Assessing The Head, Eyes, Ears, Nose, And Throat

 CASE STUDY 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 2 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 

 

 

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 Case Study Assignment, 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.

To Prepare

  • By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
  • Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style 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.

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 five possible conditions that may be considered in a differential diagnosis for the patient.

The Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the 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.

 

5 references not more than 5 years

Zero plagiarism

 

 

 

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 11, “Head and Neck”

This chapter reviews the anatomy and physiology of the head and neck. The authors also describe the procedures for conducting a physical examination of the head and neck.
Chapter 12, “Eyes”

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 13, “Ears, Nose, and Throat”

The authors of this chapter detail the proper procedures for conducting a physical exam of the ears, nose, and throat. The chapter also provides pictures and descriptions of common abnormalities in the ears, nose, and throat.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center. 

 

PLEASE PAY ATTENTION TO MY CASE STUDY AT THE TOP

Fsmt320

For this week’s forum, reflect on the course with responses to the following:    

  • Discuss a few topics you now have a better understanding of compared to when the course began.
  • How will you utilize the information we covered to be more effective at your job? 
  • How can the course can be improved?

#1

 

 

I cannot believe that eight weeks have come and gone and this course is coming to a close.  I have enjoyed the course and can take away information that will hopefully make me a better firefighter for years to come.  The course has focused on some key aspects of the job though review of incidents like the Watts Plant fire.  This had me reviewing and putting in place the NFPA concepts tree.  This approach helps to cover all bases and assure there are no holes in potential incident.  The weekly forums also had us thing about incidents both typical and uncommon.  Week 2 brought a great discussion on the best method to extinguish fires in coal mines and jigsaws with solid rocket fuel.  To read everyone’s opinion on the best method really helped see things from different views. 

       This course has me reinforcing that the learning must never stop.  Reviewing past incidents is a great way to learn from real world scenarios.  It is also clear that the NFPA literature available is a great source of information for all facets of the job from protection measures to incident concepts.  I found the course to be interesting and relative to the degree.  I do wish the assignments would open earlier each week.  Having a busy life, I try and get a lot of my work done on shift if the time is available.  Some weeks I had completed the lesson and all required reading but was unable to move forward because the forum or assignment had not opened yet.  The book that was also part of the weekly reading I found to be extremely technical and often I was honestly confused reading it.  It seemed to be disconnected form the rest of the course as well and really did not correlate to the forums or assignments.  Best of luck to everyone on the remainder of your coursed and I hope everyone has a great holiday.

 

#2

 

 

There were a few things that I didn’t know about or weren’t privy to about how building construction and fire protection systems can suppress or worsen a fire. The topic halon was interesting because I didn’t know that it is harmful to personnel and the environment. Also, how agencies are trying to stray away from using that extinguishing agent. Another topic was the case study on the Watts Fire that I learned about the fire safety concepts tree and how some buildings were grandfathered in which got me thinking about how policies, rules, codes, and standards should be changed to prevent further mishaps. This course not only discussed building construction and fire protection systems, it also gave a brief look at how the system is not perfect, and will need to be fixed to bring buildings up to code.

I believe that building construction will constantly change and this course helped me view how I should go about inspecting or sizing up a building to enter or offering ideas to help. This also helped me visualize how different factors on a building can influence a fire’s path. I would like to have a different book for the course. It seemed that the book was more for building construction in England, which I was trying to relate to what the U.S. has, as far as codes and standards the building materials.

Fsmt498 Week 8 Assignment

Read the material on the problem for this assignment in the Lesson and Assignment Eight and write a 2 page paper on the question.

 

This is a chance for you to assess four different issues that have been in the news and choose and assess one that you feel is something that is challenging your department or a department near you. Again this is not an examination of what you know, but rather how you would apply the knowledge that you have gained throughout your pursuit of a degree and apply that to problems that you may face in your career. These are not going to be large issue problems, but day to day ones and what I am looking for is not an analysis but rather a solution that you are comfortable with. Take the time to consider these issues that are real and decide how you would face the issue presented. Give me a solution and not an analysis. So, refrain one last time, you have reached the rank of Chief of Department. Read the four news articles below and chose one which might be an issue for your department and then discuss how you would address the problem. Provide information on how you would advise the municipality on how you have developed department policies and procedures to meet this issue. What legal problems could your department face with this issue?

SOCW6200 Assignment: Child Abuse And Neglect

Assignment: Child Abuse and Neglect

Physical, emotional, and sexual abuse can have a devastating impact on a child and his or her family members. Social workers need to understand how to recognize and respond to cases of abuse expertly and efficiently. With an empathetic and helpful social worker, victims/survivors of abuse can take their first step onto the long road toward healing. For this Assignment, read the case study Working With Survivors of Sexual Abuse and Trauma: The Case of Brandon and then consider what you would do if you were a social worker and had to report a parent of suspected child abuse.

  1. ·  Submit a 2-page paper in which you review the approach taken by the social worker in Brandon’s case.
  2. ·  Identify how the social worker might have used the ecological model to understand Brandon’s situation based on a person-in-environment perspective.
  3. ·  Explain the use of the ecological model in this case on micro, mezzo, and macro levels.
  4. Describe strengths the social worker may have missed in assessing Brandon and his mother.
  5. · Review the challenges that the social worker identifies and explain the impact the abuse could have had on Brandon had his strengths not been identified and addressed. Please use the Learning Resources to support your answer.

References (use 2 or more)

Plummer, S.-B., Makris, S., & Brocksen S. M. (Eds.). (2014). Social work case studies: Foundation year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

Roose, R., & De Bie, M. (2008). Children’s rights: A challenge for social work. International Social Work, 51(1), 37–46. Retrieved from the Walden Library databases.

Zastrow, C. H., & Kirst-Ashman, K. K. (2016). Understanding human behavior and the social environment (10th ed.)Boston, MA:  Cengage Learning.

 Chapter 4 (pp. 178-253)

 

 

 

Working With Survivors of Sexual Abuse and Trauma: The Case of Brandon

Brandon is a 12-year-old, Caucasian male who currently resides with his mother and her boyfriend. Six years ago, Brandon disclosed that his father had repeatedly sexually abused him between the ages of 4 and 6. Brandon’s mother called law enforcement immediately after the disclosure, and his father has been incarcerated since. Brandon has previously participated in therapy to address challenging behaviors, including physical aggression, difficulty following rules at home and school, and using inappropriate language with sexual overtones toward female peers. Brandon and his mother report that they ceased participating in therapy in the past after there was no change in Brandon’s behavior. Brandon’s teachers have suggested that his behaviors are similar to those of peers with attention deficit hyperactivity disorder, but his mother has declined educational or psychological testing because she does not want her son to be labeled and is unsure if she agrees with the use of psychotropic medication with children.

Brandon began attending trauma-focused treatment after demonstrating an increase in argumentative behavior and minor property destruction at home. His mother reported that the majority of undesired behaviors were initiated during interactions with her boyfriend. Brandon’s use of physical aggression has not increased in school; however, a female peer recently reported him for using sexually explicit language toward her. Brandon admitted to using inappropriate language toward the female peer but appeared to have a limited understanding of what the phrases used meant. Brandon’s mother noted during intake that she is concerned that her son will become a violent sexual offender or a pedophile and noted that his use of sexual language was likely the start of sexual behavior problems.

At the beginning of treatment, Brandon reported that he frequently feared for his physical safety but often could not pinpoint what made him feel unsafe. He had searched the Internet to find registered sexual offenders in his neighborhood, and he had begun sleeping with a loaded BB gun under his pillow in case someone entered the home to assault him again. Brandon had flashbacks when trying to fall asleep and described feeling like he was floating outside of his body when he thought of his abuse. He had seen a television show where victims spoke at the parole hearings of their perpetrators, and he spent many hours thinking about what he would say if he went to his father’s parole hearing in 3 years. Brandon felt like he loved his father very much and that his father was a great father except for when he hurt him. Brandon identified wanting to feel less worried, sleep better, and fight less with his mother as primary treatment goals.

I worked with Brandon in both individual and family sessions to address his symptoms of depression and post-traumatic stress disorder (PTSD). Utilizing the trauma-focused cognitive behavioral therapy approach, early sessions focused on coping skills and emotional regulation. As Brandon became more comfortable with expressing feelings and utilizing coping skills, he began discussing his sexual abuse history and the ongoing effect this experience had on his life. I met with Brandon’s mother for collateral sessions in order to help her identify and process her own feelings about his abuse and to develop skills to support Brandon through his treatment. Brandon’s mother was provided with psychoeducation regarding childhood sexual abuse, and her belief that her son would become a violent sexual offender as a result of his experience was challenged through cognitive behavioral therapy. She agreed to meet the agency psychiatrist, and after the initial consultation she agreed to have Brandon meet with the doctor. After a psychiatric evaluation, Brandon was prescribed a low dose of antidepressant medication.

Brandon completed a trauma narrative that addressed the details of his sexual abuse experience, his disclosure of the abuse, and the trial and subsequent imprisonment of his father. Brandon included a description of his feelings at each point in his narrative, as well as what he learned in treatment about childhood sexual abuse and coping skills to deal with uncomfortable feelings and impulsivity. Brandon shared his trauma narrative with his mother, who provided a safe and supportive space during this experience through the use of skills learned and practiced during collateral parent sessions. Brandon’s symptoms of depression and post-traumatic stress decreased steadily during the course of treatment. After 8 months of sessions and the successful completion of his trauma narrative, the family and I agreed that Brandon was ready to terminate trauma-focused treatment. Brandon continued receiving medication management with a psychiatrist and transitioned into home- and community-based treatment that focused on his ongoing impulsive behaviors.