Select Client From Explained for Students (Easy Guide)

This question focuses on applying theory to practical scenarios.

What This Question Is About

This question relates to select client from and requires a structured academic response.

How to Approach This Question

Focus on explaining concepts clearly and supporting them with examples.

Key Explanation

This topic involves select client from. A strong answer should include explanation, application, and examples.

Original Question

Select a client from your past or current FNP clinical rotations with an acute health problem or complaint which required at least two visits. Based on this client’s condition, conduct a literature search for two research articles that discuss various approaches to the treatment of this condition. Peer-reviewed articles must address the standardized procedure or guidelines for this diagnosis. The research articles must be original research contributions (no review articles or meta-analysis) and must have been published within the last five years. Incorporate the research findings into the decision-making for this client’s treatment. Attach the initial visit/comprehensive SOAP note and follow-up visit /focused SOAP note as appendices. You may include SOAP notes that have already been submitted in your clinical courses. If you are at a clinical site that does not see follow-ups (Urgent Care, ER, minute-clinic, etc) you may create a fictitious follow-up SOAP note addressing the issue with attention to items you would need to assess in the history and physical during the visit. The discussion on relating research to practice should be approximately 3-4 pages and the total paper should be no longer than 10 pages, excluding references and appendices. Cover the criteria listed below: Review topic and explain rationale for topic selection in the context of client care. Evaluates key concepts related to the topic. Describes multiple viewpoints if this is a controversial issue or one for which there are no clear guidelines. Assess the merit of evidence found on this topic i.e. soundness of research Evaluates current guidelines, if available. Or, recommends what these guidelines should be based on available research. Discuss the Standardized Procedure for this diagnosis. Discuss how the evidence did impact/would impact practice. What should have been done differently based on the knowledge gained? Consider cultural, spiritual, and socioeconomic issues as applicable. Length: No longer than 10 pages, excluding references and appendices Objective is precise, knowledgeable, significant, and distinguished from alternate or opposing options. Skillfully arranges evidence to setup premise of the issue. Persuasively builds the case with supportive evidence. Elaborates on all key points of the issue. Skillful recommendations and/or specific action. Suggested action is reasonable. Conclusion is precise, knowledgeable, significant, and distinguished from alternate or opposing options. Skillfully implicates impact on nursing practice, patient safety and healthcare quality. Demonstrates understanding and applies concepts learned in the course at a superior level. Concepts are integrated into insights. Provides concluding remarks that show analysis and synthesis of ideas. Appropriate references that support opinions and recommendations. Exceptional writing with no grammar, APA or spelling errors…….Sample paper- Title of paper Type your introduction paragraph here. Discuss what this paper will be about and the various topics that will be covered. Don’t forget to cite your sources throughout your paper. Avoid long quotes, if a long quote is absolutely necessary; be sure it is properly formatted per APA 7th edition guidelines. Review of topic and rationale for selection of topic Discuss why you chose this topic/patient experience for your paper. Why is it an important health care issue? Be sure to reference your appendices as needed by typing (See Appendix A). See the APA manual if you are unsure how to use Appendices. Evaluation of key concepts related to the topic Discuss the key concepts related to this topic/disease process/situation. Description of multiple viewpoints Is there more than one guideline for this condition? How are they different? Is there any conflicting data, beliefs, or controversy surrounding this condition or treatment? Assessment of the merit of evidence found on this topic (soundness of research) Discuss the quality of the research/studies that you reviewed. Evaluation of current EBM guidelines If guidelines exist for this condition, explain and discuss them. If there are no guidelines, recommend what these guidelines should be based on available research Diversity, cultural, spiritual, and socioeconomic considerations Discuss these special considerations regarding this illness/treatment. Discussion regarding the Standardized Procedure for this diagnosis If you were asked to develop a standardized procedure for this condition, what would you include? Discussion on how the evidence did impact/would impact practice This is a reflection portion. What would you have done differently based on what you learned while conducting your research about the topic? Conclusion Type your conclusion paragraph here. References soap note of original visit-SOAP Note Pediatrics HEENT Pediatrics HEENT Initials: A.D. Age: 10 years old. DOB: April 25, 2015. Gender: Male. Race: White. Ethnicity: Hispanic. Accompanied by: Arrived with his mother. Historian: The Patient and mother are reliable historians. Subjective Chief Complaint (CC): “My throat hurts and I have a fever.” History of Present Illness (HPI): A 10-year-old male presents with his mother, reporting a 2-day history of sore throat and fever that started gradually two days ago and has gotten worse over the past twenty-four hours. He describes the constant throat pain as burning and raw and rates it 6 out of 10, and says it feels more painful in the mornings and at night, especially when he swallows or talks. He has taken acetaminophen, which helped a little but did not completely relieve the pain. His highest fever at home was 101.8°F. He also feels a bit tired and has not been eating as much as usual. He does not report having a cough, a runny nose, a stuffy nose, a headache, or a rash. There are no known sick contacts at home per the mother, but the patient mentioned that some of his classmates have recently missed school due to illness. Past Medical History (PMH) Medical conditions: History of seasonal allergic rhinitis. Surgical history: No surgery reported. Hospitalizations: No Latest hospitalization reported. Medications: Loratadine 10 mg daily (for allergies), Acetaminophen 325 mg every six hours as needed for fever/pain. Allergies: NKDA (No known drug allergies); no food or environmental allergies reported. Chemical History: He denies exposure to smoking, tobacco, or nicotine products. LMP: Not applicable. Birth history: Mother reported patient was born full-term vaginal delivery without complications. Immunizations: The mother reported that the immunizations are current, including the most recent seasonal influenza vaccine, under CDC recommendations for the patient’s age group. Family History Mother: The patient’s mother is 40 years old and healthy, with no known medical conditions reported. Father: His father is alive, he is 43 years old, and has a history of asthma, diagnosed 4 years ago. Siblings: He has one younger sister, who is 6 years old, healthy, and without any chronic illnesses. Mother reported no family history of rheumatic fever, recurrent streptococcal infections, mononucleosis, or autoimmune disorders. Social History Schooling: He is in 4th grade in a local school and is doing well academically. Housing: He lives in a house with his parents and sister. Environment: Smoke-free home, no pets, no hot tubs or pools in the house. Sleep: He typically gets 9-10 hours/night, currently disrupted due to symptoms reported. Diet: The mother reports the patient eats a balanced diet but has been eating less due to his sore throat. Activity Level: He usually is active; however, his activity level has decreased over the last 2 days due to his current condition. Sexual: Not applicable. Safety: He consistently uses seatbelts, and the mother has reported no firearms in the home. Recent Travel: The patient has not traveled recently. Spiritual/Cultural Practices: No spiritual or cultural practices reported by the patient or his family. Review of Systems (ROS) General: The patient reports the presence of fever and mild fatigue for the past two days. He denies chills, night sweats, or recent weight loss or gain. HEENT: Head: The patient denies headaches or any facial pain or pressure. Eyes: He denies redness, discharge, watering, pain, or blurry vision. He denies sensitivity to light when exposed. Ears: He denies ear pain, drainage, ear ringing (tinnitus), or hearing loss. Nose: No nasal congestion, discharge, post-nasal drip, or sneezing is reported. He denies nosebleeds. Throat: The patient reports a sore throat and pain in swallowing. He denies hoarseness, swollen glands, or a sensation of something stuck in the throat. Respiratory: He denies coughing, wheezing, shortness of breath, or difficulty breathing. Cardiovascular: He denies chest pain, skipped beats, dizziness upon standing, or known heart murmurs. Gastrointestinal (GI): The patient reports a decreased appetite over the past two days but denies nausea, vomiting, abdominal pain, constipation, diarrhea, or bloating. He reports a regular bowel movement pattern. Genitourinary (GU): He denies burning or pain during urination, increased urinary frequency, urgency, or incontinence. He denies blood in the urine or nighttime urination. Skin: The patient denies rashes, lesions, itching, bruising, or recent changes in skin color or texture. Musculoskeletal (MSK): He denies joint pain, muscle aches, stiffness, swelling, or any recent injuries. Neurological: He denies dizziness, headaches, seizures, numbness, tingling, weakness, or changes in coordination or balance. Psychiatric: The patient denies any mood changes, anxiety, irritability, mood swings, behavioral changes, or difficulty concentrating. Endocrine/Hematologic/Allergy: No reports of excessive thirst, urination, heat/cold intolerance, unusual bruise or bleeding. Seasonal allergies are currently well-controlled without active symptoms. Objective Vital Signs Temp: 101.6°F HR: 102 bpm RR: 20 bpm BP: 108/70 mmHg Height: 55 inches Weight: 75 lbs (34 kg) BMI: 18.3 (normal range for age) Physical Exam Findings: General: The patient appears tired but is alert, cooperative, and in no acute distress. He is well-nourished and well-hydrated. No signs of toxicity or lethargy are noted. HEENT: Head: Head is normocephalic and atraumatic; no swelling, lesions, or tenderness on palpation. Eyes: Pupils are noted to be equal, round, and reactive to light and accommodation (PERRLA); extraocular movements are intact; conjunctivae are clear, with no erythema or discharge present. Ears: Tympanic membranes are intact and clear bilaterally with good cone of light; no erythema, bulging, or fluid levels noted; external ears non-tender. Nose: Nasal mucosa is pink and moist; no fluid accumulation, discharge, or turbinate swelling; septum midline and intact. Throat: The posterior pharynx is erythematous with mildly enlarged tonsils (2+); white exudates present on the tonsils; uvula is midline and rises symmetrically with phonation; mild discomfort on examination. Neck: Swelling of cervical lymph nodes noted, particularly anterior nodes; nodes are mobile and tender, have a full range of neck motion, and have no stiffness. Respiratory: Breath sounds are clear to auscultation bilaterally; no wheezes, rales, or rhonchi; respiratory effort is normal and non-labored; no use of accessory muscles or nasal flaring. Cardiac: Regular rate and rhythm; no murmurs, rubs, or gallops; regular S1 and S2. No swelling of the upper or lower extremities or cyanosis. Gastrointestinal (GI): Abdomen is soft, non-tender, and non-distended; bowel sounds are normoactive in all quadrants; no masses or rebound tenderness appreciated. Skin: Skin is warm, dry, and intact; no rashes, lesions, petechiae, or bruising noted; normal turgor and color. Neurological: He is alert and oriented x4; motor and sensory function intact; no focal deficits observed. Psych: Cooperative, calm, and relaxed, age-appropriate affect and interaction during exam. Assessment Differential Diagnoses 1. Streptococcal Pharyngitis (J02.0): This is the most likely diagnosis based on the patient’s presenting symptoms and results of clinical evaluation. The patient exhibits the classic triad of high-grade fever, tonsillar exudates, and tender anterior cervical lymph node swelling, all of which meet the Centor criteria used to guide diagnosis in pediatric patients. These findings strongly point to a bacterial infection rather than a virus. The absence of cough and other viral symptoms (such as nasal congestion, rhinorrhea, or hoarseness) further supports a bacterial etiology over a viral one. A positive rapid antigen detection test (RADT) for Group A Streptococcus would confirm the diagnosis. Early identification and treatment are essential to reduce symptom severity, prevent transmission, and avoid complications such as acute rheumatic fever or peritonsillar abscess. 2. Viral Pharyngitis (J02.9): A viral sore throat is less likely diagnosis in this case. Most viral infections also come with symptoms like coughing, a runny nose, or nasal congestion, none of which this patient has. While some viral cases can cause throat pain, these patients’ symptoms do not match the usual viral picture (Pellegrino et al., 2023). 3. Infectious Mononucleosis (B27.90): This diagnosis is less likely. The presence of fatigue and tonsillar enlargement with exudates could suggest mononucleosis; however, absence of hepatosplenomegaly, generalized lymphadenopathy, or prolonged fatigue makes this diagnosis less probable at this stage. Mononucleosis is more common in adolescents, though it can occur in younger children with milder symptoms (Ming et al., 2023). Plan Diagnostics: Perform Rapid Antigen Detection Test (RADT): Positive for Group A Streptococcal Pharyngitis (Shewale, 2024). Throat culture for confirmatory testing (Badr et al., 2021). Medications: Amoxicillin 875 mg PO BID x 10 days (weight-based dosing appropriately) (Norton & Myers, 2021). Acetaminophen 325 mg PO q4-6 h PRN for fever and throat pain. Patient/Parent Education: Encourage completing the full antibiotic course to clear the infection and prevent complications. Avoid sharing utensils or drinks to prevent the spread of strep. Encourage return if symptoms worsen or new symptoms develop (e.g., rash, difficulty breathing, drooling) to prevent serious complications. Maintain hydration, soft foods as tolerated, rest, and medication adherence. Follow Up: Phone follow-up in 48 hours to assess therapy improvement, or any new/concerning symptoms. May return to school after 24 hours of antibiotics and afebrile. In-clinic follow-up if no improvement or worsening of condition after 3 days of starting antibiotics (Norton & Myers, 2021). References Badr, A. F., Humedi, R. A., Alfarsi, N. A., & Alghamdi, H. A. (2021). Rapid antigen detection test (RADT) for pharyngitis diagnosis in children: Public and pharmacist perception. Saudi pharmaceutical journal, 29(7), 677-681. https://doi.org/10.1016/j.jsps.2021.04.029 Ming Y, Cheng, S., Chen, Z., Su, W., Lu, S., Wang, N., Xu, H., Zhang, L., Yu, J., & Tang, J. (2023). Infectious mononucleosis in children and differences in biomarker levels and other features between disease caused by Epstein-Barr virus and other pathogens: A single-center retrospective study in China. 11, e15071-e15071. https://doi.org/10.7717/peerj.15071 Norton, L., & Myers, A. (2021). The treatment of streptococcal tonsillitis/pharyngitis in young children. World Journal of Otorhinolaryngology – Head and Neck Surgery, 7(3), 161-165. https://doi.org/10.1016/j.wjorl.2021.05.005 Pellegrino, R., Edoardo Timitilli, Maria Carmen Verga, Guarino, A., Iride Dello Iacono, Scotese, I., Tezza, G., Dinardo, G., Riccio, S., Pellizzari, S., Iavarone, S., Lorenzetti, G., Simeone, G., Bergamini, M., Donà , D., Pierantoni, L., Garazzino, S., Esposito, S., Venturini, E., & Guido Castelli Gattinara. (2023). Acute pharyngitis in children and adults: A descriptive comparison of current recommendations from national and international guidelines and future perspectives. European Journal of Pediatrics, 182. https://doi.org/10.1007/s00431-023-05211-w Shewale, N. (2024). Use McIsaac scoring and rapid streptococcal antigen detection test to diagnose Group A streptococcal pharyngitis in children. Research journal of medical sciences, 18(12), 97-100. https://doi.org/10.36478/makrjms.2024.12.97.100

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