NURSING RN NSG6020 Week 4 Discussion Jason Carter case Study Document

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. Do you have any of the following: heat or cold intolerance, increased thirst, increased sweating, frequent urination, change in appetite? Some of the patient’s symptoms could have been attributed to a thyroid issue: fatigue, weight gain, and tachycardia. According to Goolsby & Grubbs (2015, p 87), signs of hyper and hypothyroidism include weight loss or gain, nervousness or fatigue, diarrhea or constipation, intolerance to heat or cold, insomnia or lethargy, menstrual irregularities, and skin or hair changes. Have you noticed: any bruising, bleeding gums, nose bleeds or other sites of increased bleeding? Increased bleeding can signify a serious symptom of liver disease (Goolsby & Grubbs, 2015, p. 198) and with the other symptoms of hepatomegaly, dyspnea, and RUQ tenderness, it is important to assess for this finding. 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. According to the evaluation of my physical exam, it stated that I identified the wrong rhythm for the patient; I identified the rhythm as being S3 and it said the rhythm was regular. In the expert review in the findings section though, it stated the patient did have positive S3 sound. A positive S3 sound (ventricular gallop) is heard in patients with decreased myocardial contractility, heart failure, and volume overload conditions (Goolsby & Grubbs, 2015, p. 165). 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. Assessed for jugular venous distension as jugular venous distention and hepatojugular reflux suggest an increase in right ventricular pressure (Goolsby and Grubbs, 2015, p. 168). Discussion Question 4 Based on your performance and the expert feedback in your ASSESSMENT identification of problem categories, choose one missed/incorrect category and use specific references from your text to explain the importance of this category in arriving at correct differential diagnoses for this client.