ENT_within_Primary_Care_-_Ears[807] (1).pptx
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A 36-year-old male presented with earache symptoms for 3-4 weeks. On examination, the physician noticed debris and inflammation in the right ear canal, as well as a perforation in the attic area of the right eardrum. The patient has a history of recurrent ear infections and type 1 diabetes. Differential diagnoses could include chronic suppurative otitis media or cholesteatoma. Further examination may involve an ear swab to check for infection given the debris and perforation seen. The patient's diabetes and history of recurrent infections increase his risk for recurrent ear problems.
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Ears, Nose, Throat, Eye and Vision lecture A slides
Ears, Nose, Throat, Eye and Vision lecture A slides
PEDIATRIC FILLABLE SOAP NOTE TEMPLATE PEDIATRIC FILLABLE SOAP NO.docx
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STUDENT NAME:
DATE OF ASSIGNMENT: 05/11/2020
Patient Initials: J.T.
Date of Encounter: 05/06/2020
Sex: Male
Age/DOB/Place of Birth: 12yo, DOB: 05/03/2008, Miami, FL
SUBJECTIVE
Historian: Patient J.T.
Present Concerns/CC: “My throat has been hurting recently”
Reason given by the patient for seeking medical care “in quotes”
Child Profile: (Sexual History (If appropriate); ADLs (age appropriate); Safety Practices; Changes in daycare/school/after-school care;
Sports/physical activity; Developmental Hx)
Patient is sexually inactive, a student at a local middle school, spends his time at home due to the COVID-19 pandemic, otherwise he enjoys playing videogames with his friends all day. The patient spends all of his time at home recently due to the pandemic but would otherwise go out with her family and friends sometimes.
HPI: (must include all components - OLD CARTS)
Patients throat began to hurt 2 days ago. It worsened over the past day, but he states that it is now around the same as yesterday. He states that he can still swallow food and drink, but it hurts when it passes his throat. It is present at all times of day, from when he wakes up, to when he goes to bed. The pain is localized at the back of this throat. It is dull and described as a 3/10. His mother has given him a honey and lime mixture that he states helps for a short while.
Medications: (List with reason for meds)
Patient not currently taking any medication
PMH:
Allergies: Dog hair, cat hair
Medication Intolerances:
None
Chronic Illnesses/Major traumas:
None
Hospitalizations/Surgeries:
None
Immunizations: All vaccines up to date with the exception of the most recent influenza vaccine.
Family History (please identify all immediate family)
Mother: 32 years old, no current health problems
Father: 34 years old, no current health problems
Social History (Education level, occupational history, current living situation/partner/marital status, substance use/abuse, ETOH, tobacco, and marijuana. Safety status)
Middle school student. Does not work. Lives with his parents and 2 brothers, one 6, the other 2 years old. Parents are married. Does not drink alcohol. Does not use recreational drugs, does not use tobacco products, does not smoke, does not vape. The patient states feeling safe at home with his family.
Review of Systems (ROS)
General
Denies fevers, chills, nausea, and vomiting
Cardiovascular
Denies chest pain, pressure, palpitations
Skin
Denies lesions, itching, or redness.
Respiratory
Denies shortness of breath, denies cough, denies difficulty breathing
Eyes
Denies blurred vision, denies visual loss, denies double vision
Gastrointestinal
Denies nausea and vomiting, denies abdominal pain, denies diarrhea, and bloody stools.
Ears
Denies hearing loss, pain, or dra.
Tinnitus
Tinnitus is a hearing of ringing, buzzing, hissing, or roaring sounds that originated in the ear.It is caused due to damage of inner cell and it is associated with damage to the auditory system and related with others factors such as the jaw, head, or neck injury, exposure to certain drugs, nerve damage or blood-flow problems.
Tinnitus
Tinnitus is a hearing of ringing, buzzing, hissing, or roaring sounds that originated in the ear.It is caused due to damage of inner cell and it is associated with damage to the auditory system and related with others factors such as the jaw, head, or neck injury, exposure to certain drugs, nerve damage or blood-flow problems.
Comment by Morgan, Dorothy Tali Do not forget to include a runni
Comment by Morgan, Dorothy Tali: Do not forget to include a running head to follow APA guidelines
Health History
Yensi Aguilar
Benjamin Leon School of nursing
NUR1060C: Adult Health Assessment
Professor Dorothy Morgan
April 7, 2021
Health History
Identifying data
Date of history: 28/02/2021
Examiner: Yensi Aguilar
Name: L.P.
Address: 3403 SW 6h Street
Phone Number: 786-597-3071
Age:46
Sex: Female
Race: White
Place of Birth: Honduras
Marital Status: Married
Significant Other: Husband
Occupation: Teacher
Religion: Christian
Primary Language: Spanish
Secondary Language: English
Source of referral: The patient found the hospital’s address on the internet
Source of history: Documents with the patient’s health history gave information concerning the patient. The patient also talked concerning her health status.
Reliability: Currently, the patient seems to have a stable mental and physical state.
Chief Complaints/Reasons for Visit: According to the patient, she started experiencing high fever, blood-stained sputum, night sweats, coughing, and weight loss.
Present Illness
Time of onset: according to the patient, she started experiencing symptoms two weeks ago.
Type of onset: The patient says that she started by occasionally sweating, mild cough, headache, and pain in the abdomen area. Over time, these conditions became severe.
Original Source: The patient complains of pain in her chest and respiratory tract.
Severity: During the day, the patient does not feel many discomforts, but it becomes worse at night due to lower temperatures. Hence, the condition does not deter the patient from executing tasks during the day. The severity of her state is at 5 out of 10 on a 0-to-10-point scale.
Radiation: At night, the patient feels severe pain throughout her chest region
Time Relationship: At first, this condition was still developing and was easy to handle. However, it has evolved and has gotten worse.
Duration: It has been two weeks since the patient started experiencing the symptoms.
Association: The symptoms experienced by the patient are similar to those of flu.
Source of Relief: According to the patient, she feels better when resting after doing some light physical exercise.
Source of Aggravation: The symptoms become worse during the night. Again, exposure to allergens such as dust or cold increases the symptom’s severity.
Past History
General State of Health: The patient’s general condition is fair, considering she is suffering from a chronic illness.
Childhood Illnesses: She suffered from smallpox and measles as a child
Adult Illnesses: Hypertension, Anemia, and asthma
Psychiatric Illnesses: She has experienced mild depression in the past
Accidents and Injuries: Never had an accident or injuries
Operations: The patient denies any surgical operations
Hospitalizations: After visiting the hospital, the patient got an admission to the Jackson Hospital for one week to undergo treatment for asthma and hyper ...
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Ears, Nose, Throat, Eye and Vision lecture A slides
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PEDIATRIC FILLABLE SOAP NOTE TEMPLATE PEDIATRIC FILLABLE SOAP NO.docx
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STUDENT NAME:
DATE OF ASSIGNMENT: 05/11/2020
Patient Initials: J.T.
Date of Encounter: 05/06/2020
Sex: Male
Age/DOB/Place of Birth: 12yo, DOB: 05/03/2008, Miami, FL
SUBJECTIVE
Historian: Patient J.T.
Present Concerns/CC: “My throat has been hurting recently”
Reason given by the patient for seeking medical care “in quotes”
Child Profile: (Sexual History (If appropriate); ADLs (age appropriate); Safety Practices; Changes in daycare/school/after-school care;
Sports/physical activity; Developmental Hx)
Patient is sexually inactive, a student at a local middle school, spends his time at home due to the COVID-19 pandemic, otherwise he enjoys playing videogames with his friends all day. The patient spends all of his time at home recently due to the pandemic but would otherwise go out with her family and friends sometimes.
HPI: (must include all components - OLD CARTS)
Patients throat began to hurt 2 days ago. It worsened over the past day, but he states that it is now around the same as yesterday. He states that he can still swallow food and drink, but it hurts when it passes his throat. It is present at all times of day, from when he wakes up, to when he goes to bed. The pain is localized at the back of this throat. It is dull and described as a 3/10. His mother has given him a honey and lime mixture that he states helps for a short while.
Medications: (List with reason for meds)
Patient not currently taking any medication
PMH:
Allergies: Dog hair, cat hair
Medication Intolerances:
None
Chronic Illnesses/Major traumas:
None
Hospitalizations/Surgeries:
None
Immunizations: All vaccines up to date with the exception of the most recent influenza vaccine.
Family History (please identify all immediate family)
Mother: 32 years old, no current health problems
Father: 34 years old, no current health problems
Social History (Education level, occupational history, current living situation/partner/marital status, substance use/abuse, ETOH, tobacco, and marijuana. Safety status)
Middle school student. Does not work. Lives with his parents and 2 brothers, one 6, the other 2 years old. Parents are married. Does not drink alcohol. Does not use recreational drugs, does not use tobacco products, does not smoke, does not vape. The patient states feeling safe at home with his family.
Review of Systems (ROS)
General
Denies fevers, chills, nausea, and vomiting
Cardiovascular
Denies chest pain, pressure, palpitations
Skin
Denies lesions, itching, or redness.
Respiratory
Denies shortness of breath, denies cough, denies difficulty breathing
Eyes
Denies blurred vision, denies visual loss, denies double vision
Gastrointestinal
Denies nausea and vomiting, denies abdominal pain, denies diarrhea, and bloody stools.
Ears
Denies hearing loss, pain, or dra.
Tinnitus
Tinnitus is a hearing of ringing, buzzing, hissing, or roaring sounds that originated in the ear.It is caused due to damage of inner cell and it is associated with damage to the auditory system and related with others factors such as the jaw, head, or neck injury, exposure to certain drugs, nerve damage or blood-flow problems.
Tinnitus
Tinnitus is a hearing of ringing, buzzing, hissing, or roaring sounds that originated in the ear.It is caused due to damage of inner cell and it is associated with damage to the auditory system and related with others factors such as the jaw, head, or neck injury, exposure to certain drugs, nerve damage or blood-flow problems.
Comment by Morgan, Dorothy Tali Do not forget to include a runni
Comment by Morgan, Dorothy Tali: Do not forget to include a running head to follow APA guidelines
Health History
Yensi Aguilar
Benjamin Leon School of nursing
NUR1060C: Adult Health Assessment
Professor Dorothy Morgan
April 7, 2021
Health History
Identifying data
Date of history: 28/02/2021
Examiner: Yensi Aguilar
Name: L.P.
Address: 3403 SW 6h Street
Phone Number: 786-597-3071
Age:46
Sex: Female
Race: White
Place of Birth: Honduras
Marital Status: Married
Significant Other: Husband
Occupation: Teacher
Religion: Christian
Primary Language: Spanish
Secondary Language: English
Source of referral: The patient found the hospital’s address on the internet
Source of history: Documents with the patient’s health history gave information concerning the patient. The patient also talked concerning her health status.
Reliability: Currently, the patient seems to have a stable mental and physical state.
Chief Complaints/Reasons for Visit: According to the patient, she started experiencing high fever, blood-stained sputum, night sweats, coughing, and weight loss.
Present Illness
Time of onset: according to the patient, she started experiencing symptoms two weeks ago.
Type of onset: The patient says that she started by occasionally sweating, mild cough, headache, and pain in the abdomen area. Over time, these conditions became severe.
Original Source: The patient complains of pain in her chest and respiratory tract.
Severity: During the day, the patient does not feel many discomforts, but it becomes worse at night due to lower temperatures. Hence, the condition does not deter the patient from executing tasks during the day. The severity of her state is at 5 out of 10 on a 0-to-10-point scale.
Radiation: At night, the patient feels severe pain throughout her chest region
Time Relationship: At first, this condition was still developing and was easy to handle. However, it has evolved and has gotten worse.
Duration: It has been two weeks since the patient started experiencing the symptoms.
Association: The symptoms experienced by the patient are similar to those of flu.
Source of Relief: According to the patient, she feels better when resting after doing some light physical exercise.
Source of Aggravation: The symptoms become worse during the night. Again, exposure to allergens such as dust or cold increases the symptom’s severity.
Past History
General State of Health: The patient’s general condition is fair, considering she is suffering from a chronic illness.
Childhood Illnesses: She suffered from smallpox and measles as a child
Adult Illnesses: Hypertension, Anemia, and asthma
Psychiatric Illnesses: She has experienced mild depression in the past
Accidents and Injuries: Never had an accident or injuries
Operations: The patient denies any surgical operations
Hospitalizations: After visiting the hospital, the patient got an admission to the Jackson Hospital for one week to undergo treatment for asthma and hyper ...
SOAP Note Week TwoUnited States University.docx
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United States University
FNP592: Common Illnesses Across the Lifespan
Dr. Theresa Gress
October 1, 2020
SOAP Note Week Three
ID: Mickey Mouse, DOB 1/1/2000, age 20, white Hispanic male presents to the clinic unaccompanied and appears to be a reliable historian.
S:
CC: “Cough, runny nose, and sore throat x 7 days”
HPI: New Asian male patient 28 yo presents to the clinic unaccompanied, complaining of non-productive cough, runny nose and sore throat x 7 days (1/7/2020). Currently somewhat controlling symptoms with Dayquil and Nyquil. Cough mild, worsened when laying flat. Highest temp at home 99 degrees. Patient wondering if he needs antibiotics. Rates pain in throat as 4/10, described as “aching, swallowing makes it worse”, relieved by Dayquil/nyquil. Denies headache, denies sick contacts or recent travel. Denies feeling worse outdoors or seasonally. He is a reliable historian
PMH:
Allergies: No known drug allergies. Strawberries (rash), seasonal allergies
Childhood: Asthma until high school, chickenpox at age 2
Surgical: Tonsillectomy (1998), Wisdom Teeth Removal (2005)
Medications: None
Vaccinations: received childhood vaccines, Last flu shot given Oct 2019.
Denies psychiatric history.
Social History:
Denies tobacco/e-cigarette use. Admits to occasional once every 2-3 months alcohol use – last drink
2 months ago, Engaged, works in IT, Hobbies include archery.
Family History:
Mother died age 60-Diabetes II
Sister 42yo living -HTN
Maternal Grandma died age 67- Dementia
ROS:
General: No weight change, weakness, fatigue, fevers..
Eyes: no vision change, corrective lenses, pain redness, excessive tearing, double vision, blurred vision, or blindness.
EarsNose/Throat/mouth: no hearing change, tinnitus, earaches, infection, discharge. POSITIVE FOR RHINORRHEA. No sinus pain or epistaxis. POSITIVE FOR SORE THROAT, HOARSE VOICE. No bleeding gums, dentures, sore tongue, dry mouth. Last dental exam was 4 months ago.
C/V: Denies chest pain, palpitations.
Pulmonary: POSITIVE FOR NON-PRODUCTIVE COUGH, negative hemoptysis, dyspnea, wheezing, pleuritic pain
Neuro: No headache, dizziness, focal numbness/weakness, nausea, vomiting.
Lymph: Denies swollen lymph nodes in neck.
Allergy/immunology: Denies seasonal allergies or allergy to pets, pollen or other. Denies frequent illness.
O:
VS: T – 98 P – 80 R – 16 BP – 128/72 O2 sat – 99% - 4/10 pain in throat. Wt: 205 Ht: 72 in BMI: 27.8
Skin: Natural in color, warm, smooth and dry. Good skin turgor, no lesions, rashes, ecchymosis or moles. Nails without clubbing or cyanosis.
HEENT:
Ears: pinna clean, no exudate noted. TM intact and pearly gray with cone of light bilat.
Nose: nasal mucosa pink and moist. Inferior turbinates slightly reddened bilat. Nares patent bilat. No sinus pain upon palpation. Septum midline.
Throat: oral mucosa pink and moist, tongue mobile without lesions, tonsils absent. Post.
Discussion Question 1Children and adults often present with compla.docx
Discussion Question 1
Children and adults often present with complaints of ear pain. Your differential diagnoses should include otitis media and otitis externa, in addition to other possibilities such as foreign body obstruction and cerumen impactions. Give a brief overview of otitis media and otitis externa, including signs and symptoms of the most common causative agents for both. In addition, discuss the physical exam findings that you might see with the conditions when visualizing various parts of the ear such as ear canal or the tympanic membrane. How will your assessment of the ear differ in children versus adults? What would be essential health history questions to ask patients that present with ear pain and why? Support your answers with appropriate references.
Discussion Question 2
Discuss the physical assessment of a patient who presences with the complaint of cervical lymphadenopathy. What are the specific lymph nodes that you will assess? How do you palpate the lymph nodes and what are the normal versus abnormal findings? In the presence of abnormal findings, what diagnostic tests would you order and why? Also, what are the possible differential diagnoses and would your recommendations differ for adult, pediatric, and geriatric patients?
.
APA format for SOAP NOTE 3 peer review articles 1 and half pages lon
APA format for SOAP NOTE 3 peer review articles 1 and half pages long please follow below instructions
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
case Study #3 Martha brings her 11-year old grandson, James, to your clinic to have his right ear checked
S
Cc: “Earache right ear”
HPI: Patient is an 11-year-old Caucasian boy who was brought in by his grandmother after complaining about having a mild earache for the past two days. Patient states that the pain is worse when he falls asleep and that it has become harder for him to hear, grandmother believes that he feels warm but has not taken his temperature
Medications: Patient does not take any medications
PMH: No significant illnesses, shots are up to date
FH: No history of previous ear concerns no family history of ear disease. During the school year, patient lives at home with his mother, father and he does not have pets. Patient is staying with grandmother and grandfather most of summer
SH: Student in public school and is currently on summer break, has been spending a lot of time this summer in the pool per his grandmother that he is spending the summer with.
ROS: general: negative for chills fever currently
EENT: complains of mild right ear pain and mild hearing loss, denies tinnitus, denies pain in throat, or eye pain
O
VS: T 100.8, P 94, R 18, BP 98/64
General: Patient appears to be in mild pain, holding head to right side slightly
HEENT: right tympanic membrane obscured, ear canal is read and has a musty odor from ear canal with small amount of watery drainage, head is normocephalic without signs of trauma, no nasal drainage, PEARL, no complaints of sore throat, no redness in throat
SKIN: Warm and dry, good skin turgor, prominent tan
NECK: No lymph node edema or signs of pain on palpation
NEUROLOGICAL: No complaints of headache or dizziness
Diagnostic results. WBC slightly elevated, low grade temp
A
Differential Diagnoses:
1) Acute Otitis Externa
2) Acute Otitis Media
3) Pharyngitis
Primary diagnoses/presumptive diagnoses: Acute otitis media
P – not indicated per template
Assessing for a possible ear infection would require additional information from the patient in addition to a physical assessment of the ear and the patient. Obtaining background information including recent travel, activities, family history, trauma, history of previous illnesses and treatments that have been used for treatment that were successful or not successful.
Diagnostic studies used to diagnose the specific pathogen would include obtaining a culture of purulent drainage, simple otoscopy was mostly used for diagnosing AOM (D’silva, 2013) or a more invasive way of evaluating white blood cell elevation is by completing a CBC which is not used as often as visual inspection of the ear canal. White blood cell count (WBC), a cl ...
Tympanic Membraneby Lisa MikeFILET IME SUBMIT T ED 1.docx
Tympanic Membrane
by Lisa Mike
FILE
T IME SUBMIT T ED 17 - DEC- 2016 12:02PM
SUBMISSION ID 7 54 4 537 7 9
WORD COUNT 14 00
CHARACT ER COUNT 7 57 8
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%4
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%34
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1 %30
2 %2
3 %1
4 %1
5 %1
EXCLUDE QUOT ES OFF
EXCLUDE
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OFF
EXCLUDE MAT CHES OFF
Tympanic Membrane
ORIGINALITY REPORT
PRIMARY SOURCES
Submitted to EDMC
St udent Paper
Submitted to AUT University
St udent Paper
journals.lww.com
Int ernet Source
etheses.bham.ac.uk
Int ernet Source
ukplatinumessays.com
Int ernet Source
Tympanic Membraneby Lisa MikeTympanic MembraneORIGINALITY REPORTPRIMARY SOURCES
1
Running head: WEEK TWO ASSIGNMENT TWO
8
WEEK TWO ASSIGNMENT TWO
Week Two Assignment Two: Tympanic Membrane and Thyroid Gland
Sample Student Paper
South University
NSG 3012
Week Two Assignment Two: Tympanic Membrane and Thyroid Gland
Conducting a thorough examination of the tympanic membrane and thyroid gland can identify the cause of presenting symptoms. When a patient reports ear pain, blockage, loss of hearing, and/or ear ringing the nurse will need to perform a thorough assessment to identify the cause. Tympanic ear perforation is one issue that may be identified. Additionally, when a patient reports recent weight loss, weight gain, hair loss, fatigue, irritability, and sensitivity to heat or cold, the nurse may suspect thyroid problems and will examine the thyroid. Dysfunction of the thyroid can lead to many problems, hypothyroidism is one such issue, caused by the thyroid not producing the thyroid hormone (Jarvis, 2016). An overview of the tympanic membrane and thyroid gland will be discussed to further detail the associated assessments.
Health History One
A 19-year-old Hispanic male presents to the primary care office with a constant earache lasting three days. He describes the dulling pain as deep in his left ear. He rates the pain as a 10 out of 10. He has a temperature of 101.1. It is suspected the patient may have an ear infection. The patient reports a history of ear infections. Patient denies hearing loss, discharge, ringing or buzzing, and/or ear injury.
Findings for Tympanic Membrane
Examination of the ear are mainly performed using inspection and palpation (Jarvis, 2016). The client was seated on the exam table, with the examiner’s head at the same level as the client’s. The examiner begins by inspecting both auricles for abnormalities. No abnormalities were noted, but the left ear is red in color. The auricles and mastoid areas were palpated to check for swelling, tenderness, or nodules. The left ear was tender to touch. When using an otoscope, the provider is examining the external auditory canal and tympanic membrane. When inspecting the pinna, it is important to look for lesions (Kalyanakrishnan, Sparks, & Berryhill, 2007). Inspecting the canal, the examiner is looking f ...
What is this tinnitus
Ear harm and exposure to loud noises are common causes of tinnitus. Lesser-known causes embody medications and thyroid disease. It’s not invariably doable for a doctor to spot the cause, however varied treatments are available. symptom is that the medical term for “ringing within the ears.”
Chronic Rhinosinusitis with Nasal Polyposis grade III right
Chronic Rhinosinusitis with Nasal Polyposis grade III right, grade II left
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SOAP Note Week TwoUnited States University.docx
SOAP Note Week Two
United States University
FNP592: Common Illnesses Across the Lifespan
Dr. Theresa Gress
October 1, 2020
SOAP Note Week Three
ID: Mickey Mouse, DOB 1/1/2000, age 20, white Hispanic male presents to the clinic unaccompanied and appears to be a reliable historian.
S:
CC: “Cough, runny nose, and sore throat x 7 days”
HPI: New Asian male patient 28 yo presents to the clinic unaccompanied, complaining of non-productive cough, runny nose and sore throat x 7 days (1/7/2020). Currently somewhat controlling symptoms with Dayquil and Nyquil. Cough mild, worsened when laying flat. Highest temp at home 99 degrees. Patient wondering if he needs antibiotics. Rates pain in throat as 4/10, described as “aching, swallowing makes it worse”, relieved by Dayquil/nyquil. Denies headache, denies sick contacts or recent travel. Denies feeling worse outdoors or seasonally. He is a reliable historian
PMH:
Allergies: No known drug allergies. Strawberries (rash), seasonal allergies
Childhood: Asthma until high school, chickenpox at age 2
Surgical: Tonsillectomy (1998), Wisdom Teeth Removal (2005)
Medications: None
Vaccinations: received childhood vaccines, Last flu shot given Oct 2019.
Denies psychiatric history.
Social History:
Denies tobacco/e-cigarette use. Admits to occasional once every 2-3 months alcohol use – last drink
2 months ago, Engaged, works in IT, Hobbies include archery.
Family History:
Mother died age 60-Diabetes II
Sister 42yo living -HTN
Maternal Grandma died age 67- Dementia
ROS:
General: No weight change, weakness, fatigue, fevers..
Eyes: no vision change, corrective lenses, pain redness, excessive tearing, double vision, blurred vision, or blindness.
EarsNose/Throat/mouth: no hearing change, tinnitus, earaches, infection, discharge. POSITIVE FOR RHINORRHEA. No sinus pain or epistaxis. POSITIVE FOR SORE THROAT, HOARSE VOICE. No bleeding gums, dentures, sore tongue, dry mouth. Last dental exam was 4 months ago.
C/V: Denies chest pain, palpitations.
Pulmonary: POSITIVE FOR NON-PRODUCTIVE COUGH, negative hemoptysis, dyspnea, wheezing, pleuritic pain
Neuro: No headache, dizziness, focal numbness/weakness, nausea, vomiting.
Lymph: Denies swollen lymph nodes in neck.
Allergy/immunology: Denies seasonal allergies or allergy to pets, pollen or other. Denies frequent illness.
O:
VS: T – 98 P – 80 R – 16 BP – 128/72 O2 sat – 99% - 4/10 pain in throat. Wt: 205 Ht: 72 in BMI: 27.8
Skin: Natural in color, warm, smooth and dry. Good skin turgor, no lesions, rashes, ecchymosis or moles. Nails without clubbing or cyanosis.
HEENT:
Ears: pinna clean, no exudate noted. TM intact and pearly gray with cone of light bilat.
Nose: nasal mucosa pink and moist. Inferior turbinates slightly reddened bilat. Nares patent bilat. No sinus pain upon palpation. Septum midline.
Throat: oral mucosa pink and moist, tongue mobile without lesions, tonsils absent. Post.
Discussion Question 1Children and adults often present with compla.docx
Discussion Question 1
Children and adults often present with complaints of ear pain. Your differential diagnoses should include otitis media and otitis externa, in addition to other possibilities such as foreign body obstruction and cerumen impactions. Give a brief overview of otitis media and otitis externa, including signs and symptoms of the most common causative agents for both. In addition, discuss the physical exam findings that you might see with the conditions when visualizing various parts of the ear such as ear canal or the tympanic membrane. How will your assessment of the ear differ in children versus adults? What would be essential health history questions to ask patients that present with ear pain and why? Support your answers with appropriate references.
Discussion Question 2
Discuss the physical assessment of a patient who presences with the complaint of cervical lymphadenopathy. What are the specific lymph nodes that you will assess? How do you palpate the lymph nodes and what are the normal versus abnormal findings? In the presence of abnormal findings, what diagnostic tests would you order and why? Also, what are the possible differential diagnoses and would your recommendations differ for adult, pediatric, and geriatric patients?
.
APA format for SOAP NOTE 3 peer review articles 1 and half pages lon
APA format for SOAP NOTE 3 peer review articles 1 and half pages long please follow below instructions
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
case Study #3 Martha brings her 11-year old grandson, James, to your clinic to have his right ear checked
S
Cc: “Earache right ear”
HPI: Patient is an 11-year-old Caucasian boy who was brought in by his grandmother after complaining about having a mild earache for the past two days. Patient states that the pain is worse when he falls asleep and that it has become harder for him to hear, grandmother believes that he feels warm but has not taken his temperature
Medications: Patient does not take any medications
PMH: No significant illnesses, shots are up to date
FH: No history of previous ear concerns no family history of ear disease. During the school year, patient lives at home with his mother, father and he does not have pets. Patient is staying with grandmother and grandfather most of summer
SH: Student in public school and is currently on summer break, has been spending a lot of time this summer in the pool per his grandmother that he is spending the summer with.
ROS: general: negative for chills fever currently
EENT: complains of mild right ear pain and mild hearing loss, denies tinnitus, denies pain in throat, or eye pain
O
VS: T 100.8, P 94, R 18, BP 98/64
General: Patient appears to be in mild pain, holding head to right side slightly
HEENT: right tympanic membrane obscured, ear canal is read and has a musty odor from ear canal with small amount of watery drainage, head is normocephalic without signs of trauma, no nasal drainage, PEARL, no complaints of sore throat, no redness in throat
SKIN: Warm and dry, good skin turgor, prominent tan
NECK: No lymph node edema or signs of pain on palpation
NEUROLOGICAL: No complaints of headache or dizziness
Diagnostic results. WBC slightly elevated, low grade temp
A
Differential Diagnoses:
1) Acute Otitis Externa
2) Acute Otitis Media
3) Pharyngitis
Primary diagnoses/presumptive diagnoses: Acute otitis media
P – not indicated per template
Assessing for a possible ear infection would require additional information from the patient in addition to a physical assessment of the ear and the patient. Obtaining background information including recent travel, activities, family history, trauma, history of previous illnesses and treatments that have been used for treatment that were successful or not successful.
Diagnostic studies used to diagnose the specific pathogen would include obtaining a culture of purulent drainage, simple otoscopy was mostly used for diagnosing AOM (D’silva, 2013) or a more invasive way of evaluating white blood cell elevation is by completing a CBC which is not used as often as visual inspection of the ear canal. White blood cell count (WBC), a cl ...
Tympanic Membraneby Lisa MikeFILET IME SUBMIT T ED 1.docx
Tympanic Membrane
by Lisa Mike
FILE
T IME SUBMIT T ED 17 - DEC- 2016 12:02PM
SUBMISSION ID 7 54 4 537 7 9
WORD COUNT 14 00
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ORDER_4 4 897 _109194 .DOC (39.5K)
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2 %2
3 %1
4 %1
5 %1
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Tympanic Membrane
ORIGINALITY REPORT
PRIMARY SOURCES
Submitted to EDMC
St udent Paper
Submitted to AUT University
St udent Paper
journals.lww.com
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etheses.bham.ac.uk
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Tympanic Membraneby Lisa MikeTympanic MembraneORIGINALITY REPORTPRIMARY SOURCES
1
Running head: WEEK TWO ASSIGNMENT TWO
8
WEEK TWO ASSIGNMENT TWO
Week Two Assignment Two: Tympanic Membrane and Thyroid Gland
Sample Student Paper
South University
NSG 3012
Week Two Assignment Two: Tympanic Membrane and Thyroid Gland
Conducting a thorough examination of the tympanic membrane and thyroid gland can identify the cause of presenting symptoms. When a patient reports ear pain, blockage, loss of hearing, and/or ear ringing the nurse will need to perform a thorough assessment to identify the cause. Tympanic ear perforation is one issue that may be identified. Additionally, when a patient reports recent weight loss, weight gain, hair loss, fatigue, irritability, and sensitivity to heat or cold, the nurse may suspect thyroid problems and will examine the thyroid. Dysfunction of the thyroid can lead to many problems, hypothyroidism is one such issue, caused by the thyroid not producing the thyroid hormone (Jarvis, 2016). An overview of the tympanic membrane and thyroid gland will be discussed to further detail the associated assessments.
Health History One
A 19-year-old Hispanic male presents to the primary care office with a constant earache lasting three days. He describes the dulling pain as deep in his left ear. He rates the pain as a 10 out of 10. He has a temperature of 101.1. It is suspected the patient may have an ear infection. The patient reports a history of ear infections. Patient denies hearing loss, discharge, ringing or buzzing, and/or ear injury.
Findings for Tympanic Membrane
Examination of the ear are mainly performed using inspection and palpation (Jarvis, 2016). The client was seated on the exam table, with the examiner’s head at the same level as the client’s. The examiner begins by inspecting both auricles for abnormalities. No abnormalities were noted, but the left ear is red in color. The auricles and mastoid areas were palpated to check for swelling, tenderness, or nodules. The left ear was tender to touch. When using an otoscope, the provider is examining the external auditory canal and tympanic membrane. When inspecting the pinna, it is important to look for lesions (Kalyanakrishnan, Sparks, & Berryhill, 2007). Inspecting the canal, the examiner is looking f ...
What is this tinnitus
Ear harm and exposure to loud noises are common causes of tinnitus. Lesser-known causes embody medications and thyroid disease. It’s not invariably doable for a doctor to spot the cause, however varied treatments are available. symptom is that the medical term for “ringing within the ears.”
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ENT_within_Primary_Care_-_Ears[807] (1).pptx
- 1. ENT within Primary Care – Ears “Can you hear me!!”
- 2. Agenda
- 5. Primary care ear presentations (typical) Otitis externa Otitis media Blocked ear/Wax foreign body and pain Chronic condition Sinus problems Other ear disorders
- 8. Prescribing
- 9. Referrals
- 10. 36-year-old male
- 11. History of presenting complaint: Symptoms have presented for 3-4 weeks Medical history: Recurrent ear infection. Type I diabetes (controlled well) Drug history: Insulin; aspirin; paracetamol for earache as required Family history: Nil relevant Social history: Happily married, works in IT, smokes 5 cigarettes a day, no alcohol, is a keen runner/swimmer Basic observations: Temperature 37.2, Pulse 78 BPM, Tender and swollen auricular & cervical lymph nodes on right side, Mouth and throat (NAD). All else is normal TEST yourself: Answers on next slide 1.You notice an offensive odour from the ear. When you examine the right ear there is some debris and inflammation in the ear canal. Consider and explain the history and the need for doing an ear swab? 2. Despite the debris you are able to visualise the TM. There is a perforation in the attic area (pars flaccida). What type of perforation is this? 3. What are the differential diagnoses? 4. Which other procedures could be done as part of the examination? 5. Which factors in the history may predispose to recurrent ear infections? C
- 13. Summary
- 14. Sharma A, Machen K, Clarke B, Howard, D et al. (2006) Is undergraduate otolaryngology teaching relevant to junior doctors working in accident and emergency departments? J Laryngol Otol 120(110: 949-51 Otitis externa | Health topics A to Z | CKS | NICE Scenario: Recurrent acute otitis media | Management | Otitis media - acute | CKS | NICE Antimicrobial prescribing table (bnf.org)