1. Assessing the Head, Eyes, 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 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 PrepareBy 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: CASE STUDY 4:
Focused Thyroid Exam Chantal, a 32-year-old female, comes into your office with
complaints of “feeling tired” and “hair falling out”. She has gained 30 pounds in the last year
but notes markedly decreased appetite. On ROS, she reports not sleeping well and feels cold
all the time. She is still able to enjoy her hobbies and does not believe that she is
depressed.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
2. conditions for the patient’s differential diagnosis and justify why you selected
each.REQUIRED RESOURCES: 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..Chapter 15, “Earache”This chapter covers the main
questions that need to be asked about the patient’s condition prior to the physical
examination as well as how these questions lead to a focused physical examination.Chapter
21, “Hoarseness”This chapter focuses on the most common causes of hoarseness. It
provides strategies for evaluating the patient, both through questions and through physical
exams.Chapter 25, “Nasal Symptoms and Sinus Congestion”In this chapter, the authors
highlight the key questions to ask about the patients symptoms, the key parts of the
physical examination, and potential laboratory work that might be needed to provide an
accurate diagnosis of nasal and sinus conditions.Chapter 30, “Red Eye”The focus of this
chapter is on how to determine the cause of red eyes in a patient, including key symptoms
to consider and possible diagnoses.Chapter 32, “Sore Throat”A sore throat is one most
common concerns patients describe. This chapter includes questions to ask when taking the
patient’s history, things to look for while conducting the physical exam, and possible causes
for the sore throat.Chapter 38, “Vision Loss”This chapter highlights the causes of vision loss
and how the causes of the condition can be diagnosed.Note: Download the six documents
(Student Checklists and Key Points) below, and use them as you practice conducting
assessments of the head, neck, eyes, ears, nose, and throat.Ball, J. W., Dains, J. E., Flynn, J. A.,
Solomon, B. S., & Stewart, R. W. (2019). Head and neck: Student checklist. In Seidel’s guide
to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier
Mosby.Ball, J. W., Dains, J. E., Flynn, J. A., & Solomon, B. S., & Stewart, R. W. (2019). Head and
neck: Key points. In Seidel’s guide to physical examination: An interprofessional approach
(9th ed.). St. Louis, MO: Elsevier Mosby.Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., &
Stewart, R. W. (2019). Eyes: Student checklist. In Seidel’s guide to physical examination: An
interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Ball, J. W., Dains, J. E.,
Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Eyes: Key points. In Seidel’s guide to
physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier
Mosby. Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Ears, nose,
and throat: Student checklist. In Seidel’s guide to physical examination: An interprofessional
approach (9th ed.). St. Louis, MO: Elsevier Mosby.Ball, J. W., Dains, J. E., Flynn, J. A., Solomon,
B. S., & Stewart, R. W. (2019). Ears, nose, and throat: Key points. In Seidel’s guide to physical
examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Colyar,
3. M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA: F. A. Davis. · Chapter
71, “Visual Function Evaluation: Snellen, Illiterate E, Pictorial This section explains the
procedural knowledge needed to perform eyes, ears, nose, and mouth procedures.Sullivan,
D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.·
Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in Weeks 1, 3,
4, and 5)Bedell, H. E., & Stevenson, S. B. (2013). Eye movement testing in clinical
examination. Vision Research 90, 32–37. doi:10.1016/j.visres.2013.02.001. Retrieved from
https://www.sciencedirect.com/science/article/pii/S0042698913000217 Rubin, G. S.
(2013). Measuring reading performance. Vision Research, 90, 43–51.
doi:10.1016/j.visres.2013.02.015. Retrieved from
http://www.sciencedirect.com/science/article/pii/S0042698913000436 Harmes, K. M.,
Blackwood, R. A., Burrows, H. L., Cooke, J. M., Harrison, R. V., & Passamani, P. P. (2013). Otitis
media: Diagnosis and treatment. American Family Physicians, 88(7), 435–
440.Otolaryngology Houston. (2014). Imaging of maxillary sinusitis (X-ray, CT, and MRI).
Retrieved from http://www.ghorayeb.com/ImagingMaxillarySinusitis.htmlThis website
provides medical images of sinusitis, including X-rays, CT scans, and MRIs (magnetic
resonance imaging).
