSING THE GENITALIA AND RECTUM

Assessing the Genitalia and Rectum

Assessment of the genitalia and rectum is vital in depicting genitourinary and gastrointestinal abnormalities respectively. A rectal examination is necessary to complete an abdominal exam. Meanwhile, assessment of the genitalia is usually sensitive and must be done in the presence of a chaperone. In the subsequent paragraphs, potential history, physical exam, and differential diagnosis shall be explored based on a case scenario of T.S. a 32-year-old woman who presents with dysuria, frequency, and urgency for two days. She is sexually active and has had a new partner for the past three months.

Subjective

A triad of urgency, frequency, and dysuria characterizes a pathology that is most likely in the urinary tract. Consequently, it is essential to inquire about associated symptoms such as hematuria, fever, and malaise. Association with malaise and fever is common in urinary tract infections. Similarly, it is important to inquire about the presence of any abnormal vaginal discharge, and burning sensation during urination since she is sexually active and a sexually transmitted infection might be the cause of her symptoms. Likewise, changes in the smell and color of the urine must be elicited as well as associated suprapubic pain. Related to sexually transmitted infections, it is crucial to inquire about the number of sexual partners if similar symptoms have manifested in her partner or the use of protection during intercourse (Garcia & Wray, 2022).

Similarly, her last menstrual period must be known to determine if pregnant as this will impact the management (Bono et al., 2022). Additionally, a history of medication use, alcohol, smoking, and use of illicit drugs must be elicited. A history of contact with an individual with a chronic cough or TB prior to the occurrence of the previous symptoms must be elicited as urogenital TB may present similarly. Finally, it is crucial to inquire about any history of trauma or recent urethral catheterization as these are common risk factors for urinary tract infections.

Objective

The vital signs are mandatory in this patient as it is a pelvic exam. In the general exam, the mental and nutrition status of the patient must be noted. Additionally, a complete abdominal exam must be conducted as the patient has flank pain and suprapubic tenderness. Palpation of the abdomen for any masses and percussion of the flank for costovertebral angle tenderness must be done (Bono et al., 2022). Similarly, complete respiratory and cardiovascular exams must be conducted as a routine during the assessment of any patient. Finally, a digital rectal examination must be performed to exclude associated rectal abnormalities.

Assessment

In addition to urinalysis, STI, and pap smear testing, a complete blood count and urine culture must be conducted as the patient presents with signs of infection. Similarly, a pregnancy test must be conducted as this may complicate urinary tract infections. Additionally, she has no appetite and therefore a random blood sugar must be done to exclude hypoglycemia.

Similarly, urea, creatinine, and electrolyte must be conducted to check the renal function as the

patient has flank pain. Finally, Inflammatory markers such as ESR and CRP as well as blood cultures must be done as the patient has flank pain which may indicate pyelonephritis (Bono et al., 2022). Imaging tests are not necessary for the diagnosis of lower UTI. However, the patient has flank pain, and therefore, a CT scan of the abdomen and pelvis with or without IV contrast as well as an ultrasound of the kidneys and bladder must be done to identify any pathologies and outline the architecture of the kidney and bladder (Belyayeva & Jeong, 2022)

The possible diagnoses include a urinary tract infection and a sexually-transmitted infection. Urinary tract infections refer to the infection of the bladder, urethra, ureters, or kidneys (Bono et al., 2022). UTIs are more common in women, a consequence of a short urethra and proximity of the anal and genital regions (Bono et al., 2022). A triad of frequency, dysuria, and urgency collectively defines the irritative lower urinary tract symptoms (Bono et al., 2022). Similarly, suprapubic tenderness is a key feature of lower urinary tract infections. However, the patient is also feverish and has flank pain which also denotes the potential for involvement of the upper urinary tract (Bono et al., 2022). T.S is also sexually active, a risk factor for urinary tract infection.

A sexually transmitted infection is another possible diagnosis. T.S is sexually active and she has had her new partner for the last three months which is a key risk factor for this condition (Garcia & Wray, 2022). Most STIs present with suprapubic pain. Most STIs are asymptomatic and if symptomatic manifests with urethral discharge, vaginal discharge, pruritus, and pain (Garcia & Wray, 2022). T.S was negative for the aforementioned features.

Other differential diagnoses include pyelonephritis, interstitial cystitis, and urethritis due to an STI. Pyelonephritis is of the renal pelvis and parenchyma (Belyayeva & Jeong, 2022). It is usually a complication of ascending bacterial infection of the bladder and manifests principally with frequency, dysuria, urgency, fever, malaise, flank pain, and suprapubic pain (Belyayeva & Jeong, 2022). Interstitial cystitis is a chronic noninfectious idiopathic cystitis associated with recurrent suprapubic pain (Daniels et al., 2018). It presents with urgency, frequency, suprapubic discomfort, and pain relieved by voiding. T.S has some of these features although the gradual onset of symptomatology and a duration of more than six weeks is required for the diagnosis of this condition (Daniels et al., 2018). Finally, urethritis secondary to an STI may present in females with only frequency, urgency, and dysuria with minimal or no vaginal discharge (Young et al., 2022).

Conclusion

Assessment of the genitalia and rectum is sensitive and may help identify abnormalities of the rectum and genitourinary tract. Most abnormalities of the genitourinary system particularly UTIs and STIs can be diagnosed clinically. Consequently, a comprehensive history and physical examination are mandatory. Most UTIs are common in females. Pregnancy must always be excluded in a patient presenting with features suggestive of a UTI.

References

Belyayeva, M., & Jeong, J. M. (2022). Acute Pyelonephritis. https://pubmed.ncbi.nlm.nih.gov/30137822/

Bono, M. J., Leslie, S. W., & Reygaert, W. C. (2022). Urinary Tract Infection. https://pubmed.ncbi.nlm.nih.gov/29261874/

Daniels, A. M., Schulte, A. R., & Herndon, C. M. (2018). Interstitial cystitis: An update on the disease process and treatment. Journal of Pain & Palliative Care Pharmacotherapy, 32(1), 49–58. https://doi.org/10.1080/15360288.2018.1476433

Garcia, M. R., & Wray, A. A. (2022). Sexually Transmitted Infections. https://pubmed.ncbi.nlm.nih.gov/32809643/

Young, A., Toncar, A., & Wray, A. A. (2022). Urethritis. https://pubmed.ncbi.nlm.nih.gov/30725967/

Advance Nursing Assessment and Diagnostic Reasoning

Human papillomavirus (HPV) is one of the most common sexually transmitted infections among late teens and young adults. In the year 2018, approximately 43 million cases of HPV were reported in the United States. Studies show that there are over 100 varieties of HPV (Breznik et al., 2020). Some cases of HPV can cause warts, while others have been associated with different types of cancer. The infection is also associated with other complications such as oral and upper respiratory lesions.

To prevent the spread of the infection among populations at high risks, the CDC recommends two doses of the Gardasil 9 vaccine for both males and females at ages 11 and 12. Routine screening is also recommended among sexually active individuals for early detection of the infection and treatment. The diagnosis of the disorder involves pap tests, DNA tests, and acetic acid solution tests. There is no cure for the disease. However, individuals can benefit from treatment options available for symptomatic relief. This paper demonstrates the assessment and diagnosis of a 21-year-old female patient with a chief complaint of bumps on her bottoms, and medical history of chlamydia, which was diagnosed about 2 years before the present visit.

Subjective Data

The information provided by the patient is quite limited to making a definitive diagnosis. The patient is unaware of when the bumps started appearing on her bottom but confirms having multiple sexual partners. Additionally, she confirms a history of chlamydia. This information only provides a clue of what the patient is suffering from but cannot be conclusively used in determining the cause of the patient’s symptoms. Additional subjective data such as associated symptoms, characteristics of the bumps on her bottom, and the spread of the bumps to other body parts are missing (Pfennig, 2019).

Consequently, the patient must also state whether she has noticed any changes in the size and number of the bumps, ever since she first noticed them. She also needs to provide information regarding any use of medication for her current symptoms, and whether they have been helpful or not. It is also very important for the patient to provide substantial information regarding her reproductive history such as the use of birth control pills, and her menses, for further evaluation of her condition.

Objective Data

Building upon the subjective data, the physical examination of the patient will be focused on her chief complaint. Objective data such as the patient vital signs, in addition to an examination of her heart, genitalia, abdomen, and lungs have been clearly outlined. However, a general evaluation of the patient’s health must also be conducted to find out additional symptoms such as fatigue, sleeping problems, and weight changes, to be able to determine the severity of her condition. Additionally, with a primary diagnosis of the chancre, the patient should have been screened for different types of cancer, such as rectal cancer which is mostly associated with the disorder (Jain, Patil, & Karnavat, 2020).

The reported genitourinary examination is also missing important factors such as the menstrual pattern of the patient, which might have been affected by the patient’s condition. Additional information such as vaginal bleeding or painful sex should have also been evaluated to rule out other possible causes of the patient’s symptoms such as chlamydia or gonorrhea. The only diagnostic test obtained is the HSV specimen. However, additional tests such as scraping tests for spirochetes, urinalysis for UTI, gonorrhea, and chlamydia, Tzanck smear test for herpes virus, and acetic acid tests for HPV lesions should also be ordered to rule out the respective differential diagnosis.

Assessment

The assessment for chancre is not fully supported by the provided subjective and objective data. Chancre is described as a painless genital ulcer that normally occurs during the primary stage of syphilis. As such, the subjective and objective data should have been focused on determining other symptoms of syphilis. On the contrary, the patient only reported bumps on her bottom, a history of chlamydia, and multiple sexual partners, which do not conclusively suggest chancre (Poteat, Harbatkin, & Light, 2019).

To support this assessment, the subjective portion of the patient information should have described the bump as firm and round, rather than just painless. The objective data, on the other hand, is even less supportive, as physical examination of the patient’s genitalia revealed no swellings or masses. The diagnostic tests ordered are also for HSV and not for syphilis or chancre.

Diagnostics

Based on the subjective and objective data provided for the patient, it is quite difficult to make a definitive diagnosis. Several diagnostic tests must however be ordered to determine the primary medical condition affecting the patient. For instance, lab works such as HSV viral culture for lesion test, which normally takes 7 days, must be ordered to rule out HSV as the cause of the patient’s symptoms.

Nucleic acid amplification tests should also be ordered to find out whether the patient’s symptoms are a result of gonorrhea or chlamydia. Pelvic examination in addition to KOH wet mount and pH test of the patient’s vaginal discharge is also necessary to help detect the presence of fungal or bacterial infections such as UTI (Jain et al., 2021). To rule out spirochetes, an acetic acid test must be ordered to identify subclinical lesions from HPV Scraping. Before making a diagnosis of syphilis, it is necessary to obtain a positive EIA test, confirmed with either RPR or VDRL tests. Imaging studies such as pelvic x-ray and CT scans may also help visualize anatomical deformities such as abnormal proliferation of cells to rule out cervical cancer among other genital cancers.

Primary Diagnosis

The patient’s primary diagnosis of chancre is wrong. Despite the patient’s symptoms suggesting this diagnosis, additional tests necessary to confirm the presence of chancre are missing (Poteat et al., 2019). Given that chancre normally presents in the primary stage of syphilis, stage-specific diagnostic tests such as darkfield microscopy or nontreponemal tests are required to confirm this diagnosis.

Differential Diagnosis

Looking at the provided patient history, the main differential diagnosis is anal warts (condyloma acuminata), genital herpes simplex, and molluscum contagiosum. Anal warts are a form of genital warts which normally result from human papillomavirus (HPV). This condition is usually characterized by small painless warts inside or around the anus. It is mostly diagnosed through visual examination (Jain et al., 2021).

The provided patient history of painless bumps on her bottom, with a history of chlamydia, and multiple sexual partners support the diagnosis of HPV, leading to anal warts. Genital herpes simplex is also associated with bumps or blisters, but is painful, making this diagnosis inappropriate. Molluscum contagiosum is also associated with painless bumps but spreads on the whole body rather than being localized in one area.

References

Breznik, V., Fujs Komloš, K., Hošnjak, L., Luzar, B., Kavalar, R., Miljković, J., & Poljak, M. (2020). Determination of causative human papillomavirus type in tissue specimens of common warts based on estimated viral loads. Frontiers in cellular and infection microbiology, 10, 4. https://doi.org/10.3389/fcimb.2020.00004

Jain, R. S., Behere, R. V., Patil, P. A., & Karnavat, D. R. (2021). Study of Warts affects the Humans with their signs and symptoms. Asian Journal of Pharmaceutical Research, 11(1). DOI: 10.5958/2231-5691.2021.00013.7

Jain, R. S., Patil, P. A., & Karnavat, D. R. (2020). Identification of different types of Wart affect the Human Body. Asian Journal of Research in Pharmaceutical Science, 10(1), 31-34. DOI: 10.5958/2231-5659.2020.00007.7

Pfennig, C. L. (2019). Sexually transmitted diseases in the emergency department. Emergency Medicine Clinics, 37(2), 165-192. https://doi.org/10.1016/j.emc.2019.01.001

Poteat, T., Harbatkin, D., & Light, A. D. (2019). Sexual Health for Women. The GLMA Handbook on LGBT Health [2 volumes], 229.

Patient Information:

Initials: AB                 Age: 21 Years Old                  Sex: Female                Race: White

S.

CC (chief complaint): “I have bumps on my bottom that I want to have checked out.”

HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner during the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.

Location: genital area.

Onset: Unsure of how long the pumps have been there but she noticed the about a week ago

Character: Painless and feel rough

Associated signs and symptoms: the pumps are reported to be pain and feels rough on touch. There are no associated symptoms such as itchiness and pain.

Timing: None

Exacerbating/ relieving factors: Unspecified

Severity: The pumps do not have any symptoms such as pain or itchiness. Rating on pain therefore not applicable.

Current Medications: Symbicort 160/4.5mcg 

Allergies: No known drug, food, or environmental allergies.

PMHx: The client has history of asthma. She also has a history of sexually transmitted infection (chlamydia) over 2 years ago. She completed chlamydia treatment.
Soc Hx: The patient is a college student, who reports to be sexually active and have had more than one partner in the last year. The initial sexual contact of the client was when she was 18. The client also denied tobacco use, occasional use of etoh, married, 3 children (1 girl, 2 boys).

Fam Hx: No history of breast or cervical cancer, Father history of HTN, Mother has history of HTN and GERD 

O.

OBJECTIVE:

Physical exam:

Vital Signs: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs 

CV: Regular heart rhythm with no murmurs

Lungs: CTA, chest wall symmetrical 

Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia. ABD: soft, normoactive bowel sounds, neg rebound, neg murphy’s, negMcBurney 

Diagnostic: HSV specimen obtained 

Analysis of Additional Subjective Information Top of Form

The nurse should focus on obtaining additional subjective data from the patient besides those in the case snapshot. The additional subjective data will guide the development of accurate diagnosis and treatment plan for the client. The nurse should obtain the information about additional symptoms that are associated with the external pumps on her genitalia. The nurse should obtain information such as size, shape, any discharge, or changes in the pumps that might have occurred over the past in terms of appearance.

The nurse should also obtain additional information about any history of similar pumps in the past. A history of closely related pumps of the genital area could guide the development of diagnoses such as warts in the patient. There is also the need for the nurse to obtain information related to medication use by the patient. A history of medication use such as those used in managing the pumps could aid in determining the cause of the problem (Stephen & Skillen, 2020). History on medication use could also guide the determination of whether the pumps are attributable to side effects or adverse reactions to a drug.

The nurse should also obtain information about the use of any irritants in the past that might have caused the pump. For example, information about the types of soaps that the patient uses should be obtained. The client should also be asked about her sexual preferences. This will provide information about her sexual habits, which might have led to the development of the pumps. The effect of the pumps on the self-perception of the client should also be obtained. The nurse should try to rate the effect of the pumps on her self-image and self-esteem using an appropriate rating scale (Forbes & Watt, 2020). The additional subjective data that may be needed include history of skin problems such as eczema, menstrual history, and occupational history to determine any risk factors in her workplace place. 

Analysis of Additional Objective information

Additional objective data should also be obtained from the client to increase the accuracy of the diagnosis. The nurse should have performed rectal examination. The examination could have provided clues such as the presence of hemorrhoids or anal fissures. The nurse should have also provided information about the general appearance of the client. The general appearance could have provided clues on the social, emotional and physical impact of the pumps on the client.

The nurse should have also performed head to toe examination of the client. The examination could have included the assessment of the skin to determine the existence of undetected skin lesions. The nurse should have also examined the oral cavity for any lesions, neck for inflamed lymph nodes and neck rigidity. The nurse should have also assessed the chest for any abnormal findings such as appearance, shape, or palpitations on auscultation (Cox, 2019). The above information could have guided the accuracy of the diagnoses made by the nurse. 

Is this Assessment Supported by the Subjective and Objective Assessment?

The assessment is supported by subjective and objective data. Subjective data is the data that the patient provides concerning her experience with the health problem. The information is based on the perceived experiences by the patient and the management of the health problem. Subjective data provides the basis of assessment and physical examinations of the patient. The examples of subjective data that support the assessment include the client’s complaints, history of the complains, history of any vaginal discharge, her Pap smear examinations, and any significant past medical, surgical and family history.

Objective data on the other hand is the data that the nurse obtains using assessment and physical examination techniques. The data is not based on the subjective experiences of the patient with the disease but the physiological changes in the patient due to the disease. Objective data is used to validate the subjective data (Perry et al., 2021). The examples of objective data in the case study include vital signs, auscultation of the heart and lungs and the observation of the genitalia. The diagnostic investigations that were ordered also form part of the objective data.

Appropriate Diagnostic Tests

The development of accurate diagnosis of the client’s problem can be achieved by performing a number of diagnostic investigations. One of them is skin scrap. A scrap of the pumps can be obtained for laboratory examination. The other investigation is tzank smear to test for herpes simplex. The client should be tested for syphilis using diagnostics such as Darkfield microscopy or enzyme immunoassay (Perry et al., 2021).

Current Diagnosis

The current diagnosis of chancre is accurate. Patients with chancre present with symptoms similar to those of the client in the case study. For example, the ulcers are asymptomatic and can last for a period of up to six weeks (Cox, 2019).

Differential Diagnosis

One of the differential diagnoses that should be considered for the patient in the case study is contact dermatitis. Contact dermatitis is a skin condition that is characterized by symptoms such as the presence of rashes, which are dry, scaly and cracked. It is however the least likely due to the absence of itchiness and oozing or crusting of the rashes. The second differential diagnosis is syphilis. The client has a history of multiple sexual partners, which predisposes her to syphilis. Patients with syphilis also show skin rashes such as chancre in the early stages of syphilis. The last differential diagnosis is herpes simplex. Patients with herpes simplex may have symptoms such as rashes in the genitals (Perry et al., 2021). However, it is least unlikely for the patient due to the lack of symptoms such as lymphadenopathy and fever.

Conclusion

The diagnosis of chancre in the case study is accurate. Additional subjective and objective data should be obtained to come up with an accurate diagnosis. Differential diagnoses such as syphilis, herpes simplex, and contact dermatitis should however be considered. In addition, further diagnostic investigations should be performed to come up with an accurate diagnosis.

References

Cox, C. L. (2019). Physical Assessment for Nurses and Healthcare Professionals. John Wiley & Sons.

Forbes, H., & Watt, E. (2020). Jarvis’s Health Assessment and Physical Examination – E-Book: Australian and New Zealand. Elsevier Health Sciences.

Perry, A. G., Potter, P. A., Ostendorf, W., & Laplante, N. (2021). Clinical Nursing Skills and Techniques—E-Book. Elsevier Health Sciences.

Stephen, T. C., & Skillen, D. L. (2020). Canadian Nursing Health Assessment. Lippincott Williams & Wilkins.

Genitourinary problems are a common occurrence in nursing practice. nurses utilize both subjective and objective data to develop accurate diagnoses and treatment plans for their patients. Therefore, the purpose of this paper is to examine a case study of a patient that presents with a genitourinary problem. The purpose of this paper is to examine the additional information needed in the subjective and objective portions, additional diagnostic studies, accepting or rejecting the diagnosis, and possible conditions that should be considered.

Subjective Portion

Additional subjective data should be obtained from the patient to guide the development of an accurate diagnosis. First, the nurse should ask the patient to describe the factors that precipitate or relieve the symptoms. The information will guide rule out potential causes of the client’s problem. The nurse should also obtain information about the treatments that were useda year ago when she experienced the same symptoms. Information about the patient’s sexual habits should also be obtained. This includes data about unprotected or protected sex.

The nurse should also obtain data about douching, wearing tight undergarments, and scented underwear. The nurse should also ask if her partner has similar problem to rule out the potential of a sexually transmitted infection. Information about the color or smell of the urine should also be obtained. This will help rule out causes such as urinary tract infection(Ackley et al., 2021). Besides, information about any allergies to drugs should be obtained, as it will determine the client’ treatment options. Lastly, the information about the impact of the health problem should be obtained. This includes its effect on the ability of the patient too engage in her social and occupational roles.

Objective Portion

Additional information should also be obtained in the objective portion. One of them is the review of other systems that include respiratory and cardiovascular system. The review is important to rule out any other comorbidities the client may have. The nurse should also include information about the presence or absence of abdominal tenderness, organomegaly, or guarding. The data on the presence or absence of edema should also been included. This could help rule out renal problems such as kidney disease(Ackley et al., 2021). The information about any abnormal smell should have also been provided. Such information could have helped rule out causes such as sexually transmitted infections.

Assessment Supported

Subjective ad objective data support the assessment. Subjective data is the patient’s version of a health problem. It helps healthcare providers to understand the patient experiences with a disease and its impact on their health and wellbeing. The subjective data in the case study include the client’s presenting complains, past medical and surgical history, information about review of systems, and chief complain. Objective data refers to the information that healthcare providers obtain through methods such as inspection, palpation, auscultation, and percussion. The data validates subjective assessment information. The examples of objective data in the case study include vital signs and results of pelvic examination.

Diagnostic Tests

The healthcare provider should request for several diagnostic tests. One of them is urinalysis. Urinalysis should be done to determine the presence of white blood cells, blood, or glucose. Urine culture should also be done to determine if the cause of the problem is gram positive or negative organism. Complete blood count is also recommended to detect any abnormalities such as elevated white blood cell count, which will indicate an infection. Pelvic ultrasound may also be needed to rule out causes such as renal stones. VDRL should also be done to rule out sexually transmitted infections (Weese et al., 2021). A pap smear may also be required should the healthcare provider be interested in ruling out causes such ascervical cancer.

Rejection or Acceptance

I will accept the diagnosis of urinary tract infection and reject sexually  transmitted infection. Patients diagnosed with urinary tract infections experience symptoms that align with those seen in the patient. They include dysuria, urgency, frequency, cloudy urine, strong-smelling urine, and pelvic pain(Neugent et al., 2020). Women are highly vulnerable to urinary tract infection than men due to the differences in the genitourinary structures.

Possible Conditions

As noted above, the client’s primary diagnosis is urinary tract infection. Urinary tract infection affects any part of the urinary tract such as the urethra, bladder, kidneys, and ureters. The symptoms associated with urinary tract infections include strong, persistent urge to urinate, burning sensation during urination, increased urinary frequency, cloudy urine, strong-smelling urine, and pelvic pain(Byron, 2019).

The other differential that should be considered for the patient is pyelonephritis. Pyelonephritis is a complication of urinary tract infection. It develops from ascending causative organism for the urinary tract infection to the bladder and kidneys. The affected patients experience symptoms that include fever, abdominal and flank pain, dysuria, cloudy urine, blood or pus in urine, increased urinary frequency and urgency, and fish-smelling urine(Kolman, 2019). The additional symptoms that may be experienced include nausea, chills, vomiting, fatigue, mental confusion, and moist skin.

The last differential to consider for the patient is renal stones. Renal stones or nephrolithiasis is a condition that develops from the deposition of salts and stones in the kidneys. Nephrolithiasis is associated with factors such as excess body weight, extreme dehydration, and diet. The affected patients experience symptoms that include sharp pain in the back and side below the ribs, pain radiating to the groin and lower abdomen, dysuria, and cloudy-smelling urine. There is also increased urgency, nausea and vomiting, and pink or read urine (Mayans, 2019).

Conclusion

Additional information is needed in the subjective and objective portions. I will accept the diagnosis of urinary tract infection. Additional diagnostic investigations are essential to develop an accurate diagnosis. The nurse should consider the differentials and narrow to a single cause in the treatment process. s

References

Ackley, B. J., Ladwig, G. B., Makic, M. B. F., Martinez-Kratz, M. R., & Zanotti, M. (2021). Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates—E-Book. Elsevier Health Sciences.

Byron, J. K. (2019). Urinary Tract Infection. Veterinary Clinics: Small Animal Practice, 49(2), 211–221. https://doi.org/10.1016/j.cvsm.2018.11.005

Kolman, K. B. (2019). Cystitis and Pyelonephritis: Diagnosis, Treatment, and Prevention. Primary Care: Clinics in Office Practice, 46(2), 191–202. https://doi.org/10.1016/j.pop.2019.01.001

Mayans, L. (2019). Nephrolithiasis. Primary Care: Clinics in Office Practice, 46(2), 203–212. https://doi.org/10.1016/j.pop.2019.02.001

Neugent, M. L., Hulyalkar, N. V., Nguyen, V. H., Zimmern, P. E., & De Nisco, N. J. (2020). Advances in Understanding the Human Urinary Microbiome and Its Potential Role in Urinary Tract Infection. MBio, 11(2), e00218-20. https://doi.org/10.1128/mBio.00218-20

Weese, J. S., Blondeau, J., Boothe, D., Guardabassi, L. G., Gumleyg, N., Papichh, M., Jesseni, L. R., Lappinj, M., Rankin, S., Westropp, J. L., & Sykes, J. (2021). International Society for Companion Animal Infectious Diseases (ISCAID) guidelines for the diagnosis and management of bacterial urinary tract infections in dogs and cats. 日本獣医腎泌尿器学会誌, 13(1), 46–63. https://doi.org/10.24678/javnu.13.1_46

Assessment is one of the skills that nurses should possess in their practice. Nurses use their assessment knowledge and skills in developing accurate diagnoses and plans of care for their patients. The assessment skills that nurses often use in their practice include history taking and physical examination such as observation, palpation, percussion, and auscultation. Assessment results also guide the evaluation of care given to the patients. Nurses use evaluation information to determine the accuracy of their diagnoses, plans, and interventions used to address the care needs of their patients.

Therefore, this paper is an examination of a case study of client who presented to the clinic with genitourinary problem. The client came with a history of external pumps in her genital area, which are painless and rough. The history obtained from her shows that she had the last pap smear test three years ago, which was normal. The patient does not have any significant medical, family or surgical history. Therefore, the paper examines the subjective and objective data that should be obtained for the patient, diagnostic investigations and differential diagnoses for the client.

Additional Subjective Data

The nurse should focus on obtaining additional subjective data from the patient besides those in the case snapshot. The additional subjective data will guide the development of accurate diagnosis and treatment plan for the client. The nurse should obtain the information about additional symptoms that are associated with the external pumps on her genitalia (Stephen & Skillen, 2020). The nurse should obtain information such as size, shape, any discharge, or changes in the pumps that might have occurred over the past in terms of appearance. The nurse should also obtain additional information about any history of similar pumps in the past.

A history of closely related pumps of the genital area could guide the development of diagnoses such as warts in the patient. There is also the need for the nurse to obtain information related to medication use by the patient. A history of medication uses such as those used in managing the pumps could aid in determining the cause of the problem (Stephen & Skillen, 2020). History on medication use could also guide the determination of whether the pumps are attributable to side effects or adverse reactions to a drug.

Moreover, the nurse should obtain information about the use of any irritants in the past that might have caused the pump. For example, information about the types of soaps that the patient uses should be obtained. The client should also be asked about her sexual preferences. This will provide information about her sexual habits, which might have led to the development of the pumps. The effect of the pumps on the self-perception of the client should also be obtained.

The nurse should try to rate the effect of the pumps on her self-image and self-esteem using an appropriate rating scale (Forbes & Watt, 2020). The additional subjective data that may be needed include history of skin problems such as eczema, menstrual history, and occupational history to determine any risk factors in her workplace place.

Additional Objective Data

Additional objective data should also be obtained from the client to increase the accuracy of the diagnosis. The nurse should have performed a rectal examination. The examination could have provided clues such as the presence of hemorrhoids or anal fissures. The nurse should have also provided information about the general appearance of the client. The general appearance could have provided clues on the social, emotional and physical impact of the pumps on the client (Cox, 2019). The nurse should have also performed head to toe examination of the client.

The examination could have included the assessment of the skin to determine the existence of undetected skin lesions. The nurse should have also examined the oral cavity for any lesions, neck for inflamed lymph nodes and neck rigidity. The nurse should have also assessed the chest for any abnormal findings such as appearance, shape, or palpitations on auscultation (Champagne et al., 2017). The above information could have guided the accuracy of the diagnoses made by the nurse.

Whether Subjective and Objective Data Support the Assessment

The assessment is supported by subjective and objective data. Subjective data is the data that the patient provides concerning her experience with the health problem. The information is based on the perceived experiences by the patient and the management of the health problem. Subjective data provides the basis of assessment and physical examinations of the patient. The examples of subjective data that support the assessment include the client’s complaints, history of the complains, history of any vaginal discharge, her Pap smear examinations, and any significant past medical, surgical and family history.

Objective data on the other hand is the data that the nurse obtains using assessment and physical examination techniques. The data is not based on the subjective experiences of the patient with the disease but the physiological changes in the patient due to the disease. Objective data is used to validate the subjective data (Perry et al., 2021). The examples of objective data in the case study include vital signs, auscultation of the heart and lungs and the observation of the genitalia. The diagnostic investigations that were ordered also form part of the objective data that supports the assessment.

Diagnostics

The development of accurate diagnosis of the client’s problem can be achieved by performing a number of diagnostic investigations. One of them is skin scrap. A scrap of the pumps can be obtained for laboratory examination. The other investigation is tzank smear to test for herpes simplex. The client should be tested for syphilis using diagnostics such as Darkfield microscopy or enzyme immunoassay (Perry et al., 2021).

Current Diagnosis

The current diagnosis of chancre is accurate. Patients with chancre present with symptoms similar to those of the client in the case study. For example, the ulcers are asymptomatic and can last for a period of up to six weeks (Cox, 2019).

Differential Diagnoses

One of the differential diagnoses that should be considered for the patient in the case study is contact dermatitis. Contact dermatitis is a skin condition that is characterized by symptoms such as the presence of rashes, which are dry, scaly and cracked. It is however the least likely due to the absence of itchiness and oozing or crusting of the rashes. The second differential diagnosis is syphilis. The client has a history of multiple sexual partners, which predisposes her to syphilis. Patients with syphilis also show skin rashes such as chancre in the early stages of syphilis. The last differential diagnosis is herpes simplex. Patients with herpes simplex may have symptoms such as rashes in the genitals (Perry et al., 2021). However, it is least unlikely for the patient due to the lack of symptoms such as lymphadenopathy and fever. [E-USER1] 

Conclusion

The diagnosis of chancre in the case study is accurate. Additional subjective and objective data should be obtained to come up with an accurate diagnosis. Differential diagnoses such as syphilis, herpes simplex, and contact dermatitis should however be considered. In addition, further diagnostic investigations should be performed to come up with an accurate diagnosis.

References

Champagne, B. J., Steele, S. R., Hendren, S. K., Bakaki, P. M., Roberts, P. L., Delaney, C. P., … & MacRae, H. M. (2017). The American Society of Colon and Rectal Surgeons assessment tool for performance of laparoscopic colectomy. Diseases of the Colon & Rectum, 60(7), 738-744.

Cox, C. L. (2019). Physical Assessment for Nurses and Healthcare Professionals. John Wiley & Sons.

DOI: https://doi.org/10.1097/DCR.0000000000000817

Forbes, H., & Watt, E. (2020). Jarvis’s Health Assessment and Physical Examination – E-Book: Australian and New Zealand. Elsevier Health Sciences.

Kohtz, C., Brown, S. C., Williams, R., & O’Connor, P. A. (2017). Physical assessment techniques in nursing education: a replicated study. Journal of Nursing Education, 56(5), 287-291. https://doi.org/10.3928/01484834-20170421-06

Perry, A. G., Potter, P. A., Ostendorf, W., & Laplante, N. (2021). Clinical Nursing Skills and Techniques—E-Book. Elsevier Health Sciences.

Stephen, T. C., & Skillen, D. L. (2020). Canadian Nursing Health Assessment. Lippincott Williams & Wilkins.

 [E-USER1]At least 5 differential diagnosis

Lab Assignment: Assessing the Genitalia and Rectum

Patients are frequently uncomfortable discussing with healthcare professional’s issues that involve the genitalia and rectum; however, gathering an adequate history and properly conducting a physical exam are vital. Examining case studies of genital and rectal abnormalities can help prepare advanced practice nurses to accurately assess patients with problems in these areas.

In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 

WEEKLY RESOURCES

To Prepare

• Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study.
• Based on the Episodic note case study:
  • Review this week’s Learning Resources, and consider the insights they provide about the case study. Refer to Chapter 3 of the Sullivan resource to guide you as you complete your Lab Assignment.
  • Search the Walden library or the Internet for evidence-based resources to support your answers to the questions provided.
  • Consider what history would be necessary to collect from the patient in the case study.
  • 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.

The Lab Assignment

Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature.

• Analyze the subjective portion of the note. List additional information that should be included in the documentation.
• Analyze the objective portion of the note. List additional information that should be included in the documentation.
• Is the assessment supported by the subjective and objective information? Why or why not?
• Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis?
• Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.

Accepting or Rejecting Current Diagnosis Differential Diagnoses

            I would accept the current diagnosis. TS’s complaints align with those seen in patients with urinary tract infections and sexually transmitted infections. Often, patients with these conditions experience dysuria, urgency, frequency, and fever, which are present in TS’s case (Bono et al., 2024). Therefore, additional diagnostic and laboratory tests will help determine if TS is suffering from STDs or UTIs. TS’s history of engaging in unprotected sex with her new partner makes STDs among the probable diagnoses to be considered.

            One of the differential diagnoses that should be considered for TS is perinephric abscess. Perinephric access is a condition that develops from the spread of infections from other regions of the genitourinary tract to the kidneys (Okafor & Onyeaso, 2024). The infections result in the development of abscesses. Patients experience symptoms that include fever, chills, nausea, vomiting, flank pain, and fatigue (Adams et al., 2020). Unlike urinary tract infections or STDs, patients with perinephric abscesses might not experience symptoms such as urinary frequency or dysuria.

            The other differential diagnosis that should be considered for TS is urethral syndrome. Urethral syndrome is a genitourinary condition characterized by urinary frequency, urgency, suprapubic pain, and dysuria. It develops from any condition that causes urethral irritation and inflammation. The urethral syndrome can develop due to sexually transmitted infections, urinary tract infections, or the use of foods that irritate the urethra (Sell et al., 2021). A confirmed diagnosis of either UTI or STD might indicate its co-existence with urethral syndrome.

            The last differential diagnosis that should be considered for TS is kidney stones. Kidney stones develop from crystal deposition in the kidneys. Factors such as dehydration, intake of diets rich in salt, and overweight or obesity predispose individuals to kidney stones. Patients experience symptoms such as severe, sharp back or flank pain, pain radiating to the groin or lower abdominal regions, and dysuria. Patients might also report passing red or brown urine, foul-smelling and cloudy urine, frequency, nausea and vomiting, chills, and fever (Thongprayoon et al., 2020; Wang et al., 2021). The absence of red or brown-colored urine and sharp pain show that kidney stones are not the cause of TS’s complaints.

Conclusion

            Overall, additional subjective and objective information should be obtained in the case study. Subjective and objective data support the assessment. Additional diagnostics and laboratory investigations should be ordered to develop an accurate diagnosis and treatment plan. I accept the current diagnosis based on TS’s symptoms. The three differential diagnoses that should be considered in TS’s case study include kidney stones, urethral syndrome, and perinephric abscess.

By Day 7 of Week 10

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Rubric

NURS_6512_Week_10_Assignment1_Rubric

Criteria	Ratings	Pts
This criterion is linked to a Learning Outcome With regard to the SOAP note case study provided and using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature:·   Analyze the subjective portion of the note. List additional information that should be included in the documentation.	12 to >9.0 pts ExcellentThe response clearly, accurately, and thoroughly analyzes the subjective portion of the SOAP note and lists detailed additional information to be included in the documentation. 9 to >6.0 pts GoodThe response accurately analyzes the subjective portion of the SOAP note and lists additional information to be included in the documentation. 6 to >3.0 pts FairThe response vaguely analyzes the subjective portion of the SOAP note and vaguely and/or inaccurately lists additional information to be included in the documentation. 3 to >0 pts PoorThe response inaccurately analyzes the subjective portion of the SOAP note, with inaccurate and/or missing additional information included in the documentation.	12 pts
This criterion is linked to a Learning Outcome ·   Analyze the objective portion of the note. List additional information that should be included in the documentation.	12 to >9.0 pts ExcellentThe response clearly, accurately, and thoroughly analyzes the objective portion of the SOAP note and lists detailed additional information to be included in the documentation. 9 to >6.0 pts GoodThe response accurately analyzes the objective portion of the SOAP note and lists additional information to be included in the documentation. 6 to >3.0 pts FairThe response vaguely analyzes the objective portion of the SOAP note and vaguely and/or inaccurately lists additional information to be included in the documentation. 3 to >0 pts PoorThe response inaccurately analyzes the objective portion of the SOAP note, with inaccurate and/or missing additional information included in the documentation.	12 pts
This criterion is linked to a Learning Outcome ·  Is the assessment supported by the subjective and objective information? Why or why not?	16 to >13.0 pts ExcellentThe response clearly and accurately identifies whether or not the assessment is supported by the subjective and/or objective information, with a thorough and detailed explanation. 13 to >10.0 pts GoodThe response accurately identifies whether or not the assessment is supported by the subjective and/or objective information, with a clear explanation. 10 to >7.0 pts FairThe response vaguely identifies whether or not the assessment is supported by the subjective and/or objective information, with a vague explanation. 7 to >0 pts PoorThe response inaccurately identifies whether or not the assessment is supported by the subjective and/or objective information, with an inaccurate or missing explanation.	16 pts
This criterion is linked to a Learning Outcome ·   What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?	20 to >17.0 pts ExcellentThe response thoroughly and accurately describes appropriate diagnostic tests for the case and explains clearly, thoroughly, and accurately how the test results would be used to make a diagnosis. 17 to >14.0 pts GoodThe response accurately describes appropriate diagnostic tests for the case and explains how the test results would be used to make a diagnosis. 14 to >11.0 pts FairThe response vaguely and/or with some inaccuracy describes appropriate diagnostic tests for the case and vaguely and/or with some inaccuracy explains how the test results would be used to make a diagnosis. 11 to >0 pts PoorThe response inaccurately describes appropriate diagnostic tests for the case, with an inaccurate or missing explanation of how the test results would be used to make a diagnosis.	20 pts
This criterion is linked to a Learning Outcome ·   Would you reject or accept the current diagnosis? Why or why not?·   Identify three possible conditions that may be considered as a differenial diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.	25 to >22.0 pts ExcellentThe response states clearly whether to accept or reject the current diagnosis, with a thorough, accurate, and detailed explanation of sound reasoning. The response clearly, thoroughly, and accurately identifies three conditions as a differential diagnosis, with reasoning that is explained clearly, accurately, and thoroughly using three or more different references from current evidence-based literature. 22 to >19.0 pts GoodThe response states whether to accept or reject the current diagnosis, with an accurate explanation of sound reasoning. The response accurately identifies three conditions as a differential diagnosis, with reasoning that is explained using three different references from current evidence-based literature. 19 to >16.0 pts FairThe response states whether to accept or reject the current diagnosis, with a vague explanation of the reasoning. The response identifies two to three conditions as a differential diagnosis, with reasoning that is explained vaguely and/or inaccurately using three or fewer references from current evidence-based literature. 16 to >0 pts PoorThe response inaccurately states or is missing a statement of whether to accept or reject the current diagnosis, with an explanation that is inaccurate and/or missing. The response identifies three or fewer conditions as a differential diagnosis, with reasoning that is missing or explained inaccurately using two or fewer references from current evidence-based literature.	25 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.	5 to >4.0 pts ExcellentParagraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 4 to >3.0 pts GoodParagraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. 3 to >2.0 pts FairParagraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic. 2 to >0 pts PoorParagraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.	5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation	5 to >4.0 pts ExcellentUses correct grammar, spelling, and punctuation with no errors. 4 to >3.0 pts GoodContains a few (1 or 2) grammar, spelling, and punctuation errors. 3 to >2.0 pts FairContains several (3 or 4) grammar, spelling, and punctuation errors. 2 to >0 pts PoorContains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.	5 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.	5 to >4.0 pts ExcellentUses correct APA format with no errors. 4 to >3.0 pts GoodContains a few (1 or 2) APA format errors. 3 to >2.0 pts FairContains several (3 or 4) APA format errors. 2 to >0 pts PoorContains many (≥ 5) APA format errors.	5 pts
Total Points: 100

Submission

Submitted!

Nov 4, 2023 at 8:01am

Submission Details

Download WK10Assgn1JacksonL.docx

Grade: 97 (100 pts possible)

Graded Anonymously: no

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Comments:

WEEK 10 ASSIGNMENT For this Assignment you were to write a paper using narrative/paragraphs to answer the questions per RUBRIC. 1. Analyze the subjective portion of the note. List additional information that should be included in the documentation. COMMENT: You Listed additional information that should be included in the documentation. There is a lot of information in the Subjective area that could have been added. NOT SURE WHY YOU NUMBERED THE INFORMATION 2. Analyze the objective portion of the note. List additional information that should be included in the documentation. COMMENT: You Listed additional information that should be included in the documentation. 3. Is the assessment supported by the subjective and objective information? Why or why not? COMMENT: You answered whether the assessment was supported by the subjective and objective information. 4. What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis? COMMENT: You listed diagnostics that would be appropriate for this case and mentioned how the results would be used to make a diagnosis. 5. Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature COMMENT: You rejected/accepted the current diagnosis. You indicated why or why not You Did Identify three possible conditions OTHER THAN UTI AND STI that may be considered as a differential diagnosis for this patient. You Did Explain your reasoning using at least three different references from current evidence-based literature. Dr. Lewis