Clinical Case Studies for the Family Nurse Practitioner by Leslie Neal-Boylan

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By Leslie Neal-Boylan

Clinical Case reviews for the relatives Nurse Practitioner is a key source for complex perform nurses and graduate scholars looking to attempt their talents in assessing, diagnosing, and dealing with situations in kinfolk and first care.  Composed of greater than 70 situations starting from universal to particular, the publication compiles years of expertise from specialists within the box. it really is equipped chronologically, featuring situations from neonatal to geriatric care in a regular process equipped at the cleaning soap format.  This comprises differential analysis and a sequence of serious pondering questions excellent for self-assessment or lecture room use.

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Nose: Both nostrils patent; no discharge. Oropharynx: Mucous membranes moist; no teeth present; no lesions. Neck: Supple; no nodes. Respiratory: RR = 28; clear in all lobes; no adventitious sounds noted; no retractions; no deformities of the thoracic cage noted. Cardiac/Peripheral vascular: HR = 120; regular rhythm; no murmur noted; brachial and femoral pulses present and 2+ bilaterally. Abdomen/Gastrointestinal: Soft, nontender, nondistended, no evidence of hepatosplenomegaly. Umbilical cord is in place without signs and symptoms of infection.

Chest radiographs are not routinely necessary. The nonspecific findings of hyperinflation and patchy infiltrates may be seen on the chest radiograph. What is the most likely differential diagnosis and why? Bronchiolitis: The most likely differential diagnosis is bronchiolitis related to an infection with RSV. Michael’s history and physical examination form the primary basis for the diagnosis of bronchiolitis. Bronchiolitis is usually due to a viral infection of the small lower airways (bronchioles).

Ears: Pinnae normal; tympanic membranes gray bilaterally with positive light reflex. Nose: Both nostrils patent; no discharge. Oropharynx: Mucous membranes moist; no teeth present; no lesions. Neck: Supple; no nodes. Respiratory: RR = 28; clear in all lobes; no adventitious sounds noted; no retractions; no deformities of the thoracic cage noted. Cardiac/Peripheral vascular: HR = 120; thrill noted in pulmonic area; continuous, systolic, grade 3 heart murmur noted on exam in the pulmonic area of the chest with both the bell and diaphragm; no radiation of the murmur to the back or axilla; brachial and femoral pulses present and 2+ bilaterally.

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