Assessing the Ears, Nose, and Throat
NURS 6512 Week 5 Discussion: Assessing the Ears, Nose, and Throat
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.
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Order Paper NowNote: 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 – Discussion: Assessing the Ears, Nose, and Throat
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- Discussion: Assessing the Ears, Nose, and Throat
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- Discussion: Assessing the Ears, Nose, and Throat
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 for Discussion: Assessing the Ears, Nose, and Throat:
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.
By Day 3 of Discussion: Assessing the Ears, Nose, and Throat
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.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Read a selection of your colleagues’ responses.
By Day 6 of Discussion: Assessing the Ears, Nose, and Throat
Respond to at least two of your colleagues on two different days who were assigned different case studies than you. Analyze the possible conditions from your colleagues’ differential diagnoses. Determine which of the conditions you would reject and why. Identify the most likely condition and justify your reasoning.
Rubric Detail
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Content
Outstanding Performance | Excellent Performance | Competent Performance | Proficient Performance | Room for Improvement | |
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Main Posting: Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. |
Points Range: 44 (44%) – 44 (44%)
Thoroughly responds to the discussion question(s) is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. supported by at least 3 current, credible sources |
Points Range: 40 (40%) – 43 (43%)
Responds to the discussion question(s) is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 75% of post has exceptional depth and breadth supported by at least 3 credible references |
Points Range: 35 (35%) – 39 (39%)
Responds to most of the discussion question(s) is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of post has exceptional depth and breadth supported by at least 3 credible references |
Points Range: 31 (31%) – 34 (34%)
Responds to some of the discussion question(s) one to two criteria are not addressed or are superficially addressed is somewhat lacking reflection and critical analysis and synthesis somewhat represents knowledge gained from the course readings for the module. post is cited with fewer than 2 credible references |
Points Range: 0 (0%) – 30 (30%)
Does not respond to the discussion question(s) lacks depth or superficially addresses criteria lacks reflection and critical analysis and synthesis does not represent knowledge gained from the course readings for the module. contains only 1 or no credible references |
Main Posting: Writing |
Points Range: 6 (6%) – 6 (6%)
Written clearly and concisely Contains no grammatical or spelling errors Fully adheres to current APA manual writing rules and style |
Points Range: 5.5 (5.5%) – 5.5 (5.5%)
Written clearly and concisely May contain one or no grammatical or spelling error Adheres to current APA manual writing rules and style |
Points Range: 5 (5%) – 5 (5%)
Written concisely May contain one to two grammatical or spelling error Adheres to current APA manual writing rules and style |
Points Range: 4.5 (4.5%) – 4.5 (4.5%)
Written somewhat concisely May contain more than two spelling or grammatical errors Contains some APA formatting errors |
Points Range: 0 (0%) – 4 (4%)
Not written clearly or concisely Contains more than two spelling or grammatical errors Does not adhere to current APA manual writing rules and style |
Main Posting: Timely and full participation |
Points Range: 10 (10%) – 10 (10%)
Meets requirements for timely and full participation posts main discussion by due date |
Points Range: 0 (0%) – 0 (0%)
NA
|
Points Range: 0 (0%) – 0 (0%)
NA
|
Points Range: 0 (0%) – 0 (0%)
NA
|
Points Range: 0 (0%) – 0 (0%)
Does not meet requirement for full participation
|
First Response:
Post to colleague’s main post that is reflective and justified with credible sources. |
Points Range: 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings responds to questions posed by faculty the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives |
Points Range: 8.5 (8.5%) – 8.5 (8.5%)
Response exhibits critical thinking and application to practice settings
|
Points Range: 7.5 (7.5%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting
|
Points Range: 6.5 (6.5%) – 7 (7%)
Response is on topic, may have some depth
|
Points Range: 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth
|
First Response: Writing |
Points Range: 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues Response to faculty questions are fully answered if posed Provides clear, concise opinions and ideas that are supported by two or more credible sources Response is effectively written in Standard Edited English |
Points Range: 5.5 (5.5%) – 5.5 (5.5%)
Communication is professional and respectful to colleagues Response to faculty questions are answered if posed Provides clear, concise opinions and ideas that are supported by two or more credible sources Response is effectively written in Standard Edited English |
Points Range: 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues Response to faculty questions are mostly answered if posed Provides opinions and ideas that are supported by few credible sources Response is written in Standard Edited English |
Points Range: 4.5 (4.5%) – 4.5 (4.5%)
Responses posted in the discussion may lack effective professional communication Response to faculty questions are somewhat answered if posed Few or no credible sources are cited |
Points Range: 0 (0%) – 4 (4%)
Responses posted in the discussion lack effective Response to faculty questions are missing No credible sources are cited |
First Response: Timely and full participation |
Points Range: 5 (5%) – 5 (5%)
Meets requirements for timely and full participation posts by due date |
Points Range: 0 (0%) – 0 (0%)
NA
|
Points Range: 0 (0%) – 0 (0%)
NA
|
Points Range: 0 (0%) – 0 (0%)
NA
|
Points Range: 0 (0%) – 0 (0%)
Does not meet requirement for full participation
|
Second Response: Post to colleague’s main post that is reflective and justified with credible sources. |
Points Range: 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings * responds to questions posed by faculty the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives |
Points Range: 8.5 (8.5%) – 8.5 (8.5%)
Response exhibits critical thinking and application to practice settings
|
Points Range: 7.5 (7.5%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting
|
Points Range: 6.5 (6.5%) – 7 (7%)
Response is on topic, may have some depth
|
Points Range: 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth
|
Second Response: Writing |
Points Range: 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues Response to faculty questions are fully answered if posed Provides clear, concise opinions and ideas that are supported by two or more credible sources Response is effectively written in Standard Edited English |
Points Range: 5.5 (5.5%) – 5.5 (5.5%)
Communication is professional and respectful to colleagues Response to faculty questions are answered if posed Provides clear, concise opinions and ideas that are supported by two or more credible sources Response is effectively written in Standard Edited English |
Points Range: 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues Response to faculty questions are mostly answered if posed Provides opinions and ideas that are supported by few credible sources Response is written in Standard Edited English |
Points Range: 4.5 (4.5%) – 4.5 (4.5%)
Responses posted in the discussion may lack effective professional communication Response to faculty questions are somewhat answered if posed Few or no credible sources are cited |
Points Range: 0 (0%) – 4 (4%)
Responses posted in the discussion lack effective Response to faculty questions are missing No credible sources are cited |
Second Response: Timely and full participation |
Points Range: 5 (5%) – 5 (5%)
Meets requirements for timely and full participation Posts by due date |
Points Range: 0 (0%) – 0 (0%)
NA
|
Points Range: 0 (0%) – 0 (0%)
NA
|
Points Range: 0 (0%) – 0 (0%)
NA
|
Points Range: 0 (0%) – 0 (0%)
Does not meet requirement for full participation
|
Total Points: 100 |
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