NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS

Walden University NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS

Whether one passes or fails an academic assignment such as the Walden University NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS

The introduction for the Walden University NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS

After the introduction, move into the main part of the NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS

NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS Patient initial:S.M Age: 48 years old Gender: Male 

CC: Bilateral Foot Pain 

HPI 

S.M is a 48-year-old Hispanic male present to the facility with complaints of discomfort in her toes and the left foot, as well as heel of the right foot tingling and numbness over the previous two weeks. He is worried about his life since the pain forces him to drop his work equipment. The patient states that he is unable to bear weight. In the right wrist, the pain is assessed at a 37 out of 10. When he engages in physical activity, the pain is intensified. Nevertheless, relaxing and using medications including Ibuprofen 800mg PO as required and Tylenol 325mg PO as appropriate will help to alleviate the pain. 

Current Medications for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS Patient

Ibuprofen 800mg PO as required for pain 

Multivitamin PO daily 

Tylenol 500mg PO as needed for pain  

Allergies 

No known drug or environmental allergies 

 PMH 

Type 2 Diabetes Mellitus 

PSH 

No surgical history 

Sexual/Reproductive History: Heterosexual; sexually active 

Personal/Social History: Married, denies cigarette smoking, alcohol, and illicit drug use 

Immunization History: Patient’s immunizations up to date; Influenza vaccine 2020; Last Tdap 11/2017 

Significant Family History: 

Mother: History of obesity  

Father: History of diabetes 

Paternal grandmother: died age 80 due to hypertension  

Paternal grandfather died age 86 from cardiac arrest; history of dementia 

Maternal grandmother died age 75 from heart attack; history of breast cancer  

Maternal grandfather died age 72 from throat cancer 

Lifestyle: S.M lives at home with his 40 years old wife. He works 9 hours a day at a workshop. He has a primary care physician and goes for his monthly checkups. He denies mental health problems. He denies exposure to domestic violence. 

Review of Systems for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS: 

General: Denies experiencing headaches, migraines or insomnia 

HEENT: Head: Atraumatic and Normocephalic,. Eyes: no double vision or vision loss. ENT: the oral mucosa seems moist; Denies hearing loss or problems 

Neck: No pain or discomfort; Trachea midline Breasts:  

Respiratory: No history of SOB, or past TB illnesses.  

Cardiovascular/Peripheral Vascular: ; No chest pain or discomfort; Denies heart palpitation 

Gastrointestinal: No appetite loss or changes or weight gain. Denies vomiting, nausea, diarrhea, or constipation 

Genitourinary: Denies incontinence or frequency on urination. 

Musculoskeletal: pain in her toes and left foot, with tingling and numbness in the heel of the right foot  

Neurological: Denies history of seizures. 

Skin: Intact, warm and dry. Denies open wounds or rashes. 

Objective Data 

Vital signs: Temp 97.9 oral; BP 122/45 MAP 70 Right arm sitting; HR 77; RR 16 non-labored; O2 99% room air; Wt.: 60kg; Ht: 5’5”; BMI: 26.4 

General: Patient alert and oriented x4 with no acute distress. He is a well-nourished and developed man who appears his stated age. 

HEENT: Pupils respond equally to light. He is not jaundiced or pale. Moist Oral mucosa. No pharyngeal erythema. 

Neck: There is no neck elevation. No carotid swelling, or bruit. 

Chest/Lungs: is adequate bilateral air entry. Bilaterally clear lung sounds. No coughing or wheezing.  

Heart/Peripheral Vascular: Ha uniform rhythm and rate . No gallop, murmur, rub. Regular peripheral circulation 

Abdomen: stomach is soft and nontender. Bowel sounds present and regular. Recent known bowel movement 1 days ago 

Genital/Rectal: Deffered 

Musculoskeletal: Has full ROM. No found swelling or deformities. Right foot strength 3/5 and Left toe abduction 2/5 

Neurological: Alert and oriented with no acute distress; Has a steady gait. Congruent mood and affect. 

Diagnostic results: 

X-ray Upper extremity: X-rays of the feet may be ordered if there is limited toe motion, or evidence of arthritis or trauma. (Cleveland Clinic, 2021) 

Tinel’s Sign: tap or press on the median nerve in your feet with a reflex hammer. If your toes tingle or if you feel an electric-shock-like sensation, the test is positive (Cleveland Clinic, 2021). 

Phalen test: rests his feet on a table and allows the heel to fall forward freely. If numbness and tingling is experience in the toes within 60 seconds, the test is positive (Cleveland Clinic, 2021). 

Differential Diagnoses 

Tarsal Tunnel Syndrome: Tarsal tunnel syndrome is a more probable differential diagnosis, and it happens when the tibial nerve, which runs posterior to the medial side, gets entrapped, causing symptoms such as searing pain or tingling in the sole of the foot or the lower heel (Rose & Singh, 2020). A positive Tinel’s test is common in individuals with tarsal tunnel syndrome, (Rose & Singh, 2020). 

Multiple Sclerosis: Numbness is a feeling that is absent, reduced, or altered. One may get a pins and needles feeling along with the sense of your leg being “asleep” (NMSS, 2020). Despite the patient’s complaints of tingling and numbing, no indication of changed sensation was made. 

Paget’s Disease: Paget’s disease is a condition in which bone metabolism is accelerated as a consequence of aberrant and excessive bone resorption and creation (McCance & Huether, 2014). This is a more significant diagnosis to evaluate, because it impacts the axial skeleton, “particularly the vertebrae, head, sacrum, sternum, pelvic, and femur. The symptoms correspond to the issues displayed by the patient. 

Peripheral Neuropathy: Peripheral neuropathy is a sort of nerve injury that damages the legs and feet, as well as the hands and arms on occasion. Burning, tingling, or “pins and needles” sensations, numbness, discomfort, and weakness are some of the symptoms (NIDDK, 2018). The symptoms correspond to the complaints expressed by the patient. 

Foot Sprain: A foot sprain is a frequent ailment, especially in the workplace and in sports. A ligament damage caused by an acute traumatic incident or chronic repeated motions is known as an acute foot sprain (May & Varacallo, 2020). As a manual worker, the patient’s legs are repeatedly moved, potentially spraining her feet. 

Also Read:

DIGITAL CLINICAL EXPERIENCE: COMPREHENSIVE (HEAD-TO-TOE) PHYSICAL ASSESSMENT

LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM

References 

May J. D., & Varacallo M. (2020). Foot Sprain. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551514/ 

McCance, K. L., & Huether, S. E. (2014). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). Mosby 

National Institute of Diabetes and Digestive and Kidney Diseases (2018). Peripheral Neuropathy. Retrieved from https://www.niddk.nih.gov/health- information/diabetes/overview/preventing-problems/nerve-damage-diabetic- neuropathies/peripheral-neuropathy 

National Multiple Sclerosis Society. (2020). Numbness or Tingling. Retrieved from https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Numbness 

Rose, B., & Singh, D. (2020). Ingerior heel pain. Othopaedics and Trauma, 34(1), 10–16. https://doi.org/10.1016/j.mporth.2019.11.002 

Sample Answer 2 for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS

Patient Information:

Initials: N.T, Age: 46 years, Sex: Female, Race: White

S.

CC ” I have pain in both ankles”

HPI: N.T. is a forty-six-year-old white female patient who reported to the facility for a check. She complains of pain in both her ankles, even though she expresses more concern with the right ankle. The patient was playing soccer during the weekend when she heard a pop sound, which led to uncomfortable pain. The patient also experienced swelling following the pop sound. Consequently she is also unable to bear her weight. The pain is throbbing and more concentrated on the right ankle. She also rates the pain while resting. The pain is also radiating up the right lower extremity.

Current Medications: The patient is not using any medication currently.

Allergies: There are no records of allergies to food, medication, or environment.

PMHx: The patient indicated that she took her full dose of COVID-19. All other immunizations and annual flu tests are up to date.

Soc Hx: The patient is currently a single parent with three children. She works in the hotel industry. She likes playing soccer, which she does mostly during weekends but also occasionally in the evenings. She denies the previous or current use of alcohol. She also denies smoking or use of other illegal drugs.

Fam Hx: The patient’s parents are still alive; the father is eighty years old, and the mother is seventy-seven years old. The father is living with diabetes and hypertension while the mother has been treated for depression before and is currently living with osteoporosis. She has one elder brother and a younger sister and both are fairly healthy with no major health concerns.

 ROS:

GENERAL: No fatigue, weakness, chills, fever, and weight loss.

  HEENT: The patient’s head is normal; No visual loss, blurred vision, or double vision. She also denies reduced hearing, sneezing, congestion, sore throat, or even runny nose.  

SKIN: No signs of rash, itching, or bruising.  

 CARDIOVASCULAR: No chest discomfort, chest pain, or pressure. Denies palpitations or edema.  

RESPIRATORY: The patient denies any shortness of breath, sputum, or cough.

GASTROINTESTINAL:  The patient denies anorexia, nausea, vomiting, or abdominal pain.

GENITOURINARY:  No burning or pain during urination. She denies pregnancy. NEUROLOGICAL: She denies headache, dizziness, paralysis, ataxia, or numbness.

MUSCULOSKELETAL: She reports bilateral ankle pain. The pain is more concentrated on the right ankle as compared to the left ankle. She also reports swelling in the right ankle and is unable to bear her weight.  

HEMATOLOGIC: No anemia or bleeding.  

LYMPHATICS:  No history of splenectomy; denies enlarged nodes.

PSYCHIATRIC: No history of headache or mental illness.

  ENDOCRINOLOGIC: No Polydipsia or polyuria.   

 ALLERGIES:  No known allergies, either to food, medication, or environment

O.

Physical exam:

Vital signs: BP: 116/75, Temp: 97.0, RR: 18, HR: 76, Height: 6.2, Weight: 141 lbs

General: The patient is well-dressed and groomed. She is alert and oriented. She appears concerned regarding her ankle pain which started after hearing a pop sound when playing soccer during the weekend.

HEENT: The head is atraumatic and Normocephalic.  No ear pain or discharge. No loss of vision, no runny or stuffy nose. The patient’s neck is supple.

Skin:  The skin is warm and dry, with no wounds and no skin rashes. Bruising was seen in the right lateral ankle.

Chest: The heartbeat and heart rate are both regular, with no gallops, murmurs, or extra sounds. No cough or dyspnea. The patient’s lungs are clear.

The musculoskeletal system: The patient’s right ankle has bruises, and the fibula’s lower aspects are tender upon palpation. Less motion range was observed in the ankles. The swelling was also observed. Pain experienced on the leg when bearing weight. The left ankle had no bruising, swelling, or tenderness.

Diagnostic results: The Ottawa Ankle rule is to be used to help determine if the patient needs an X-ray to confirm or rule out a fracture (Morais et al.,2021). Ultrasound can be conducted to assess the structure of the soft tissues such as ligaments and tendons.

Differential Diagnoses

1. An Ankle sprain: This is a condition which usually occurs when the ligaments supporting a person’s ankle are torn or stretched. In most cases, the foot can forcefully turn outward or inward. Ankle sprains are known to be common when individuals participate in activities such as soccer and go for a sudden directional change (Halabchi & Hassabi, 2020). The condition can have varied severity, usually from mild to severe. This condition may present with various symptoms, such as finding it difficult to walk, joint stiffness, soreness, bruising, swelling, and pain. The patient was playing soccer when she heard a pop sound, leading to pain and swelling in her right ankle. The patient showed several of these symptoms which makes an ankle sprain one of the diagnoses.
2. Achilles tendonitis: This is a condition that may present with pain and discomfort due to tendon injuries like a tear or inflammation. The condition is sometimes known as Achilles tendinitis. In most cases, the illness may come due to a repetitive strain or overuse of the Achilles tendon, which then makes a patient to experience swelling and pain. It can also result due to weak or tight calf muscles which is known to lead to higher strain on the Achilles tendon. Other causes include a sudden increase in physical activity which can be characterized by an increased frequency, duration or intensity of the physical exercise or activity that a person engages in. Some of the symptoms include pain in the back of a person’s leg, pain exacerbated with activity, a stiff Achilles tendon, and swelling (Touzell, 2020). In addition, a patient may experience a mild thickening of the tendon, tenderness and a significant reduced range or motion.  The patient heard a pop sound when playing soccer, which makes this condition suspect.

• Chronic Ankle Instability: This is a condition that may result from multiple cases of ankle sprains, which then makes the patient prone to injuries. This condition may present with various symptoms such as ankle instability, injuries, swelling, pain, and re-injuries for more than half a year (Herzog et al.,2019). The patient may also experience recurrent sprains, complications maintaining balance and feelings of giving away. The condition is also known to substantially impact a persons, stability, mobility and the overall quality of life. The patient reported some of these symptoms, which makes this condition to be a potential diagnosis. However, the patient has no history of incomplete healed ligaments, which again makes this condition less likely.

1. Ankle fracture: This is a condition that entails cracking or breaking of one or more of the bones which make up the ankle joint. It can occur in either the talus, fibula or tibia. Ankle fracture may happen when a person experiences events such as an awkward landing or forceful impact. The condition can also be caused by osteoporosis which causes the bones to weaken, hence exposing the person to the condition. Sudden rolling or twisting of the ankle with force can also lead to this condition. Consequently, a person may put stress on the ankle, leading to the condition. Some of the symptoms include complications bearing weight, bruising, and swelling (Briet et al.,2019). Other symptoms may also include misalignment or deformity of the ankle and pain. The patient presented with some of these symptoms, making this a potential diagnosis.
2. Muscle soreness: Muscle soreness can be experienced after an individual takes part in physical activity or exercise. The condition is sometimes known as a delayed onset of muscle soreness. The condition is in most cases experienced when an individual takes part in physical exercise or activity that entail the eccentric muscle contraction, or lengthening of the muscle under tension. In addition, it is known to typically begin twenty four hours to forty eight hours after an exercise can have its peak around seventy two hours. The patient may experience reduced flexibility and strength and pain or discomfort in the skeletal muscles (Heiss et al.,2019). Other symptoms may include muscle discomfort, tenderness and stiffness. An individual with the condition may also experience an exacerbation of the soreness when the affected muscles are stretched or moved. The patient experienced pain when playing soccer, which makes this a potential diagnosis.

References

Briet, J. P., Hietbrink, F., Smeeing, D. P., Dijkgraaf, M. G., Verleisdonk, E. J., & Houwert, R. M. (2019). Ankle fracture classification: an innovative system for describing ankle fractures. The Journal of Foot and Ankle Surgery, 58(3), 492-496. https://doi.org/10.1053/j.jfas.2018.09.028

Halabchi, F., & Hassabi, M. (2020). Acute ankle sprain in athletes: Clinical aspects and algorithmic approach. World Journal of Orthopedics, 11(12), 534. https://doi.org/10.5312%2Fwjo.v11.i12.534

Heiss, R., Lutter, C., Freiwald, J., Hoppe, M. W., Grim, C., Poettgen, K., … & Hotfiel, T. (2019). Advances in delayed-onset muscle soreness (DOMS)–part II: treatment and prevention. Sportverletzung· Sportschaden, 33(01), 21-29. DOI: 10.1055/a-0810-3516

Herzog, M. M., Kerr, Z. Y., Marshall, S. W., & Wikstrom, E. A. (2019). Epidemiology of ankle sprains and chronic ankle instability. Journal of Athletic Training, 54(6), 603-610. https://doi.org/10.4085/1062-6050-447-17

Morais, B., Branquinho, A., Barreira, M., Correia, J., Machado, M., Marques, N., … & Diogo, N. (2021). Validation of the Ottawa ankle rules: Strategies for increasing specificity. Injury, 52(4), 1017-1022. https://doi.org/10.1016/j.injury.2021.01.006

Touzell, A. (2020). The Achilles tendon: Management of acute and chronic conditions. Australian Journal of General Practice, 49(11), 715–719. Doi: 10.3316/INFORMIT.553809190362672.

NURS 6512 Lab Assignment Assessing the Genitalia and Rectum Sample

Lab Assignment: Assessing the Genitalia and Rectum  

Genitourinary problems are among the public health concerns globally. Nurses and other healthcare providers adopt evidence-based interventions that would optimize patient outcomes in the treatment of these conditions. Subjective and objective data help nurses to formulate diagnoses and treatment plans. Therefore, this essay examines TS’s case study. TS has presented to the hospital complaining of dysuria, urgency, and frequency for the last two days. The essay focuses on topics that include additional subjective and objective information that should be obtained from the patient, if subjective and objective data supports the assessment, appropriate diagnostics, accepting or rejecting the diagnosis, and differential diagnoses to be considered for the patient.  

Additional Subjective Information 

Additional subjective information should be obtained from TS. Firstly, information about the character of her urine should be obtained. This includes information such as the smell and color of the urine. Bloodstained urine could indicate bladder problems while urine with a strong smell could imply that TS has a urinary tract infection. The nurse should also ask for information about the presence or absence of abnormal vaginal discharge. For instance, yellow or purulent vaginal discharge would indicate sexually transmitted infections. The character of TS’s symptoms should also be obtained. This includes seeking information on the factors that precipitate or alleviate her urinary symptoms. She should be asked about any activity that worsens or relieves her symptoms (Kaur & Kaur, 2021). The nurse should also assess her current level of pain using the pain rating scale. Pain rating could indicate the severity of her condition.  

The nurse should also ask TS about her sexual habits. This includes sexual preferences and the use of protection when engaging in sexual intercourse. The information would help the nurse rule out causes such as sexually transmitted infections. Additional sexual-related information that should be obtained includes the use of contraceptives, the last menstrual period, and menstrual cycle problems. The nurse should also obtain information about any history of recurrent urinary tract infections. This would help determine if she has chronic urinary tract infections. Similarly, information about the history of sexually transmitted infections should be obtained to rule them out in her case. Information about her partner’s history of sexually transmitted infections and testing should also be obtained to rule out a risk of STD transmission. Information about TS’s social history is also needed. This includes data about smoking, dietary practices, and alcohol use (Bono et al., 2024). The nurse should also rule out the potential of heredity of TS’s problem. Information about a family history of health problems such as kidney disease or symptoms that TS has should be obtained.  

Additional Objective Information 

Additional objective information should be obtained in TS’s case to guide the development of an accurate diagnosis and treatment plan. Firstly, the nurse should provide information about TS’s general appearance. Information such as her overall grooming, weight changes, presence or absence of chills or fatigue should be included in the objective portion. Abdominal assessment should provide information about the presence or absence of organomegaly, or abnormal pulsations. The case study should also provide detailed information about urine description (Bono et al., 2024). This includes urine color, smell, and the presence or absence of pus or blood in the urine.  

The nurse should also provide information about the assessment of the genitourinary system. Information such as the presence or absence of vaginal discharge, lesions, or trauma should be documented to rule out causes such as sexually transmitted infections and intimate partner violence. The nurse should also assess TS’s level of pain. She should use a pain rating scale to determine the severity of her pain and prioritize the treatment plan accordingly (Boon et al., 2021). Pain assessment should also include TS’s experiences of pain on abdominal palpation.  

If the Assessment is Supported by Subjective and Objective Information 

Subjective and objective information support TS’s assessment. Nurses obtain subjective information by asking patients questions that relate to their health problems and different body systems. The subjective data helps the nurse determine the severity of a health problem and its impact on the client’s health and overall well-being. TS’s case study has subjective information. They include her chief complaints, history of her presenting illness, surgical history, past medical history, medication use, allergies, and social history. Nurses obtain objective data from their patients by using methods such as inspection, palpation, auscultation, and percussion. The objective data validates subjective claims by the patient. The case study has objective information. They include TS’s vital signs, abdominal assessment, and diagnostics ordered.  

Appropriate Diagnostics for the Case 

Some diagnostic and laboratory investigations should be ordered in TS’s case study to guide develop an accurate diagnosis and treatment plan. Firstly, a urinalysis test should be performed to rule out urinary tract infections. A diagnosis of urinary tract infection will be made should her urine test reveal the presence of leucocytes and nitrites. The presence of proteins in urine will indicate cardiovascular problems such as hypertension while the presence of glucose would imply that TS has diabetes. The presence of ketones will indicate the possibility of dehydration. TS should also be tested for sexually transmitted infections. Blood tests, vaginal swabs, and urine samples should be taken to rule out sexually transmitted infections such as gonorrhea and chlamydia infections. An abdominal CT scan should also be performed to rule out causes such as kidney stones. MRI might also be needed to rule out kidney stones and other renal pathologies that could be associated with TS’s problems (Kaur & Kaur, 2021). Lastly, cervical screening for cervical cancer should be done. Cervical screening would also help rule out other causes such as vaginosis in TS’s case.  

Accepting or Rejecting Current Diagnosis Differential Diagnoses 

I would accept the current diagnosis. TS’s complaints align with those seen in patients with urinary tract infections and sexually transmitted infections. Often, patients with these conditions experience dysuria, urgency, frequency, and fever, which are present in TS’s case (Bono et al., 2024). Therefore, additional diagnostic and laboratory tests will help determine if TS is suffering from STDs or UTIs. TS’s history of engaging in unprotected sex with her new partner makes STDs among the probable diagnoses to be considered.  

One of the differential diagnoses that should be considered for TS is perinephric abscess. Perinephric access is a condition that develops from the spread of infections from other regions of the genitourinary tract to the kidneys (Okafor & Onyeaso, 2024). The infections result in the development of abscesses. Patients experience symptoms that include fever, chills, nausea, vomiting, flank pain, and fatigue (Adams et al., 2020). Unlike urinary tract infections or STDs, patients with perinephric abscesses might not experience symptoms such as urinary frequency or dysuria.  

The other differential diagnosis that should be considered for TS is urethral syndrome. Urethral syndrome is a genitourinary condition characterized by urinary frequency, urgency, suprapubic pain, and dysuria. It develops from any condition that causes urethral irritation and inflammation. The urethral syndrome can develop due to sexually transmitted infections, urinary tract infections, or the use of foods that irritate the urethra (Sell et al., 2021). A confirmed diagnosis of either UTI or STD might indicate its co-existence with urethral syndrome.  

The last differential diagnosis that should be considered for TS is kidney stones. Kidney stones develop from crystal deposition in the kidneys. Factors such as dehydration, intake of diets rich in salt, and overweight or obesity predispose individuals to kidney stones. Patients experience symptoms such as severe, sharp back or flank pain, pain radiating to the groin or lower abdominal regions, and dysuria. Patients might also report passing red or brown urine, foul-smelling and cloudy urine, frequency, nausea and vomiting, chills, and fever (Thongprayoon et al., 2020; Wang et al., 2021). The absence of red or brown-colored urine and sharp pain show that kidney stones are not the cause of TS’s complaints.  

Conclusion 

Overall, additional subjective and objective information should be obtained in the case study. Subjective and objective data support the assessment. Additional diagnostics and laboratory investigations should be ordered to develop an accurate diagnosis and treatment plan. I accept the current diagnosis based on TS’s symptoms. The three differential diagnoses that should be considered in TS’s case study include kidney stones, urethral syndrome, and perinephric abscess.  

References 

Adams, M., Bouzigard, R., Al-Obaidi, M., & Zangeneh, T. T. (2020). Perinephric abscess in a renal transplant recipient due to Mycoplasma hominis: Case report and review of the literature. Transplant Infectious Disease, 22(5), e13308. https://doi.org/10.1111/tid.13308 

Bono, M. J., Leslie, S. W., & Reygaert, W. C. (2024). Uncomplicated Urinary Tract Infections. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK470195/ 

Boon, H. A., Bruel, A. V. den, Struyf, T., Gillemot, A., Bullens, D., & Verbakel, J. Y. (2021). Clinical Features for the Diagnosis of Pediatric Urinary Tract Infections: Systematic Review and Meta-Analysis. The Annals of Family Medicine, 19(5), 437–446. https://doi.org/10.1370/afm.2684 

Kaur, R., & Kaur, R. (2021). Symptoms, risk factors, diagnosis and treatment of urinary tract infections. Postgraduate Medical Journal, 97(1154), 803–812. https://doi.org/10.1136/postgradmedj-2020-139090 

Okafor, C. N., & Onyeaso, E. E. (2024). Perinephric Abscess. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK536936/ 

Sell, J., Nasir, M., & Courchesne, C. (2021). Urethritis: Rapid Evidence Review. American Family Physician, 103(9), 553–558. 

Thongprayoon, C., Krambeck, A. E., & Rule, A. D. (2020). Determining the true burden of kidney stone disease. Nature Reviews Nephrology, 16(12), Article 12. https://doi.org/10.1038/s41581-020-0320-7 

Wang, Z., Zhang, Y., Zhang, J., Deng, Q., & Liang, H. (2021). Recent advances on the mechanisms of kidney stone formation (Review). International Journal of Molecular Medicine, 48(2), 1–10. https://doi.org/10.3892/ijmm.2021.4982