Week 4 Case Study: APA FORMAT, MUST CITE AND REFERENCE
Case 1
Review the pharyngitis scenarios and determine the most likely cause, including pathogen and mode of transmission. Discuss data that support your decision and treatment strategies.
Scenario 1: Susan is a 16-year-old with sudden onset of severe sore throat for the past day. She feels like she had a fever but did not check her temperature (i.e., subjective fever). She states it is very painful to swallow, and she thinks she sees white spots on her throat. She denies cough, rhinorrhea, nausea, otalgia, shortness of breath, or headache. She reports no exposure to sick individuals.
- Medications: none.
- Allergies: none.
- Social history: nonsmoker and drinks alcohol (two to three beers) one to two times a month.
- Physical examination: vital signs – temperature 101.0°F; pulse 100 beats per minute; respirations 18 per minute; blood pressure 110/66 mmHg.
- General: ill and tired appearance.
- Head, Eyes, Ears, Nose, and Throat: unremarkable except for erythematous oropharynx with small petechiae and white tonsillar exudates.
- Neck: anterior cervical lymphadenopathy; two on right, three on left; all small (< 0.5 cm) and tender.
- Cardiovascular, Lungs, and Abdomen: unremarkable.
Answer the following questions or provide responses based on this scenario.
- What is the most likely diagnosis and pathogen causing this disorder and mode of transmission?
- Discuss data that supports your decision.
- What diagnostic test, if any, should be done?
- Develop a treatment plan for this patient.
Case 2
Scenarios 2: Mr. Menendez is a 65-year-old man presenting with 2–3 days of coughing up thick yellow sputum, shortness of, and fever (he did not check the actual temperature), and chills. He states his chest hurts when he breathes. He denies headache, rhinorrhea, sinus pain, and nausea. He reports no exposure to sick individuals.
- Medications: lisinopril 10 mg a day by mouth.
- Allergies: no known drug allergy.
- Social history: smokes 1 pack of cigarettes per day (has done so for 30 years); denies alcohol use; works as a landscaper.
- Physical examination: vital signs – temperature 101°F; pulse 98 beats per minute; respirations 22 per minute; blood pressure 140/86 mmHg; pulse oximeter 93%.
- General: ill and tired appearance, coughing during visit with thick yellow sputum noted.
- HEENT: unremarkable.
- Neck: small anterior and posterior cervical nodes.
- CV: unremarkable.
- Lungs: right basilar crackles with dullness to percussion in right lower lobe.
- Abdomen: unremarkable.
Answer the following questions or provide responses based on this scenario.
- What is the most likely diagnosis and pathogen causing this disorder?
- Discuss the mode of transmission. Discuss the data that support your decision.
- What diagnostic test, if any, should be done?
- Develop a treatment plan for this patient.
TEXTBOOK & READING:
From your textbook. Applied Pathophysiology for the Advanced Practice Nurse, read the following chapter:
- Pulmonary Function