NURSING NSG 6020 / NSG6020 WEEK 1 DISCUSSION

Discussion Question 1 Based on your performance and the expert feedback in your HISTORY collection, describe two missed questions and your understanding of why they were important to collect for this case history. Use ...

Discussion Question 1 Based on your performance and the expert feedback in your HISTORY collection, describe two missed questions and your understanding of why they were important to collect for this case history. Use specific references from your text to explain. For this patient, I would ask her if she has noticed and/or felt any breast lumps or and/or had any discharge from her breast as of late. Discharge from the breast can be the result of excessive breast stimulation or pregnancy. According to Goolsby & Grubbs (2015), nipple discharge coupled with a mass or lump in the breast can be a sign of cancer. This patient stated that she has a familial history of breast. The patient also stated that she had experienced some breast tenderness when she last performed a self-exam. I would certainly ask if this tenderness that she has is consistent or intermittent. Lastly, the patient stated that her friend stated that her mammogram was painful. The patient seemed to express apprehension and fear when it came to mammograms. I would ask this to describe to me her feelings towards breast cancer, especially since she has never gotten one before. Discussion Question 2 Based on your performance and the expert feedback in your PHYSICAL EXAM collection, describe two errors in your exam performance or documentation. Use specific references from your text to explain the importance of these findings in correct assessment of this client. When conducting an examination on a patient, especially with one who is new or in this case, hasn’t seen a PCP in years, you want to make sure a rapport is established with the patient so that they are comfortable, trust you as the healthcare provider, and are more likely to adhere to suggested treatment regimen. Many health care professionals forget that a big portion of helping This study source was downloaded by 100000831988016 from CourseHero.com on 03-12-2022 03:55:33 GMT -06:00 https://www.coursehero.com/file/65317813/NSG-6020-Week-1-Discussiondocx/ and healing patients evolve around making sure that the patient is comfortable. With that being said, I would make sure that I chat with the patient first to get her feelings as towards being there at the office because that is already a stressful place for anyone. Also ensuring that some form of trust and privacy is met helps to establish a furthering future relationship between patient and provider (Bickley, 2016). Secondly, from a simple standpoint of the actual exam being performed, there was no percussion or palpitation of the patient’s abdomen, let alone any abdominal assessment of any kind. I would have certainly conducted an abdominal assessment on this patient. Dull areas of percussion in any individual and deep palpation could suggest underlying masses or enlarged organs (Bickley, 2017) For an example, an enlarged liver organ could have been palpated which would suggest the concern for malignancy of this organ if that were the issue. Discussion Question 3 Based on your performance on the PHYSICAL EXAM collection, describe one key finding that you included in your list and describe a specific physical exam that you can perform at the point-of-care to further evaluate the finding. Use specific references from your text. The patient came into the clinic wanting to get checked out overall, but in particular expressed having not had a Pap and/or mammogram in some time. The key finding for me here would be to further investigate the patient’s growing concerns over breast cancer. The patient stated that she had a friend who had a mammogram done and it was extremely painful. The patient also stated that her aunt battled breast cancer. Furthermore, along with the voiced concerns over getting a mammogram, the patient is already putting herself at a risk for breast cancer because of her smoking. This too warrants further investigation of the actual disease process. I would educate this patient on quitting smoking and also doing self-breast examinations. According to Bickley, This study source was downloaded by 100000831988016 from CourseHero.com on 03-12-2022 03:55:33 GMT -06:00 https://www.coursehero.com/file/65317813/NSG-6020-Week-1-Discussiondocx/ 2016, it is important for individuals to know the signs and symptoms associated with breast abnormalities in the breast region. Knowing how to properly detect a lump or mass early could save a person life. Discussion Question 4