Decision making for the Advanced Practice Nurse

For this assignment:

Consider that you are the provider on duty at a local urgent care clinic. As you read each of the patient scenarios, think about what the non-emergent diagnosis might be for this patient. Then consider this patients presentation and situation in light of emergency, life threatening, or life altering diagnoses. Answer the following questions for each patient:

#1 Identify which of the provided diagnoses should be assigned to each patient.

#2 Identify what signs and symptoms give you a clue that the disease process might be more serious than it presents.

#3 Is it appropriate to continue to treat this patient or do they require a higher level of care? If they require a higher level of care, please explain your rationale.

Meet your patients for the day:

Im having trouble breathing! That is certainly a phrase that will get the attention of a healthcare provider, but what does it mean? Is the patients nose stopped up? Are they having a panic attack and having only the sense of shortness of breath? Or are the lungs experiencing reduced oxygen exchange? Is the cause infection, impaired circulation, a mechanical injury, or something else? What body system is causing the issue? The only thing for certain is that we need to act quickly to figure it all out. As you know, time is of the essence.

Whitiker Carson, an 13-year-old male, was just brought to the clinic by his father. Whitiker has been sick for a few days with a fever ranging from 100.8 to 102.5. He has a snotty nose and is coughing frequently. The first few days his mom assumed he had a cold, but now Whitaker doesnt want to eat and is not even interested in his new gaming system. His cough sounds thick and he hasnt been able to rest because of the coughing. He says that when he coughs it makes his chest hurt, and he looks like a sick kiddo.

Approximately 30 minutes ago, Carlos Feliz, a 17-year-old high school basketball player, was jumping for a layup and had sudden intense pain in his left chest. He presented to the clinic with visible tachypnea and in a state of agitation. He is holding his left chest and keeps whispering that he cant breathe. Vitals: Height 66, Weight 152 lbs., B/P 108/68, HR 104, O2 on RA 94%, Resp 30, Temp 37.2

Rebecca Winsdale, a 36-year-old female, complains of shortness of breath and cough. She is training for a marathon next month but cant seem to control her breathing. She has used her rescue inhaler several times today already but doesnt think that it is doing much. She has heard a few wheezes, but the dry cough seems to be her chief complaint because it is throwing off her exercise regimen.

Marlin Corest, a 68-year-old male, was brought to the clinic by his daughter. She came to visit him earlier and thinks that something is very wrong. She states that his color doesnt look good, and he is not himself. She couldnt even get him to eat the cinnamon roll she brought for him. Mr. Corest has smoked cigarettes since he was 14 years old and was diagnosed with COPD last year, but this is an acute change. He is coughing up a lot more sputum, and the daughter says that Mr. Corests finger oxygen machine showed 84 when she got to his house.

Carla Shinto, the 51-year-old last patient of the day, arrived at the clinic with a complaint of shortness of breath, cough, and extreme fatigue for several days. However, she stated that something changed in the night last night. She is standing up, leaning against the exam table with outstretched arms when you enter the room. When asked about whether the cough was productive, the patient stated that she has been coughing up foamy pink stuff, but since its not green she doesnt think its an infection. She additionally stated that her husband has been complaining that her breathing is noisy, and she has been sleeping propped up on too many pillows. She is not resting well and gets winded just getting up to go to the bathroom. Is this a respiratory problem or is there more to know? Vitals: B/P 146/90, HR 94, O2 sat on RA 91%, Temp 37.4, Resp 28

Please note that there are more answer options provided than the number of scenarios presented. It is essential to carefully read each scenario in its entirety before selecting your answer. Use critical thinking and refer to your textbooks and clinical resources to guide your decisions. Focus on identifying key details in the scenarios that align with the best clinical response. This approach will help ensure accuracy and deepen your understanding of the concepts being assessed.

• Asthma Exacerbation
• Chronic Obstructive Pulmonary Disease Exacerbation
• Pneumonia
• Pneumothorax
• Pulmonary Edema
• Costochondritis
• Pulmonary Embolism

Make sure to answer with concise, but thorough thoughts. You may use a combination of full sentences and phrases or lists as long as your answers are professional, understandable, and cover the content well. Make sure to cite any professional references used, including your text(s), in proper APA 7 format in the provided space at the end of the document.