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4 Jan 2018

Relating to Dental hygiene

These activities parallel which of the following private practice activities?

A. History taking and diagnosis.

B. Diagnosis.

C. History taking, diagnosis, and treatment planning.

D. History taking, diagnosis, and treatment.

E. History taking, treatment planning, implementation and evaluation.

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Nestor Rutherford
Nestor RutherfordLv2
4 Jan 2018
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Related questions

Discussion: Assessing the Ears, Nose, and Throat Most 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 case studies to review for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case. Case 1: Nose Focused Examination 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. To prepare: 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 10 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 a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient's differential diagnosis and justify why you selected each.

Mrs. Smith, a 40-year-old teacher, has just moved to a new community has decided it is time to select a family physician. For some time now she has avoided consulting a physician, but the pain in her wrists, elbows, ankles, and knee joints is relentless despite the increase in her daily dose of aspirin. Additionally the joints are red and swollen.

When taking her family history, the physician learned that her mother and older sister had both been diagnosed with rheumatoid arthritis. When Mrs. Smith asked him why aspirin was not particularly effective, he explained that aspirin inhibited two enzymes, cyclooxygenase-1 and cyclooxygenase-2 (COX-1 and COX-2) when, in fact, inhibition of COX-2 was what was required to relieve inflammation and joint pain. He further explained that the inhibition of COX-1decreased the production of molecules that induced mucus production in the stomach and facilitated kidney water excretion. Because individuals who take aspirin to relieve the effect of inflammation are also inhibiting COX-1, they are at risk for bleeding ulcers and water retention.

The physician then ordered serum tests that could confirm the diagnosis of rheumatoid arthritis. Also, he gave her a prescription for a specific COX-2 inhibitor, a drug recently approved by the FDA. In addition, he recommended that she read a particular review article that described the role of TNF in inflammation and the clinical trials designed to use anti-TNF antibodies as therapy for certain groups of patients who had rheumatoid arthritis.

Laboratory Data:

Assay Patient Results Reference Range

C-reactive protein 8 mg/dL < 0.5 mg/dL

CCP IgG antibodies 100 Units < 20 Units

IgM Rheumatoid Factor Positive Titer = 64 Negative

ANA Negative Negative

Anti - dsDNA Negative Negative

Serum complement C3 1.1 mg/mL 0.75 – 1.65 mg/mL

Questions:

1.What is the role of TNF in rheumatoid arthritis? What is the anticipated outcome when anti-TNF antibodies are injected in patients with RA?

2.What genetic associations exist with RA and the occurrence of RA relative to gender?

3.What is Rheumatoid Factor?

4.Why is Cyclic Citrullinated Peptide antibodies ordered for the initial diagnosis of RA?

5.Why were ANA and Anti-dsDNA ordered on this patient?

6.Which test is used to monitor inflammation levels after diagnosis?

Please help me answering the following questions for the clinical case:

86 year old woman is admitted to the hospital after she had a seizure while waiting for swallow evaluation as the outpatient. Family reports that the patient has baseline advanced dementia, which has been worsening over the last year. She is not verbal. Her Medical History: Dementia (NH resident, totally dependent in ADL/IADL Activities of Daily Living/Instrumental Activities of Daily Living), High Blood Pressure, Constipation.
Her physical examination: Nothing to be noted, except the dry mouth and of the mural mucosal membranes and tachycardia. Her neurological examination revealed a somnolent, non-communicative patient.
CT of the head revealed no changes since the previous test one year ago: There is no acute parenchymal hemorrhage or extra-axial fluid collection. It is severe, extensive parenchymal volume loss with ex vacuo dilatation of the lateral, third, and fourth ventricles. There are confluent areas of low attenuation in the white matter diffusely, consistent with extensive chronic small vessel ischemic changes. calcifications. There is no mass, mass effect, or midline shift. There are no bony lesions nor fractures. Extensive chronic small vessel ischemic changes. BMP showed Na+ 155. The water deficit was replaced with D5W at 125 cc/hr, with a gradual drop in the sodium level to normal. The patient became more alert but continued to refuse food.

Questions:

What do you think is going on?

What would you do?

What happened?

Which is the main goal of the treatment? How much fluid should you order? What type of fluid? How should the correction of fluid be made? Why?

What is your final diagnosis?

What are the risks of this condition?

What did we learn from this case?

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