Diagnostic Reasoning and Rationale for Acute Illness

DIAGNOSTIC REASONING AND RATIONALE FOR ACUTE ILLNESS 5

DiagnosticReasoning and Rationale for Acute Illness

DiagnosticReasoning and Rationale for Acute Illness

Practitioner’sability to make proper judgments that can result in an accurateidentification of illness is one factor that facilitates a successfuldelivery of quality health care to the patients. In all cases, thisidentification depends on the evident unique factors distinguishing aparticular illness from others with similar or close symptoms(Djulbegovic etal.,2015). Such process is diagnostic reasoning, and it leads to anaccurate explanation of both the causes and the symptoms of anillness. In its clinical purpose, it facilitates the planning for thepossible treatment of illness by first collecting data from apatient, generation a hypothesis, representing a problem and thendetermining the appropriate treatment (Djulbegovicet al.,2015). Proper diagnostic reasoning approach in the provision ofhealth care reduces errors and improves accuracy in the treatment ofacute illness.

WhatQuestions Need To Be Asked And What Body Part Needs To Be Examined?

Inthe assessment of an acute cough, the practitioner may ask thepatient some questions followed by an examination of chest, lungs,esophagus and the nose to achieve a clear understanding of thepossible condition. For instance, the practitioner can ask thenumber of weeks the patients have been sick. Such question can helprule out if the condition is truly acute if the patient’s answer ismore than two weeks (Crampton, 2013). In addition, the doctor mayrequire the patient to describe a cough to distinguish if thecondition is lung cancer (a weak cough) or vocal cord paralysis (astrong or a difficult cough) (Carek, 2011). Also, questions onwhether a patient smokes or not are important for this diagnosis.Furthermore, questions on the time of the day the condition is severeand whether it is related to a meal of physical conditions. Thisenables the physician to know if its asthma (a cough at night),bronchiectasis (in the morning after waking up) or allergy (ifrelated to food or physical conditions) (Crampton, 2013). Finally,the doctor may ask about the medical history since some recurrentinfections may reveal some conditions such as bronchiectasis orcystic fibrosis.

WhatDiagnostic Tests Need To Be Obtained And Why?

Basedon the patient response to the questions and the physicalexamination, the doctor may carry out some tests to increase theaccuracy of the process and further understand the illness (Carek,2011). For instance, the doctor can do mucus test to check bacterialinfection, Chest X-Ray test that reveals pneumonia or lung cancerconditions or the Lung functional tests that help determine thebreathing difficulties the patient may be experiencing.

Howwould you handle abnormal finding?

Insome situations, the patient’s response, physical examination andthe tests may reveal abnormal findings. Medical practitioners callthem unexpected results and they pose ethical dilemma (Crampton,2013). In cases of abnormal results, it is wise to run other testsrelated to abnormality. Also, it is important to seek the secondopinion from other physicians (Djulbegovic etal.,2015). Furthermore, they may require the doctor to ask the patientabout any abnormal medical conditions worth knowing for thetreatment.

Whatwill be your differentials?

Thedifferential diagnosis of a cough includes the length of thecondition. An acute cough lasts for less than two weeks whilesub-acute last for less than eight weeks. The chronic condition lastfor more than eight weeks. Also, acute cough is caused by viralinfections while normal allergy or asthma is influenced by exposureto some agents (Carek, 2011). Finally, an acute cough can healwithout treatment. Other differentials important to distinguish acough from other diseases include the length of the condition, thedescription a patient provides and the time of the day the conditionthe condition is severe.

Tosum it up, diagnostic reasoning is important in solving medicalproblems and improving patient’s experience. Due to its reliance onpatients’ data, practitioners should have proper analytical skillsand knowledge on diseases. Such skills are important to preventdiagnostic errors that arise leading to providing the patients withthe wrong treatment or medications. Finally, the use of diagnostictools is also important to increase the accuracy and effectiveness ofthe treatment.

References

Carek,J. (2011). Evaluationof the Patient with Chronic Cough – American Family Physician.Aafp.org.Retrieved 2 October 2016, fromhttp://www.aafp.org/afp/2011/1015/p887.html

Crampton,J. (2013). Why nurses should use clinical reasoning to diagnose acough. PrimaryHealth Care,23(7), 18-24.

Djulbegovic,B., Ende, J., Hamm, R. M., Mayrhofer, T., Hozo, I., &amp Pauker, S.G. (2015). When is rational to order a diagnostic test, or prescribetreatment: the threshold model as an explanation of practicevariation. EuropeanJournal of Clinical Investigation, 45(5), 485-493.doi:10.1111/eci.12421