Please paraphrase this Reflection done. This is Amanda Wheaton case as i-Human Patients. (Course; NRP 531) University of phoenix.
Reflection: i-Human patient Amanda Wheaton
Questions I asked in the beginning of the history examination were directly related to patient’s complaints, which were sore throat, headache, fever, swollen glands, and chill. I used OLDCARTS to obtain details of her symptoms. Additionally, I asked if she had other symptoms such as cough, body aches, runny nose, and earaches to rule out flu, sinus infection, ear infection, and/or upper respiratory infection. I went over any changes in her medications, medical issues, and allergies since the last time she was seen. I asked her regarding sexual history and oral sex because sexually transmitted diseases such as chlamydia, gonorrhea, and HIV can be transmitted by oral sex and can present moderate to severe sore throat (Chow & Doron, 2020). I asked basic questions during ROS assessment to make sure she was not experiencing SOB, chest pain, asthma, and other serious conditions, along with pertinent questions related to her symptoms.
I conducted mostly problem-focused physical exam and examined pertinent areas related to acute pharyngitis, such as her mouth, throat, neck, and cervical lymph nodes. Most adult patients with PA are mostly related to respiratory viruses, and I wanted to make sure I wasn’t overlooking any areas (Chow & Doron, 2020). Upon examining patient’s throat and assessed tonsillar erythema and exudates, I was able to focus the physical exam toward GAS diagnosis. I also examined her eyes for any drainage, ears for signs of infection, nostril for sinus drainage, auscultated lung sounds, and assessed abdomen to rule out any other possible diagnosis.
The article “Evaluation of acute pharyngitis in adults” by Anthony Chow and Shira Doron (2020) states that respiratory viruses and group A Streptococcus (GAS) are the most common causes of acute pharyngitis (AP), and other bacteria, herpes, HIV, and some sexually transmitted infections (STI) are less common but cannot be ruled out. The article summarizes the following: the systematic approach to diagnose viral pharyngitis, which is most common case of AP, otherwise test for GAS and other pathogens can be conducted; usually sensitive rapid antigen test is used to diagnose GAS however, follow-up throat culture is used for patients with high risk for complications or for those who reside in GAS prevalent areas; sexual history evaluation and risk factors for HIV & STI assessment are important not to be ruled out; always evaluate for signs and symptoms for upper airway obstruction to assess patients requiring emergency or additional care; and majority patients with AP and GAS are clinically diagnosed and recover with adequate treatment in 5-10 days, and patients should be evaluated for alternative diagnoses or other complications when failed to improve within these time period (Chow & Doron, 2020).
This article was helpful in guiding me in what to ask and look for in a patient with acute pharyngitis, especially rationale behind oral sex question and clinical signs to examine in patient with suspected GAS. Examining range of motion in neck was a helpful insight to assess airway obstruction (Chow & Doron, 2020). I felt like I was asking too many unnecessary questions during history assessment and examining in much too detail during physical exam, because I did not know what I was looking for and how to ask/assess. This article gave me a basis for what to ask, what to look for, what to rule out, and how to diagnose & treat without overly questioning and examining, which was extremely helpful.
References:
Chow, A. & Doron, S. (2020). Evaluation of acute pharyngitis in adults. UpToDate. Retrieved on August 23, 2021 from
