NR569 Differential Diagnosis In Acute Care
Midterm Exam – Questions & A+ Solutions
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Terms in this set (75)
Comprehensive Patient Assessment - Appropriate for new patients in the office or
hospital.
- Provides fundamental and personalized knowledge
about patient.
- Strengthens the clinician-patient relationship.
- Helps identify or rule out physical causes related to
patient concerns.
- Provides a baseline for future assessments.
- Creates a platform for health promotion through
education and counseling.
- Develops proficiency in the skills of physical
assessment.
Focused Patient Assessment - Appropriate for established patients, especially
during routine or urgent care visits.
- Addresses focused concerns or symptoms.
- Assesses symptoms restricted to a specific body
system.
- Applies examination methods relevant to assessing
the concern or problem as thoroughly and carefully
as possible.
Subjective Information - The clinical record from the Chief Complaint (CC)
through the Review of Systems (ROS) is considered
SUBJECTIVE information.
- Includes symptoms which are health concerns the
patient tells the provider.
- Includes feelings, perceptions, and concerns
obtained from the clinical interview.
- Examples: complaints of sore throat, headache, or
pain.
,Objective Information - All physical examination, laboratory information
and test data are objective data.
Components of Comprehensive Adult - Initial information (Identifying patient
Health History information/source/reliability)
- Chief Complaint(s)
- History of Present Illness
- Past Medical History
- Family History
- Personal/Social History
- Review of Systems (ROS)
SNAPPS method - Summarize the history and findings.
- Narrow the differential diagnosis to two to three
possibilities.
- Analyze the differential by comparing and
contrasting the possibilities.
- Probe the preceptor by asking questions about
alternative approaches or uncertainties.
- Plan the management of the patient's health issues.
- Select an issue from the case for self-directed
learning.
Creating a Differential Diagnosis - The differential diagnosis process involves using
Hoofbeats = Horses NOT Zebras clinical reasoning to distinguish between two or more
conditions that share similar signs and symptoms.
Based on the CC the NP gathers information through
PMH (subjective data) and physical examination
(objective data) to establish a broad list of common &
uncommon diagnosis. As the provider collects more
data, competing hypotheses are either confirmed,
disproved, or their priority changes.
, Steps for Creating a Differential 1. Initially start with a broad list of diagnoses until
Diagnosis further information or data is obtained.
2. List your top diagnosis FIRST followed by other
potential diagnoses for a specific problem *but keep
it problem oriented until you have an actual
diagnosis.*
3. Aggressively prioritize work up of the most likely
and most harmful (ie, life threatening) diagnoses
under consideration.
4. Prioritize the work up of ACUTE and REVERSIBLE
diseases followed by CHRONIC and IRREVERSIBLE
(eg, delirium r/t a medical cause vs. chronic,
progressive dementia).
5. As information or data that effectively rules out a
particular diagnosis for a chief complaint becomes
available, remove that diagnosis from your list &
focus your attention on remaining possibilities.
6. Once a diagnosis has been confirmed, the
problem list should be diagnosis-oriented rather than
problem-oriented.
Pertinent Positive - Symptoms or signs that are present that you would
expect to find if a possible cause for for a patient's
problem were true, which then supports the
diagnosis.
Pertinent Negative Expected symptoms or signs that are not present,
facts that you would expect to find if a possible
cause for a patient's problem were true, which then
weaken this diagnosis by their absence.
Midterm Exam – Questions & A+ Solutions
Save Groups
Terms in this set (75)
Comprehensive Patient Assessment - Appropriate for new patients in the office or
hospital.
- Provides fundamental and personalized knowledge
about patient.
- Strengthens the clinician-patient relationship.
- Helps identify or rule out physical causes related to
patient concerns.
- Provides a baseline for future assessments.
- Creates a platform for health promotion through
education and counseling.
- Develops proficiency in the skills of physical
assessment.
Focused Patient Assessment - Appropriate for established patients, especially
during routine or urgent care visits.
- Addresses focused concerns or symptoms.
- Assesses symptoms restricted to a specific body
system.
- Applies examination methods relevant to assessing
the concern or problem as thoroughly and carefully
as possible.
Subjective Information - The clinical record from the Chief Complaint (CC)
through the Review of Systems (ROS) is considered
SUBJECTIVE information.
- Includes symptoms which are health concerns the
patient tells the provider.
- Includes feelings, perceptions, and concerns
obtained from the clinical interview.
- Examples: complaints of sore throat, headache, or
pain.
,Objective Information - All physical examination, laboratory information
and test data are objective data.
Components of Comprehensive Adult - Initial information (Identifying patient
Health History information/source/reliability)
- Chief Complaint(s)
- History of Present Illness
- Past Medical History
- Family History
- Personal/Social History
- Review of Systems (ROS)
SNAPPS method - Summarize the history and findings.
- Narrow the differential diagnosis to two to three
possibilities.
- Analyze the differential by comparing and
contrasting the possibilities.
- Probe the preceptor by asking questions about
alternative approaches or uncertainties.
- Plan the management of the patient's health issues.
- Select an issue from the case for self-directed
learning.
Creating a Differential Diagnosis - The differential diagnosis process involves using
Hoofbeats = Horses NOT Zebras clinical reasoning to distinguish between two or more
conditions that share similar signs and symptoms.
Based on the CC the NP gathers information through
PMH (subjective data) and physical examination
(objective data) to establish a broad list of common &
uncommon diagnosis. As the provider collects more
data, competing hypotheses are either confirmed,
disproved, or their priority changes.
, Steps for Creating a Differential 1. Initially start with a broad list of diagnoses until
Diagnosis further information or data is obtained.
2. List your top diagnosis FIRST followed by other
potential diagnoses for a specific problem *but keep
it problem oriented until you have an actual
diagnosis.*
3. Aggressively prioritize work up of the most likely
and most harmful (ie, life threatening) diagnoses
under consideration.
4. Prioritize the work up of ACUTE and REVERSIBLE
diseases followed by CHRONIC and IRREVERSIBLE
(eg, delirium r/t a medical cause vs. chronic,
progressive dementia).
5. As information or data that effectively rules out a
particular diagnosis for a chief complaint becomes
available, remove that diagnosis from your list &
focus your attention on remaining possibilities.
6. Once a diagnosis has been confirmed, the
problem list should be diagnosis-oriented rather than
problem-oriented.
Pertinent Positive - Symptoms or signs that are present that you would
expect to find if a possible cause for for a patient's
problem were true, which then supports the
diagnosis.
Pertinent Negative Expected symptoms or signs that are not present,
facts that you would expect to find if a possible
cause for a patient's problem were true, which then
weaken this diagnosis by their absence.
