NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING THE HEAD, EYES, EARS, NOSE, AND THROAT

Walden University NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING THE HEAD, EYES, EARS, NOSE, AND THROAT– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING THE HEAD, EYES, EARS, NOSE, AND THROAT 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 THE HEAD, EYES, EARS, NOSE, AND THROAT

Whether one passes or fails an academic assignment such as the Walden University NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING THE HEAD, EYES, EARS, NOSE, AND THROAT 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 THE HEAD, EYES, EARS, NOSE, AND THROAT

The introduction for the Walden University NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING THE HEAD, EYES, EARS, NOSE, AND THROAT 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 THE HEAD, EYES, EARS, NOSE, AND THROAT

After the introduction, move into the main part of the NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING THE HEAD, EYES, EARS, NOSE, AND THROAT 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 THE HEAD, EYES, EARS, NOSE, AND THROAT

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 THE HEAD, EYES, EARS, NOSE, AND THROAT

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 THE HEAD, EYES, EARS, NOSE, AND THROAT

Patient Information: 

Initials: CH 

Age: 28 years 

Sex: Female 

S. 

CC (chief complaint): Runny nose and itchy eyes  

HPI: Charlotte is a 28-year-old lady who presented with complaints of a runny nose and itchy eyes for 9 days. These symptoms are intermittent and occur every spring for approximately six to eight weeks. The nasal discharge is of clear mucus. There is an associated fullness and popping of ears, on-and-off sneezes throughout the day, and a tickle in the throat. There is a history of partial relief with Claritin. There is no reported cough, hotness of the body, or hearing loss. 

Location: Nose and eyes. 

Onset: 9 days ago. 

Character: Intermittent. 

Associated signs and symptoms: On and off sneezing, tickle in the throat, fullness, and popping of the ears. 

Timing: Every spring for six to eight weeks.  

Exacerbating/ relieving factors: Partial relief by Claritin. There is no known exacerbating factor. 

Severity: Unknown.  

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

Allergies: There is no known allergy to any medication, food, or environmental components. The patient’s symptoms, however, recur every spring thus there is a possible allergy to pollen which could be the major trigger of the patient’s seasonality of symptoms. 

PMH: The patient is neither hypertensive nor diabetic. There is no other reported significant chronic medical condition. The patient has never undergone any surgical procedure. 

Soc Hx: The patient is an accountant. She likes traveling and photography. She is recently married with one child. There is no reported history of smoking or chronic alcohol use. She is currently lactating and is not on any contraception. 

Fam Hx: The patient has a positive history of similar presentations in her grandfather. There is no family history of diabetes or hypertension.  

ROS:  

GENERAL: She reports no recent unintended weight loss, fever, or generalized body malaise. 

SKIN: She reports no pruritus, abnormal skin discoloration, or skin rash. 

CARDIOVASCULAR: She reports no left-sided chest pains, palpitations, easy fatigability, or shortness of breath even on exertion or lying flat. 

RESPIRATORY: She reports no dyspnea, no chest pain, no cough, and no chest tightness.  

ABDOMINAL: She reports no abdominal swelling, abdominal pain, nausea, vomiting, diarrhea, or constipation.  

GENITOURINARY: She denies discomfort or burning sensation on urination, no blood in urine, and no frequency. Her menstrual cycle is regular with her last experienced menstrual period occurring two weeks ago. 

NEUROLOGICAL: She denies headaches, dizziness, seizures, tingling sensation, numbness, weakness, loss of bladder and bowel control, or loss of consciousness.  

MUSCULOSKELETAL: She has a history of joint swelling and tenderness with a diagnosis of gout that has since resolved with treatment.   

HEMATOLOGIC: She reports no anemia, no excessive bleeding, and no easy bruising. 

LYMPHATICS: She denies any lymphadenopathy, splenomegaly, or past splenectomy.  

PSYCHIATRIC: She has no psychiatric history of depression, psychosis, or other mental disorder. 

ENDOCRINOLOGIC: She denies excessive diaphoresis and heat or cold intolerance. She experiences polydipsia and polyuria. 

ALLERGIES:  She reports no history of allergic reactions. 

O. 

Physical exam:  

VITALS: BP 102/80 mmHg, HR 72 bpm, RR 14, Temperature 98.0 F, BMI 22.0 

GENERAL: The patient is in good general condition and not distressed. She is mildly dehydrated. The patient is obese. 

HEENT: The head is atraumatic. Extraocular movements are intact with pupils being equally and bilaterally reactive to light. There is no scleral jaundice but there is redness of the eyes. The tonsils are not swollen but her throat is mildly erythematous. The external ear canals are free of foreign bodies or wax. The nasal mucosa is pale, boggy, and has clear thin secretions. The nasal turbinates are enlarged with resultant airway obstruction.  

RESPIRATORY: The chest moves with respiration. It is resonant on percussion. There are normal vesicular breath sounds and good bilateral air entry on auscultation.  

CARDIOVASCULAR: The point of maximal pulsation is in the fifth intercostal space midclavicular line. There is a normal cardiac activity in the precordium. S1 and S2 heart sounds were present with no murmurs or thrills. 

ABDOMINAL: The abdomen is no abdominal distension. There is minimal tenderness in the right upper quadrant. There are no elicited masses or organomegaly. Bowel sounds are present. 

MUSCULOSKELETAL: There is joint swelling, joint stiffness, or tenderness. There is no limitation in the range of motion.  

NEUROLOGICAL: The patient is alert and oriented. There are no focal neurological deficits, weakness, or loss of sensation.  

SKIN: The skin is warm and dry. 

PSYCHIATRIC: The mood is stable with congruent affect. 

Diagnostic results:  

A complete blood count showed elevated eosinophilic cell count with the other differential cell count being within normal ranges. This suggests an allergic process or parasitic infestation which is unlikely based on the patient’s presentations. 

Rhinoscopy showed a pale and boggy nasal mucosa covered with clear mucus. The absence of purulent nasal discharge rules out an infective process. 

Skin prick test was positive for allergic reaction. 

A CT scan of the head showed no evidence of basal skull fracture, chronic sinusitis, or nasal polyposis. 

A. 

Differential Diagnoses: 

1. Allergic rhinitis: This is the most likely diagnosis. This is because the patient presented with typical nasal and non-nasal symptoms. The nasal symptoms included a runny nose and sneezing whereas non-nasal symptoms included itchy eyes, redness of the eyes, and tickling of the throat (Nur Husna et al., 2022). Allergic rhinitis can also present with eustachian tube dysfunction which manifests with features such as aural fullness, aural pressure, ear pain, and popping (Juszczak et al., 2020). The patient reported fullness of the ears and popping of the ears thus there is a possibility of eustachian tube dysfunction attributed to existing allergic rhinitis. Allergic rhinitis can be seasonal, perennial, or episodic (Emeryk et al., 2019). The patient probably has seasonal allergic rhinitis due to the recurrence of symptoms during spring which is associated with the abundance of triggering pollens. The presence of a positive family history of similar presentation may point to the genetic predisposition of the atopic condition. The effectiveness of Claritin in symptomatic relief suggests an allergic process. This is because Claritin is an antihistamine that can effectively reduce allergic reactions through the suppression of proinflammatory reactions. 

2. Non-allergic rhinitis: Non-allergic rhinitis is another possible diagnosis. This is because some of the presenting complaints are similar to those of allergic rhinitis. This includes rhinorrhea, sneezing, and nasal congestion. However, non-allergic rhinitis does not display seasonality of symptoms as witnessed in the patient in this case. The presence of non-nasal symptoms such as itchy eyes makes allergic rhinitis more probable than non-allergic rhinitis. Non-allergic rhinitis of inflammatory and non-inflammatory etiologies such as post-infectious rhinitis, eosinophilic rhinitis, and medication-induced rhinitis should thus be excluded through further workups (Agnihotri et al., 2019). This will enable the formulation of a tailored appropriate management plan. 

3. Eustachian tube dysfunction: This is a likely differential diagnosis. The aural fullness and popping sounds reported by the patient are characteristic of eustachian tube dysfunction (Hamrang-Yousefi et al., 2022). The presence of additional seasonal features such as itchy eyes and runny nose rules out eustachian tube dysfunction as the only diagnosis. Serious complications such as otitis media with effusion should be assessed.  

P.   

This section is not required for the assignments in this course (NURS 6512) but will be required for future courses. 

Also Read:

DIGITAL CLINICAL EXPERIENCE: FOCUSED EXAM: COUGH

LAB ASSIGNMENT: ASSESSING THE ABDOMEN

DIGITAL CLINICAL EXPERIENCE: ASSESSING THE HEART, LUNGS, AND PERIPHERAL VASCULAR SYSTEM

ASSESSING MUSCULOSKELETAL PAIN

CASE STUDY ASSIGNMENT: ASSESSING NEUROLOGICAL SYMPTOMS

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

LAB ASSIGNMENT: ASSESSING THE GENITALIA AND RECTUM

References 

Agnihotri, N. T., & McGrath, K. G. (2019). Allergic and nonallergic rhinitis. Allergy and asthma proceedings, 40(6), 376–379. https://doi.org/10.2500/aap.2019.40.4251 

Emeryk, A., Emeryk-Maksymiuk, J., & Janeczek, K. (2019). New guidelines for the treatment of seasonal allergic rhinitis. Advances in Dermatology and Allergology, 36(3), 255–260. https://doi.org/10.5114/ada.2018.75749  

Hamrang-Yousefi, S., Ng, J., & Andaloro, C. (2022). Eustachian Tube Dysfunction. In StatPearls. StatPearls Publishing. 

Juszczak, H. M., & Loftus, P. A. (2020). Role of Allergy in Eustachian Tube Dysfunction. Current allergy and asthma reports, 20(10), 54. https://doi.org/10.1007/s11882-020-00951-3 

Nur Husna, S. M., Tan, H.-T. T., Md Shukri, N., Mohd Ashari, N. S., & Wong, K. K. (2022). Allergic rhinitis: A clinical and pathophysiological overview. Frontiers in Medicine, 9. https://doi.org/10.3389/fmed.2022.874114

Sample Answer 2 for NURS 6512 CASE STUDY ASSIGNMENT: ASSESSING THE HEAD, EYES, EARS, NOSE, AND THROAT

Patient Information:

J, Male, 13 years old

CC (chief complaint) ‘I feel pain when swallowing’

HPI: Jason is a 13-year-old patient that came to the hospital accompanied by his mother with complaints of painful swallowing. The patient reports that the problem started as a bad sore throat which worsens with swallowing. He also reports that he feels tired. His mother gave him some over the counter medication (Children’s Motrin), which made his fever better but did not help in relieving the symptoms associated with sore throat. Jayson reports that the symptoms worsen at night. The client’s symptoms started two days ago.

Current Medications: The patient reported that he currently uses children’s Motrin which his mother gave him. He does not use any other kind of medication.

Allergies: The patient denies any history of allergic reaction to food drugs or environmental allergens.

PMHx: The patient’s medical history is unremarkable. He has no history of hospitalization or any other chronic illnesses. The patient does not have any history of surgeries. His immunization history is up to date.
Soc Hx: The patient is a student. He resides with his family. He loves participating in active physical activities such as football. He wears a helmet when riding a bicycle. He denies any use of substances such as alcohol or smoking in his family.

Fam Hx: The patient’s grandfather died of depression. His grandmother is diabetic and has been on treatment for the last 20 years. His uncle was diagnosed with alcohol use disorder three months ago and is on treatment. There is no history of other chronic illnesses in the family.

ROS:

GENERAL:  The patient is dressed appropriately for the occasion. He appears alert and oriented to place, time and self. The patient reports fatigue and denies weight loss, fever or chills

HEENT:  Eyes: Denies visual loss, blurred vision, double vision or yellow sclerae. Ears, Nose, Throat:  Denies hearing loss, sneezing, congestion or runny nose. The patient reports sore throat which has made it difficult for him to swallow.

SKIN:  Denies rash or itching.

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

RESPIRATORY:  Denies shortness of breath, cough or sputum.

GASTROINTESTINAL:  Denies anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood.

GENITOURINARY:  denies urgency, frequency, or dysuria.

NEUROLOGICAL:  Denies headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.

MUSCULOSKELETAL:  Denies muscle, back pain, joint pain or stiffness.

HEMATOLOGIC:  Denies anemia, bleeding or bruising.

LYMPHATICS:  Denies enlarged nodes. No history of splenectomy.

PSYCHIATRIC:  Denies history of depression or anxiety.

ENDOCRINOLOGIC:  Denies reports of sweating, cold or heat intolerance. No polyuria or polydipsia.

ALLERGIES:  Denies history of asthma, hives, eczema or rhinitis.

O.

Vitals: Temperature 37.5. RR 20 breaths per minute regular, SPO2 98%

Physical exam: HEENT: There is no evidence of head injuries. Hair is equally distributed. The patient has no eye squinting. He does not use corrective lenses. There is no eye drainage or red eyes. Visual acuity is 20/20. The patient denies loss of balance or reduced hearing ability. There are normal bone and air conduction. There is no halitosis. There are no dental problems. Tonsils are edematous (2+) with stones present on the right side. He has white patches on his tongue. There is no lymphadenopathy. There is full range of motion on neck movement.

Respiratory: The patient breaths with ease. There is no nasal flaring, crackles or wheezing and cough. There is no central or peripheral cyanosis.

Cardiovascular: S1 and S2 heart sounds heard. There are no palpitations, tachycardia, chest indrawing, or edema.

Diagnostic results: Some of the recommended laboratory investigations include pharyngeal swab, sputum test and rapid antigen testing to identify the cause of the infection. Blood examinations such as complete blood count may be necessary to identify the potential cause of the infection. Methods such as complete blood count and rapid antigen testing have low sensitivity rates. CT scans may be used in cases where the care provider suspects peritonsillar abscess since it has sensitivity of up to 100%. Of all these diagnostics, the use of throat swabs and sputum culture provide the most accurate results for diagnosing patients with throat disorders such as that seen in this case study.

A.

Differential Diagnoses

Tonsillitis: Tonsillitis is the primary diagnosis for this client. Tonsillitis is the inflammation of the tonsils and contributes to about 1.3% of all the outpatient visits in America. The main causes of tonsillitis are bacterial and viral infections. Viral infections contribute to most of the cases of trump tonsillitis. Tonsillitis caused by bacterial infections are largely attributed to Group A beta hemolytic streptococcus. The affected patients present the hospital with symptoms that include fever, sore throat, tonsilla exudates and tender anterior cervical chain lymphadenopathy. There are also additional symptoms such as dysphagia and odynophagia due to tonsilla swelling. Physical examination of the tonsils may reveal swelling and erythema. There may also be tonsilla inflammation which decreases visualization of the posterior oropharynx (Al-Rawashdeh et al., 2022; Anderson & Paterek, 2022). The patient in this case study has symptoms that align with those seen in tonsillitis. For example, the patient has sore throat, dysphagia, erythema, and tonsil stones. This makes tonsillitis the client’s primary diagnosis.

            Epiglottitis:  Epiglottitis is the client’s secondary diagnosis that should be considered. Epiglottitis is a disorder that is characterized by the inflammation of the epiglottis. Epiglottitis develops from factors such as inflammation or trauma to the epiglottis. Patients present the hospital with symptoms such as fever, dysphagia, drooling, sore throat, muffled voice, the difficulty in breathing, and fatigue. There is also the presence of inspirational stridor and patient leaning forward to ease the breathing process (Allen et al., 2021; Dowdy & Cornelius, 2020). However, epiglottitis is the least likely diagnosis for this patient because of the lack of symptoms such as drooling, inspirational stridor, and leaning forward to ease breathing.

            Pharyngitis:  Pharyngitis is the other diagnosis that should be considered for this patient. It is characterized by the inflammation of the pharynx due to causes such as infections caused by bacteria or viruses. Patients may present with symptoms that are like those of tonsillitis. They include fever, sneezing, chills, headache, runny nose, fatigue, and cough (Bennett et al., 2022; Sykes et al., 2020). Despite the similarities, pharyngitis is the least likely cause of the client’s problem because there is the involvement of the tonsils. Patients with pharyngitis do not have symptoms such as tonsillitis.

Peritonsillar abscess: Peritonsillar abscess is the other secondary diagnosis to be considered for the client. Peritonsillar abscess is a complication of tonsilitis. Patients experience symptoms such as fevers, chills, dysphagia, headache, and sore throat. Peritonsillar abscess is the least possible diagnosis because of the acute nature of the patient’s symptoms.

Ludwig angina: The last differential to consider is Ludwig angina. Ludwig angina develops from infections of the submandibular space (Al-Qahtani et al., 2020). The healthcare provider should establish if the patient has a history of dental problems, which may have led to Ludwig angina. This will help rule out tonsilitis and other differential diagnoses.

This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

References

Allen, M., Meraj, T. S., Oska, S., Spillinger, A., Folbe, A. J., & Cramer, J. D. (2021). Acute epiglottitis: Analysis of U.S. mortality trends from 1979 to 2017. American Journal of Otolaryngology, 42(2), 102882. https://doi.org/10.1016/j.amjoto.2020.102882

Al-Qahtani, A., Haidar, H., & Larem, A. (2020). Textbook of Clinical Otolaryngology. Springer Nature.

Al-Rawashdeh, B. M., Altawil, M., Khdair Ahmad, F., Alharazneh, A., Hamdan, L., Muamar, A. S. H., Alkhaldi, S., Tamimi, Z., Husami, R., Husami, R., & Ababneh, N. A. (2022). Vitamin D Levels in Children with Recurrent Acute Tonsillitis in Jordan: A Case-Control Study. International Journal of Environmental Research and Public Health, 19(14), Article 14. https://doi.org/10.3390/ijerph19148744

Anderson, J., & Paterek, E. (2022). Tonsillitis. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK544342/

Bennett, J., Moreland, N. J., Zhang, J., Crane, J., Sika-Paotonu, D., Carapetis, J., Williamson, D. A., & Baker, M. G. (2022). Risk factors for group A streptococcal pharyngitis and skin infections: A case control study. The Lancet Regional Health – Western Pacific, 26, 100507. https://doi.org/10.1016/j.lanwpc.2022.100507

Dowdy, R. A. E., & Cornelius, B. W. (2020). Medical Management of Epiglottitis. Anesthesia Progress, 67(2), 90–97. https://doi.org/10.2344/anpr-66-04-08

Sykes, E. A., Wu, V., Beyea, M. M., Simpson, M. T. W., & Beyea, J. A. (2020). Pharyngitis: Approach to diagnosis and treatment. Canadian Family Physician, 66(4), 251–257.