Discussion: Assessing the Ears, Nose, and ThroatMost 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. 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 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.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.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.

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Imagine that some of your colleagues mention using cognitive behavior therapy, dialectical behavioral therapy, acceptance and commitment therapy, and reality therapy. Your colleagues continue to say that based on their experiences, they really like these therapies and that they appear to work. Your instincts also tell you that perhaps they might be helpful for your client in your case study. However, from Week 1, you recall that experiences and instincts as sources of knowledge are quite limited because they are biased. Instead, it is important to utilize existing research and data to support your choices of interventions. Theory helps inform the evidence-based practice process that should guide social workers’ practice.In this Discussion, you examine the research related to a therapy based on cognitive or cognitive behavior theory to determine its effectiveness.To prepare: Recall the client from the case study you have been using in this course. You will apply your research for this Discussion to that client. Select one therapy from the following: cognitive behavior therapy, dialectical behavioral therapy, acceptance and commitment therapy, or reality therapy. Conduct a search in the Walden Library for one peer-reviewed research study about the effectiveness of the therapy you selected. Note: You must select a study that has not already been used by a colleague in the Discussion. Each student is required to identify a unique research study. Remember when looking for studies to take into account your client’s age and developmental stage and presenting problem.By Day 3Post: Provide the reference for the study you found using APA guidelines. Briefly paraphrase, in 2 to 3 sentences, the methodological context (i.e., research method, how data was collected, and the instruments used) of the study and the findings. Evaluate the findings in terms of its applicability or appropriateness for the client in your case study. Determine whether you would use or not use the therapy you selected for the client in your selected case study (consider how culturally relevant it is, how aligned it is with social work ethics, etc.) and explain why.Required ReadingsTurner, F. J. (Ed.). (2017). Social work treatment: Interlocking theoretical approaches (6th ed.). New York, NY: Oxford University Press.Chapter 4: Cognitive Behavior Theory and Social Work Treatment (pp. 54–79)Chapter 5: Cognitive Theory and Social Work Treatment (pp. 80–95)González-Prendes, A. A., & Thomas, S. A. (2009). Culturally sensitive treatment of anger in African American women: A single case study. Clinical Case Studies, 8(5), 383–402. https://doi-org.ezp.waldenulibrary.org/10.1177/1534650109345004 Note: You will access this article from the Walden Library databases.Graham, M. A., Sauerheber, J. D., & Britzman, M. J. (2013). Choice theory and family counseling: A pragmatic, culturally sensitive approach. Family Journal, 21(2), 230–234. https://doi-org.ezp.waldenulibrary.org/10.1177/1066480712466538 Note: You will access this article from the Walden Library databases.Document: Worksheet: Dissecting a Theory and Its Application to a Case Study (Word document)Document: Theory Into Practice: Four Social Work Case Studies (PDF)Required MediaSommers-Flanagan, J., & Sommers-Flanagan, R. (2014). Counseling and psychotherapy theories in context and practice [Video file]. Retrieved from http://www.psychotherapy.net.ezp.waldenulibrary.org/stream/waldenu/video?vid=277 This week, watch the “Behavioral Therapy” and “Cognitive-Behavioral Therapy” segments by clicking the applicable links under the “Chapters” tab. Note: You will access this video from the Walden Library databases.Optional ResourcesGregory, V. L. (2010). Cognitive-behavioral therapy for bipolar disorder: implications for clinical social workers. Journal of Social Service Research, 36(5), 460–469. https://doi.org/10.1080/01488376.2010.510950Gregory, V. L. (2010). Cognitive-behavioral therapy for schizophrenia: applications to social work practice. Social Work in Mental Health, 8(2), 140–159. https://doi.org/10.1080/15332980902791086Pössel, P., & Knopf, K. (2011). Bridging the gaps: An attempt to integrate three major cognitive depression models. Cognitive Therapy & Research, 35(4), 342–358. https://doi.org/10.1007/s10608-010-9325-z(Only read pp. 342–344)Hinton, D. E., & Pollack, M. H. (2009). Introduction to the special issue: Anxiety disorders in cross-cultural perspective. CNS Neuroscience & Therapeutics, 15(3), 207–209. doi:10.1111/j.1755-5949.2009.00097.xRobey, P., Burdenski, T. K., Britzman, M., Crowell, J., & Cisse, G. S. (2011). Systemic applications of choice theory and reality therapy: An interview with Glasser Scholars. The Family Journal, 19(4), 427–433. https://doi.org/10.1177/1066480711415038

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