1. Assessing the Ears, Nose, and Throat Essay
Assessing the Ears, Nose, and Throat EssayDiscussion: 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.Assessing
the Ears, Nose, and Throat Essay. 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
2. 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. Assessing the Ears, Nose,
and Throat Essay. 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. 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 5 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. d Readings Note: To access this
week's required library resources, please click on the link to the Course Readings List,
found in the Course Materials section of 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 10, “Head and Neck” (pp. 184-203) This chapter reviews
the anatomy and physiology of the head and neck. Assessing the Ears, Nose, and Throat
Essay. The authors also describe the procedures for conducting a physical examination of
the head and neck. Chapter 11, “Eyes” (pp. 204-230) In this chapter, the authors describe
the anatomy and function of the eyes. In addition, the authors explain the steps involved in
conducting a physical examination of the eyes. Chapter 12, “Ears, Nose, and Throat” (pp.
231-259) The authors of this chapter detail the proper procedures for conducting a physical
exam of the ears, nose, and throat.ORDER A PLAGIARISM- FREE PAPER NOWThe chapter
also provides pictures and descriptions of common abnormalities in the ears, nose, and
throat. 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 15,
“Earache” (pp. 174–183) This chapter covers the main questions that need to be asked
about the patient’s condition prior to the physical examination, as well as how these
questions lead to a focused physical examination. Chapter 21, “Hoarseness” (pp. 248-255)
This chapter focuses on the most common causes of hoarseness. It provides strategies for
evaluating the patient both through questions and through physical exams. Chapter 25,
“Nasal Symptoms and Sinus Congestion” (pp.301-309) In this chapter, the authors highlight
the key questions to ask about the patients symptoms, the key parts of the physical
examination, and potential laboratory work that might be needed to provide an accurate
3. diagnosis of nasal and sinus conditions. Chapter 30, “Red Eye” (pp. 357-368) The focus of
this chapter is on how to determine the cause of red eyes in a patient, including key
symptoms to consider and possible diagnoses. Chapter 32, “Sore Throat” (pp. 381-389) A
sore throat is one most common concerns patients describe. This chapter includes
questions to ask when taking the patient’s history, things to look for while conducting the
physical exam, and possible causes for the sore throat. Chapter 38, “Vision Loss” (pp. 446-
457) This chapter highlights the causes of vision loss and how the causes of the condition
can be diagnosed. My topic is focus only on case # 2. Assessing the Ears, Nose, and Throat
EssayCase 2: Focused Throat ExamName: LilyDate:12/27/18Time: 8:00
am Age:20Sex:FSUBJECTIVECC: “I’m havinga sore throat for three days ”HPI: This is a
20years old student at the local community collegewho comes to the clinic today at 8.00pm
complaining of having a sore throat for three days. She also stated that the symptoms began
three days ago when she noticed decreased appetite, headache and pain with swallowing.
The patient admits episodes of swollen tonsils, and slight hoarseness in her voice but
doesn’t sound congested. Additionally, as the patient recounts these symptoms, I noticed
that she has a runny noseMedications: None PMHthe patient has no past medical
history.Allergies: N/AMedication Intolerances: N/AChronic Illnesses/Major traumas:
decreased appetite, headache and pain with swallowing and slight hoarseness in her
voice.Hospitalizations/Surgeries.None.Assessing the Ears, Nose, and Throat Essay Family
History: Father (alive) diabetes; Mother (alive) healthy.Social History.Sheis a student at the
local community college. She also reports she is benefiting much from her studies. She lives
in a dorm on campus. She agrees to drink alcohol on the weekends but denies smoking
tobacco. She also agrees her family is supportive and has adequate food and shelter.Diet:
She states “I have difficulty in swallowing and the pain worsen with talking or
swallowing.”Exercise and Leisure: she does not do any exercises. Sleep:She states that he
does not sleep well due to pain sensation in the throat.Immunization: Received flu vaccine
in October 2015.Environmental hazard: Agrees taking alcoholROS specific to sore
throatGeneral. The patient experienced nausea and vomiting with swollen throat but denies
headache. The patient denies skin changes, cough, and shortness of breath and weight
changes.Fever/Chills. The patient admits having fever. Appetite.The patient admits she does
not have much of appetite now.Voice. The patient admits havinga horse voice. Lymph
Nodes.The patientdenies swollen lymph nodes.Halitosis.The patientis not sure but admits
having a kind of a gross taste in her mouth and feels like it smells.Throat.The patient admits
having hoarseness, or throat pain.CNS; patient denies headache and confusion.Assessing the
Ears, Nose, and Throat EssayOBJECTIVEWeight 121 BMI21.6Temp95.8BP120/70Height
5’1Pulse81Resp15General Appearance.An adult female that is able to answer questions
appropriately and active. She is well dressed. The patient is very cooperative in regards to
all aspects of the examination.Skin. Skin is clean. No rushes of lesions noted.Cardiovascular.
Pulses 3+ throughout. S1, S2 with regular rate and rhythm. No peripheral edema.Presence
of extra sounds and murmurs.Respiratory.Respirations not regular. Symmetric chest
wall.Throat.Havehoarseness, or throat pain.Psychiatric.Cooperative, Maintains eye contact,
dressed well and answers questions correctly.Lab Tests. Antisteroptolysin Special
Tests.Throat swab ASSESSMENT FINDINGS AND PLANDiagnosis. Differential diagnosis.IM
4. (Infectious Mononucleosis): IM present similar symptoms to bacterial sore throat infections
and is common in young adults (Akhtar et al. 2018). In this case, IM is of particular concern
because the patient’s age, and pain during swallowing which could also indicate a common
IM finding known as splenomegaly.Streptococcal tonsillopharyngitis: this patient’s sudden
onset sore throat, decreased Appetite, headaches, and pain with swallowing meet the
microbial testing criteria for GAS (group A streptococcal Pharyngitis) if It is found positive,
it should get treated with antibiotics(Mistik,Gokahmetoglu, Balci, &Onuk, 2015).Viral
Pharyngitis:this could be the cause of the patient’s sore throathowever; it is less likely due
to lack of cold symptoms.Upper respiratory infection: this patient’s symptoms meet Upper
respiratory infection testing criteria.Assessing the Ears, Nose, and Throat
EssayLaryngitis:the patient’sslight voice hoarseness meets Laryngitis testing criteria
(Akhtar et al. 2018).Z723 lack of physical exerciseR 110-nausea and vomitingZ 724
Inappropriate eating habitsMedication: Acetaminophen to provide pain relief and reduce
fever if a patient sore throat is caused by infection (Sadeghirad et al.
2017).Education:education includes teaching the patient home remedies for a sore throat.
Thisincludes instructing the patient to follow ways to feel better when having a sore throat
which includes: Gargling with warm water, to soothe a scratchy sore throat, use of OTC pain
reliefs, and consuming a drop of honeyto soothe the irritated throat. Instruct the patient to
stay hydrated because staying dehydrated is an essential part of sore throat treatment
(Mistik,Gokahmetoglu, Balci, &Onuk, 2015). When the patient gets dehydrated, her body
will not be able to produce enough mucus and saliva causing inflammation and swelling
(Ball et al. 2015). Advice the patient that water is the best choice to help her gets hydrated.
Also, instruct the patient to have a steam shower and breathe in steam from warm
showers(Akhtar et al. 2018). This will help the patient to ease the pain of sore throat and
reduce swelling. Instruct the patient to raise her head whenever the congestion comes with
the sore throat. This will help the patient to breathe easier.Follow-up: Labs collected today
will be sent to Lab.Referral: have the patient return and do further laboratory test if the
symptoms do not resolve .Patient encounter evaluation: due to my experience, experience
with this patient was of a great learning. Also, this case discussion enabled me to establish a
sore throat differential diagnosis considering the risk factors. I also learnt the benefits of
treating a patient with sore throat disease. Assessing the Ears, Nose, and Throat
Essay ReferencesAkhtar, M., Van Heukelom, P. G., Ahmed, A., Tranter, R. D., White, E.,
Shekem, N., ...& Mohr, N. M. (2018). Telemedicine Physical Examination Utilizing a
Consumer Device Demonstrates Poor Concordance with In-Person Physical Examination in
Emergency Department Patients with Sore Throat: A Prospective Blinded
Study. Telemedicine and e-Health.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.Mistik, S., Gokahmetoglu, S., Balci, E., &Onuk, F. A. (2015).Sore throat in primary care
project: a clinical score to diagnose viral sore throat. Family practice, 32(3), 263-
268.Sadeghirad, B., Siemieniuk, R. A., Brignardello-Petersen, R., Papola, D., Lytvyn, L.,
Vandvik, P. O., ...&Agoritsas, T. (2017). Corticosteroids for treatment of sore throat:
systematic review and meta-analysis of randomised trials. bmj, 358, j3887. Assessing the
Ears, Nose, and Throat Essay
