CriticalThinking and Diagnostic Reasoning
Components of Assessment |
Subjective PQRST |
Objective |
Differential Diagnosis |
List relevant labs and diagnostic studies |
What causes pain (P) |
Easily frustrated |
Meningitis |
CT scan (Computed axial tomography) |
|
What does the pain feel like? (Q) |
Anxious |
Carotid Artery Dissection |
MRI Scan (Magnetic resonance imaging) |
|
Does the pain come from a given region? (R) |
Fearful |
Multiple sclerosis |
Carotid Doppler (Carotid ultrasound) |
|
How severe is the pain on a scale of 1-10? (S) |
Speech is slurred |
MRA (Magnetic resonance angiogram) |
||
How long has the pain been there (T) |
Only eats food on the left side of the tray |
Cerebral arteriogram |
CriticalThinking and Diagnostic Reasoning
Abnormal Finding |
Nurse Diagnosis |
Ventricular hypertrophy |
Acute Ischemic stroke |
Hemorrhagic stroke |
Factorsto be considered during Gathering of Objective and Subjective Dataand Provision of Health Care
Developmental/AgeConsiderations
Patient diagnosis for particular diseases should take intoconsideration the developmental stage of the individual affected. Thebody has a unique way of executing the metabolic functions. However,the response to aberrant conditions depends on the developmentalstage of the particular patient (Hoffe & Balducci, 2012). It iscritical that as one is conducting the medical diagnosis, the age ofthe patient must be taken into consideration. For example, thepatient in question is aged 55. The response of the patient to theparticular disease is different from that of younger children.Because of the same, it is essential that as a nurse, one takes intoconsideration such factors when conducting the diagnosis.
SocioeconomicConsiderations
Socioeconomic factors are of vital significance when it comes todiagnosis of patients. Notably, it is essential that the factors beconsidered before subjecting the patient to the diagnostic process.For example, it is critical to consider the patient’s ability toafford the identified diagnostic tests. Further, there is the aspectof understanding the literacy levels of the patient. It helps indetermining whether the patient understands the questions they havebeen asked and the ability to provide the right answers (Verkissenet al., 2014).
Cross-culturalConsiderations
Cultural considerations are vital when conducting an interview toestablish the cause of disease. It is essential that as a nurse, oneevaluates the factors to help in the accurate diagnosis of thecondition. Further, the questions asked should be well-formulated toensure that the patient does not feel offended. For example, inassessing the 55-year-old patient, it is critical to assess whethershe hails from the minority or nonminority. It is essential that as aclinician one takes into consideration such factors since it woulddetermine the attitude that would be employed in dealing with thepatient (Sirois, Darby, & Tolle, 2013). As a clinician, it isvital to consider the cultural identity of the patient since it willdictate the kind of questions asked to help in getting the subjectiveor objective data.
EthicalConsiderations
Ethical factors must be considered by the clinician when seekingquestions from the patient. It is vital that one does not askquestions that can be portrayed as leading the patient into gettingstigmatized. It is essential that the patient gets ample time to makethem feel at ease when providing answers to the questions that havebeen asked. Ethical issues have been identified as crucial factors inhelping get information from the client. It is essential that theinterviewer exercises ethics in as they seek to get the subjectiveand objective data from the patient.
OtherAdditional Information
Finally, it is vital that the nurse creates as good rapport with thepatient to facilitate the acquisition of subjective and objectivedata. The establishment of a good relationship results in thecreation of cohesion making the patient comfortable to answerquestions asked.
References
Hoffe, S., & Balducci, L. (2012). Cancer and Age: GeneralConsiderations. Clinics in Geriatric Medicine.http://doi.org/10.1016/j.cger.2011.09.001
Sirois, M. L., Darby, M., & Tolle, S. (2013). UnderstandingMuslim patients: Cross-cultural dental hygiene care. InternationalJournal of Dental Hygiene, 11(2), 105–114.http://doi.org/10.1111/j.1601-5037.2012.00559.x
Verkissen, M. N., Ezendam, N. P. M., Fransen, M. P., Essink-Bot, M.L., Aarts, M. J., Nicolaije, K. A. H., … Husson, O. (2014). Therole of health literacy in perceived information provision andsatisfaction among women with ovarian tumors: A study from thepopulation-based PROFILES registry. Patient Education andCounseling, 95(3), 421–428.http://doi.org/10.1016/j.pec.2014.03.008