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Advanced Health Assessment & Clinical Diagnosis in Primary Care - E-Book

Advanced Health Assessment & Clinical Diagnosis in Primary Care - E-Book

Joyce E. Dains | Linda Ciofu Baumann | Pamela Scheibel

(2012)

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Book Details

Abstract

Take your understanding to a whole new level with Pageburst digital books on VitalSource! Easy-to-use, interactive features let you make highlights, share notes, run instant topic searches, and so much more. Best of all, with Pageburst, you get flexible online, offline, and mobile access to all your digital books.

Designed for advanced practice nurses and advanced practice nursing students, as well as Physician's Assistant students and practitioners, Advanced Health Assessment & Clinical Diagnosis in Primary Care, 4th Edition, is a practical resource that takes you to the "next step" of health assessment, beyond basic history and physical examination and through the diagnostic reasoning process. Accessible and concise, it approaches physical examination by focusing on a specific chief complaint rather than a diagnosis of a disease entity. Each chapter is organized into four major areas: Focused History; Focused Physical Examination; Laboratory and Diagnostic Studies; and Differential Diagnosis. Those who master the diagnostic reasoning process in this text will be able to accurately diagnose the majority of conditions they will see in clinical practice.

  • Easy-to-follow format with consistent organization improves your ability to understand and accurately perform the different elements of the diagnostic reasoning process:
    • Focused History sections walk you through the thinking process involved in obtaining a pertinent, relevant, problem-specific history that will assist in differential diagnosis.
    • Key Questions highlight what questions to ask the patient, followed by an explanation of what the patient's responses might signify, to guide you toward an accurate assessment and precise diagnosis.
    • Focused Physical Examination sections explain how to conduct more advanced diagnostic techniques and offer interpretations of the findings.
    • Laboratory and Diagnostic Studies sections give a brief outline of what types of laboratory or diagnostic studies would be appropriate for the chief complaint or suspected diagnosis.
    • Differential Diagnosis sections contain the most common differential diagnoses for each chief complaint and summarize the history and physical examination findings, along with the laboratory and diagnostic studies indicated.
  • Differential Diagnosis tables offer an at-a-glance summary of possible diagnoses.
  • Reordered table of contents, organized alphabetically by patient problem rather than by body system, simplifies and accelerates information retrieval. A list of chapters by body system is also included for reference.
  • Three new chapters:
    • Chapter 23: Palpitations
    • Chapter 36: Weight Loss/Gain (Unintentional)
    • Chapter 38: The Abdominal X-ray
  • Additional Evidence-Based Practice boxes provide additional research-based tips on conducting the most effective exams for more accurate diagnoses.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Table of contents IFC1
Advanced Health Assessmentand Clinical Diagnosisin Primary Care Fourth Edition iii
Copyright Page iv
REVIEWERS v
ACKNOWLEDGMENTS vi
INTRODUCTION vii
PART I AN INTRODUCTION TO CLINICAL REASONING 1
CHAPTER 1 Clinical Reasoning, Differential Diagosis, Evidence-Based Practice, and Symptom Analysis 2
DIAGNOSTIC REASONING 2
THE DIAGNOSTIC PROCESS 2
EXPERT VERSUS NOVICE CLINICIANS 3
DEVELOPING CLINICAL JUDGMENT 4
NEGOTIATING GOALS AND EXPECTATIONS OF A PATIENT ENCOUNTER 4
EVIDENCE-BASED PRACTICE 4
SUMMARY 5
REFERENCES AND READINGS 5
PART II COMMON SYMPTOMS IN PRIMARY CARE 7
CHAPTER 2 Abdominal Pain 8
DIAGNOSTIC REASONING: FOCUSED HISTORY 9
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 15
LABORATORY AND DIAGNOSTIC STUDIES 18
DIFFERENTIAL DIAGNOSIS 20
ACUTE CONDITIONS THAT CAUSE ABDOMINAL PAIN 21
CHRONIC CONDITIONS THAT CAUSE LOWER ABDOMINAL PAIN 23
CHRONIC CONDITIONS THAT CAUSE UPPER ABDOMINAL PAIN 24
REFERENCES AND READINGS 29
CHAPTER 3 Affective Changes 30
DIAGNOSTIC REASONING: FOCUSED HISTORY 30
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 35
LABORATORY AND DIAGNOSTIC STUDIES 39
DIFFERENTIAL DIAGNOSIS 39
REFERENCES AND READINGS 45
CHAPTER 4 Amenorrhea 46
DIAGNOSTIC REASONING: FOCUSED HISTORY 46
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 53
LABORATORY AND DIAGNOSTIC STUDIES 55
DIFFERENTIAL DIAGNOSIS 57
REFERENCES AND READINGS 60
CHAPTER 5 Breast Lumps and Nipple Discharge 61
DIAGNOSTIC REASONING: FOCUSED HISTORY FOR BREAST LUMPS 61
DIAGNOSTIC REASONING: FOCUSED HISTORY FOR NIPPLE DISCHARGE 63
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 65
LABORATORY AND DIAGNOSTIC STUDIES 68
DIFFERENTIAL DIAGNOSIS 70
REFERENCES AND READINGS 73
CHAPTER 6 Breast Pain 74
DIAGNOSTIC REASONING: FOCUSED HISTORY 74
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 76
LABORATORY AND DIAGNOSTIC STUDIES 76
DIFFERENTIAL DIAGNOSIS 78
REFERENCES AND READINGS 80
CHAPTER 7 Chest Pain 81
DIAGNOSTIC REASONING: FOCUSED HISTORY 81
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 86
LABORATORY AND DIAGNOSTIC STUDIES 89
DIFFERENTIAL DIAGNOSIS 91
REFERENCES AND READINGS 97
CHAPTER 8 Confusion in Older Adults 98
DIAGNOSTIC REASONING: FOCUSED HISTORY 98
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 101
LABORATORY AND DIAGNOSTIC STUDIES 104
DIFFERENTIAL DIAGNOSIS 105
REFERENCES AND READINGS 110
CHAPTER 9 Constipation 111
DIAGNOSTIC REASONING: FOCUSED HISTORY 111
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 115
LABORATORY AND DIAGNOSTIC STUDIES 115
DIFFERENTIAL DIAGNOSIS 117
REFERENCES AND READINGS 119
CHAPTER 10 Cough 120
DIAGNOSTIC REASONING: FOCUSED HISTORY 120
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 124
LABORATORY AND DIAGNOSTIC STUDIES 126
DIFFERENTIAL DIAGNOSIS 127
REFERENCES AND READINGS 133
CHAPTER 11 Diarrhea 134
DIAGNOSTIC REASONING: FOCUSED HISTORY 134
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 139
LABORATORY AND DIAGNOSTIC STUDIES 141
DIFFERENTIAL DIAGNOSIS 143
REFERENCES AND READINGS 148
CHAPTER 12 Dizziness 149
DIAGNOSTIC REASONING: FOCUSED HISTORY 149
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 152
LABORATORY AND DIAGNOSTIC STUDIES 154
DIFFERENTIAL DIAGNOSIS 155
REFERENCES AND READINGS 158
CHAPTER 13 Dyspnea 159
DIAGNOSTIC REASONING: FOCUSED HISTORY 159
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 163
LABORATORY AND DIAGNOSTIC STUDIES 168
DIFFERENTIAL DIAGNOSIS 169
REFERENCES AND READINGS 173
CHAPTER 14 Earache 174
DIAGNOSTIC REASONING: FOCUSED HISTORY 174
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 177
LABORATORY AND DIAGNOSTIC STUDIES 180
DIFFERENTIAL DIAGNOSIS 181
REFERENCES AND READINGS 183
CHAPTER 15 Fatigue 184
DIAGNOSTIC REASONING: FOCUSED HISTORY 184
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 187
LABORATORY AND DIAGNOSTIC STUDIES 188
DIFFERENTIAL DIAGNOSIS 189
REFERENCES AND READINGS 193
CHAPTER 16 Fever 194
DIAGNOSTIC REASONING: FOCUSED HISTORY 194
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 199
LABORATORY AND DIAGNOSTIC STUDIES 202
DIFFERENTIAL DIAGNOSIS 204
REFERENCES AND READINGS 207
CHAPTER 17 Genitourinary Problems in Males 208
DIAGNOSTIC REASONING: FOCUSED HISTORY 208
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 212
LABORATORY AND DIAGNOSTIC STUDIES 213
DIFFERENTIAL DIAGNOSIS 217
REFERENCES AND READINGS 220
CHAPTER 18 Headache 221
DIAGNOSTIC REASONING: FOCUSED HISTORY 221
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 226
LABORATORY AND DIAGNOSTIC STUDIES 228
DIFFERENTIAL DIAGNOSIS 229
REFERENCES AND READINGS 234
CHAPTER 19 Hoarseness 235
DIAGNOSTIC REASONING: FOCUSED HISTORY 235
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 238
LABORATORY AND DIAGNOSTIC STUDIES 239
DIFFERENTIAL DIAGNOSIS 239
REFERENCES AND READINGS 242
CHAPTER 20 Limb Pain 243
DIAGNOSTIC REASONING: FOCUSED HISTORY 243
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 248
LABORATORY AND DIAGNOSTIC STUDIES 252
DIFFERENTIAL DIAGNOSIS 253
REFERENCES AND READINGS 266
CHAPTER 21 Low Back Pain (Acute) 267
DIAGNOSTIC REASONING: FOCUSED HISTORY 267
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 271
LABORATORY AND DIAGNOSTIC STUDIES 274
DIFFERENTIAL DIAGNOSIS 274
REFERENCES AND READINGS 279
CHAPTER 22 Nasal Symptoms and Sinus Congestion 280
DIAGNOSTIC REASONING: FOCUSED HISTORY 280
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 283
LABORATORY AND DIAGNOSTIC STUDIES 284
DIFFERENTIAL DIAGNOSIS 285
REFERENCES AND READINGS 287
CHAPTER 23 Palpitations 288
DIAGNOSTIC REASONING: FOCUSED HISTORY 288
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 290
LABORATORY AND DIAGNOSTIC STUDIES 291
DIFFERENTIAL DIAGNOSIS 292
REFERENCES AND READINGS 295
CHAPTER 24 Penile Discharge 296
DIAGNOSTIC REASONING: FOCUSED HISTORY 296
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 298
LABORATORY AND DIAGNOSTIC STUDIES 299
DIFFERENTIAL DIAGNOSIS 300
REFERENCES AND READINGS 302
CHAPTER 25 Rashes and Skin Lesions 303
DIAGNOSTIC REASONING: INITIAL FOCUSED PHYSICAL EXAMINATION 303
DIAGNOSTIC REASONING: FOCUSED HISTORY 308
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 311
LABORATORY AND DIAGNOSTIC STUDIES 312
DIFFERENTIAL DIAGNOSIS 313
REFERENCES AND READINGS 320
CHAPTER 26 Rectal Pain, Itching, and Bleeding 321
DIAGNOSTIC REASONING: FOCUSED HISTORY 322
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 326
LABORATORY AND DIAGNOSTIC STUDIES 327
DIFFERENTIAL DIAGNOSIS 328
REFERENCES AND READINGS 333
CHAPTER 27 Red Eye 334
DIAGNOSTIC REASONING: FOCUSED HISTORY 334
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 338
LABORATORY AND DIAGNOSTIC STUDIES 340
DIFFERENTIAL DIAGNOSIS 341
REFERENCES AND READINGS 344
CHAPTER 28 Sleep Problems 345
DIAGNOSTIC REASONING: FOCUSED HISTORY 345
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 350
LABORATORY AND DIAGNOSTIC STUDIES 350
DIFFERENTIAL DIAGNOSIS 351
REFERENCES AND READINGS 355
CHAPTER 29 Sore Throat 356
DIAGNOSTIC REASONING: FOCUSED HISTORY 356
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 358
LABORATORY AND DIAGNOSTIC STUDIES 361
DIFFERENTIAL DIAGNOSIS 361
REFERENCES AND READINGS 365
CHAPTER 30 Syncope 366
DIAGNOSTIC REASONING: FOCUSED HISTORY 366
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 369
LABORATORY AND DIAGNOSTIC STUDIES 369
DIFFERENTIAL DIAGNOSIS 370
REFERENCES AND READINGS 373
CHAPTER 31 Urinary Incontinence 374
DIAGNOSTIC REASONING: FOCUSED HISTORY Adults 374
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 378
LABORATORY AND DIAGNOSTIC STUDIES 379
DIFFERENTIAL DIAGNOSIS 380
REFERENCES AND READINGS 384
CHAPTER 32 Urinary Problems in Females and Children 385
DIAGNOSTIC REASONING: FOCUSED HISTORY 385
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 389
LABORATORY AND DIAGNOSTIC STUDIES 389
DIFFERENTIAL DIAGNOSIS 391
REFERENCES AND READINGS 395
CHAPTER 33 Vaginal Bleeding 396
DIAGNOSTIC REASONING: FOCUSED HISTORY 396
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 402
LABORATORY AND DIAGNOSTIC STUDIES 403
DIFFERENTIAL DIAGNOSIS 405
REFERENCES AND READINGS 410
CHAPTER 34 Vaginal Discharge and Itching 411
DIAGNOSTIC REASONING: FOCUSED HISTORY 411
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 415
LABORATORY AND DIAGNOSTIC STUDIES 416
DIFFERENTIAL DIAGNOSIS 419
REFERENCES AND READINGS 422
CHAPTER 35 Vision Loss 423
DIAGNOSTIC REASONING: FOCUSED HISTORY 423
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 427
LABORATORY AND DIAGNOSTIC STUDIES 430
DIFFERENTIAL DIAGNOSIS 430
REFERENCES AND READINGS 434
CHAPTER 36 Weight Loss/Gain (Unintentional) 435
DIAGNOSTIC REASONING: FOCUSED HISTORY 435
DIAGNOSTIC REASONING: FOCUSED PHYSICAL EXAMINATION 440
DIFFERENTIAL DIAGNOSIS 442
REFERENCES AND READINGS 446
PART III DIAGNOSTIC IMAGING 447
CHAPTER 37 The Chest X-ray 448
DIAGNOSTIC REASONING: VIEWING THE CHEST IMAGE 448
DIAGNOSTIC REASONING: SYSTEMATIC EXAMINATION 450
REFERENCES AND READINGS 456
CHAPTER 38 The Abdominal X-ray 457
DIAGNOSTIC REASONING: VIEWING THE ABDOMINAL IMAGE 457
DIAGNOSTIC REASONING: SYSTEMATIC EXAMINATION 458
REFERENCES AND READINGS 464
APPENDIX A Conversion Tables 465
APPENDIX B Temperatue Equivalents 466
APPENDIX C Body Mass Index Chart 467
INDEX 469