The Family Nurse Practitioner

1 Cover

2 Title Page The Family Nurse Practitioner Clinical Case Studies SECOND EDITION Edited by Leslie Neal‐Boylan, PhD, APRN, CRRN, FAAN, FARN Mansfield Kaseman Health Clinic Rockville, MD, USA

3 Copyright Page

4 ContributorsEDITOR CONTRIBUTORS

5 Preface

6 Acknowledgments

7 Introduction

8 Abbreviations and Acronyms

9 Section 1: The Neonate Case 1.1: Cardiovascular Screening Exam SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 1.2: Pulmonary Screening Exam SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 1.3: Skin Screening Exam SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 1.4: Oxygenation SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 1.5: Nutrition and Weight SUBJECTIVE OBJECTIVE CRITICAL THINKING

10 Section 2: The Infant Case 2.1: Nutrition and Weight SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 2.2: Breastfeeding SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 2.3: Growth and Development SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 2.4: Heart Murmur SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 2.5: Cough SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 2.6: Diarrhea SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 2.7: Fall from Height SUBJECTIVE OBJECTIVE CRITICAL THINKING

11 Section 3: The Toddler/Preschool Child Case 3.1: Earache SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 3.2: Bedwetting SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 3.3: Burn SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 3.4: Toothache SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 3.5: Abdominal Pain SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 3.6: Lesion on Penis SUBJECTIVE OBJECTIVE CRITICAL THINKING

12 Section 4: The School‐Aged Child Case 4.1: Rash without Fever SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 4.2: Rash with Fever SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 4.3: Red Eye SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 4.4: Sore Throat SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 4.5: Disruptive Behavior SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 4.6: Cough and Difficulty Breathing SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 4.7: Left Arm Pain SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 4.8: Nightmares SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 4.9: Gastrointestinal Complaint SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 4.10: Food Allergies SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 4.11: Obesity SUBJECTIVE OBJECTIVE CRITICAL THINKING

13 Section 5: The Adolescent Case 5.1: Drug Use SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 5.2: Weight Loss SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 5.3: Menstrual Cramps SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 5.4: Missed Periods SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 5.5: Birth Control Decision‐Making SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 5.6: Vaginal Discharge SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 5.7: Sexual Identity SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 5.8: Knee Pain SUBJECTIVE OBJECTIVE CRITICAL THINKING

14 Section 6: Women’s Health Case 6.1: Preconception Planning SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 6.2: Bleeding in the First Trimester of Pregnancy SUBJECTIVE OBJECTIVE CRITIAL THINKING Case 6.3: Night Sweats SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 6.4: Pelvic Pain SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 6.5: Vaginal Itching SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 6.6: Redness and Swelling in the Breast SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 6.7: Sexual Assault SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 6.8: Abdominal Pain SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 6.9: Urinary Frequency SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 6.10: Headache SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 6.11: Fatigue and Joint Pain SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 6.12: Muscle Tenderness SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 6.13: Insomnia SUBJECTIVE OBJECTIVE CRITICAL THINKING

15 Section 7: Men’s Health Case 7.1: Fatigue SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 7.2: Testicular Pain SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 7.3: Prostate Changes SUBJECTIVE OBJECTIVE CRITICAL THINKING

16 Section 8: General Adult Health Case 8.1: Substance Use Disorder (SUD) SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.2: Foot Ulcer SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.3: Abdominal Pain and Weight Gain SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.4: Burning Leg Pain SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.5: Difficulty Breathing SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.6: Burning Epigastric Pain after Meals SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.7: Chest Pain and Dyspnea without Radiation SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.8: Chest Pain with Radiation SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.9: Persistent Cough and Joint Tenderness SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.10: Morning Headache SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.11: Facial Pain SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.12: Fatigue, Confusion, and Weight Loss SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.13: Hand Numbness SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.14: Chronic Diarrhea SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.15: Intractable Pain SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 8.16: Wrist Pain and Swelling SUBJECTIVE OBJECTIVE CRITICAL THINKING

17 Section 9: Mental Health Case 9.1: Sad Mood SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 9.2: More Than Depression SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 9.3: Postpartum Depression SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 9.4: Anxiety SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 9.5: Trauma SUBJECTIVE OBJECTIVE CRITICAL THINKING

18 Section 10: The Older Adult Case 10.1: Forgetfulness SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 10.2: Behavior Change SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 10.3: Tremors SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 10.4: Weight Gain and Fatigue SUBJECTIVE OBJECTIVESUBJECTIVE OBJECTIVE CRITICAL THINKING Case 10.5: Visual Changes SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 10.6: Back Pain SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 10.7: Acute Joint Pain SUBJECTIVE OBJECTIVE CRITIAL THINKING Case 10.8: Itching and Soreness SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 10.9: Knee Pain SUBJECTIVE OBJECTIVE CRITICAL THINKING Case 10.10: Hyperthermia and Mental Status Changes in the Elderly OBJECTIVE CRITICAL THINKING

19 Section 11: ResolutionsCase 1.1 Cardiovascular Screening Exam RESOLUTION REFERENCES AND RESOURCES Case 1.2 Pulmonary Screening ExamRESOLUTION REFERENCES AND RESOURCES Case 1.3 Skin Screening ExamRESOLUTION REFERENCES AND RESOURCES Case 1.4 OxygenationRESOLUTION REFERENCES AND RESOURCES Case 1.5 Nutrition and WeightRESOLUTION REFERENCES AND RESOURCESCase 2.1 Nutrition and Weight RESOLUTION REFERENCES AND RESOURCES Case 2.2 BreastfeedingRESOLUTION REFERENCES AND RESOURCES Case 2.3 Growth and DevelopmentRESOLUTION REFERENCES AND RESOURCES Case 2.4 Heart MurmurRESOLUTION REFERENCES AND RESOURCES Case 2.5 CoughRESOLUTION REFERENCES AND RESOURCES Case 2.6 DiarrheaRESOLUTION REFERENCES AND RESOURCES Case 2.7 Fall from HeightRESOLUTION REFERENCES AND RESOURCESCase 3.1 Earache RESOLUTION REFERENCES AND RESOURCES Case 3.2 BedwettingRESOLUTION REFERENCES AND RESOURCES Case 3.3 BurnRESOLUTION REFERENCES AND RESOURCES Case 3.4 ToothacheRESOLUTION REFERENCES AND RESOURCES Case 3.5 Abdominal PainRESOLUTION REFERENCES AND RESOURCES Case 3.6 Lesion on PenisRESOLUTION REFERENCES AND RESOURCESCase 4.1 Rash without Fever RESOLUTION REFERENCES AND RESOURCES Case 4.2 Rash with FeverRESOLUTION REFERENCES AND RESOURCES Case 4.3 Red EyeRESOLUTION REFERENCES AND RESOURCES Case 4.4 Sore ThroatRESOLUTION REFERENCES AND RESOURCES Case 4.5 Disruptive BehaviorRESOLUTION REFERENCES AND RESOURCES Case 4.6 Cough and Difficulty BreathingRESOLUTION REFERENCES AND RESOURCES Case 4.7 Left Arm PainRESOLUTION REFERENCES AND RESOURCES Case 4.