ed on your performance and the expert feedback in your HISTORY collection, describe
two missed questions and your understanding of why they were
... [Show More] important to collect for
this case history. Use specific references from your text to explain.
This provider did not ask if there was any trauma to the patient’s abdomen or if the
pain in her abdomen comes and goes. Abdominal trauma can result in an enlarged spleen
which can rupture and become a medical emergency. Left upper abdominal pain with
tenderness, pain in left shoulder, and confusion are signs and symptoms of a ruptured
spleen (Mayo Clinic, 2019). Secondly, when considering a diagnosis of sickle cell disease,
intermittent abdominal pain can be caused by vaso-occlusive pain in children. Vasoocclusive pain affects many body parts including bones and joints, abdomen, and soft
tissue. Children can present with dactylitis, which is bilateral painfully swollen hands and
or feet (Maakaron, 2019).
Discussion Question 2
Based on your performance and the expert feedback in your PHYSICAL EXAM
collection, describe two errors in your exam performance or documentation. Use specific
references from your text to explain the importance of these findings in correct assessment
of this client.
During the physical exam this provider failed to exam the patients
gait and stance under the neurological category. According to i-Human
Patients (2019) children refusing to ambulate is a critical finding and can
suggest Leukemia, bone pain, infection, heart failure, or arthritis. Leukemia
can present with symptoms of fatigue, bone, and joint pain causing the
child to refuse walking or bearing weight (Goolsby & Grubbs, 2015).
Another error during the physical exam was not inspecting the eyes. The
findings from the expert feedback showed scleral icterus, leading the
provider to check bilirubin levels. Scleral icterus is yellowing of the sclera
and is indicative of liver dysfunction (Andre, 2017). [Show Less]