Differential Diagnosis Exercise ( Dde )

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10/5/2014 Creighton University College of Nursing Differential Diagnosis Exercise (DDE) Name: Mary M. McAuliffe Clinical Sign or Presenting Problem : Fever A. Identify appropriate history questions to be asked of the patient, nursing staff, or family in order to discriminate critical characteristics or attributes about the presenting problem. HPI Onset: When did you first notice the fever? Where were you when you first began having the symptoms? Location: Not applicable Duration: Is the fever constant or does it come and go? When is it worst? Have you noticed a pattern to the fevers? When is it the highest? When is it the lowest? Characteristics: How high has your fever gotten? How long does it last? Associated Symptoms: Are you…show more content…
ALLERGIES: Thorough review of all medication, food, and environmental allergies is necessary. MEDICATIONS: Any use of diuretics, pain medications, antiarrhythmic agents, anti-seizure drugs, sedatives, antibiotics, antihistamines, barbiturates, cephalosporins, salicylates, and sulfonamides?(Ross & Basello, 2003) FAMILY HX: Family history of chronic leukemia, lymphomas, renal cell carcinomas or metastatic cancers (Ross & Basello, 2003) Any family history of immunocompromise? SOCIAL HX: Any recent travel? If so, where to and for what duration of time? Causes (if recent travel to distant countries) may include Malaria, Viral Hepatitis, Diarrheal disorders, or Typhoid fever (Merck’s Manual, 2014). If recent travel around U.S., causes may include tick exposure (rickettsiosis, Lyme’s disease), mosquito exposure (arboviral encephalitis), wild animal exposure (rabies), fleas (plague), cat-scratch disease or toxoplasmosis, reptiles (salmonella), or bats (rabies) (Merck’s Manual, 2014). Any drug use? Drugs that can cause increased heat production include amphetamines, cocaine, ecstasy, and anesthetics (Merck’s Manuals, 2014). ROS Constitutional: overall health status including physical, mental, and functional health (ADL’s, etc), recent weight loss or weight gain, fever, chills, repeated infections HEENT: headache, ear pain, runny nose, sore throat, neck pain or stiffness Cardiovascular: chest pain

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