Clinical Diagnosis E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: Essential Clinical Skills for Nurses
• Sprache: Englisch

Seitenzahl: 248

Veröffentlichungsjahr: 2011

Beschreibung

The role and function of the nurse is rapidly changing. Some nurses are now required to undertake clinical diagnosis of the patient, a responsibility traditionally undertaken by a doctor. Clinical Diagnosis helps prepare nurses to fulfill this role, providing them with the skills and underpinning knowledge to make clinical diagnoses of patients effectively. Each chapter follows the same layout for each symptom or sign, exploring the definition, causes, history, precipitating factors, associated signs and symptoms, important considerations, relevant clinical examination, and investigations and tests. * The first UK text to explore clinical diagnosis from a nursing perspective * In the Essential Clinical Skills for Nurses series * Written by an authority in the field * Concise, accessible, and evidence-based

Leseprobe

Contents

Cover

Title Page

Copyright

Contributors List

Foreword

1: An Overview to Clinical Diagnosis

LEARNING OUTCOMES

INTRODUCTION

OBJECTIVES OF HISTORY TAKING

ESTABLISHING A RAPPORT WITH THE PATIENT

IMPORTANCE OF EFFECTIVE LISTENING SKILLS

SEQUENCE OF HISTORY TAKING

AN OVERVIEW OF CLINICAL EXAMINATION

SYMPTOMS OF DISEASE

TESTS AND INVESTIGATIONS

CONCLUSION

2: Clinical Diagnosis of Symptoms Associated with the Respiratory System

LEARNING OUTCOMES

ACUTE BREATHLESSNESS

COUGH

HAEMOPTYSIS

INSPIRATORY STRIDOR

3: Clinical Diagnosis of Symptoms Associated with the Cardiovascular System

LEARNING OUTCOMES

CHEST PAIN

PALPITATIONS

HYPERTENSION

CALF SWELLING

LEG ULCER

BRUISING

ANAEMIA

HYPOTENSION

4: Clinical Diagnosis of Symptoms Associated with the Gastrointestinal System

LEARNING OUTCOMES

NAUSEA AND VOMITING

ABDOMINAL PAIN

ABDOMINAL SWELLING

HAEMATEMESIS

ASCITES

CONSTIPATION

DIARRHOEA

DYSPHAGIA

INTESTINAL OBSTRUCTION

MELAENA

RECTAL BLEEDING

JAUNDICE

WEIGHT LOSS

WEIGHT GAIN

HICCUP

STEATORRHOEA

5: Clinical Diagnosis of Symptoms Associated with the Neurological System

LEARNING OUTCOMES

HEADACHE

SYNCOPE

DIZZINESS

SEIZURE

TREMOR

HEMIPLEGIA

ACUTE CONFUSION

REDUCED CONSCIOUS LEVEL AND COMA

6: Clinical Diagnosis of Symptoms Associated with the Musculoskeletal System

LEARNING OUTCOMES

MUSCLE WASTING AND WEAKNESS

PAINFUL JOINTS

DEFORMITY

LOSS OF FUNCTION

7: Clinical Diagnosis of Symptoms Associated with the Genitourinary System

LEARNING OUTCOMES

ANURIA AND OLIGURIA

POLYURIA

URETHRAL DISCHARGE

DYSURIA

INCONTINENCE

SCROTAL SWELLING

RETENTION OF URINE

GYNAECOMASTIA

8: Clinical Diagnosis of Symptoms Associated with the Ears, Nose and Throat

LEARNING OUTCOMES

DYSPHAGIA

DEAFNESS

SORE THROAT

MOUTH ULCERS

Index

This edition first published 2011. © 2011 by Blackwell Publishing Ltd

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Library of Congress Cataloging-in-Publication Data

Clinical diagnosis / edited by Phil Jevon. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4443-3516-3 (pbk. : alk. paper) 1. Diagnosis, Differential. 2. Clinical medicine–Decision making. 3. Medical history taking. I. Jevon, Philip. [DNLM: 1. Diagnostic Techniques and Procedures. WB 141] RC71.5C38 2010 616.07′5–dc22 2010040964

A catalogue record for this book is available from the British Library.

This book is published in the following electronic formats: ePDF 9781444340037; Wiley Online Library 9781444340051; ePub 9781444340044

Contributors List

Kathryn Blakey, MBBS nMRCGP General Practice vocational training scheme Birmingham West Midlands

Yonas Mhando, MD GPST Trainee, Northern Deanery; Formerly Clinical Teaching Fellow & Honorary Clinical Lecturer University of Birmingham & Manor Hospital, Walsall, West Midlands

Dev Mohan Gulur, MBBS, MRCS SpR in Urology, Mersey Rotation

Phil Jevon, RN, BSc (Hons), PGCE Resuscitation Officer/Clinical Skills Lead Manor Hospital, Walsall

Dev Mittapalli, MBBS, MRCS, PGCME SpR in General Surgery, East of Scotland (Dundee) Surgical Rotation, and Honorary Clinical Lecturer at the University of Birmingham

Michael Parry, BSc (Hons), MBChB, MRCS Specialist Registrar, Severn Deanery and Clinical Research Fellow, University of Bristol

Gareth Walters, BSc (Hons), MBChB MRCP (UK), MRCP (London), FHEA, MinstLM, LCGI Specialist Registrar in Respiratory and General Medicine, West Midlands Rotation, and Honorary Clinical Lecturer, University of Birmingham

Yi-Yang Ng, MBChB, MRCS, AHEA, PGCME GP Registrar, Dartford, Kent Sussex and Surrey Deanery previously Clinical Teaching Fellow, Manor Hospital Walsall, West Midlands and Honorary Clinical Lecturer

Foreword

As nursing progresses in terms of skill set and competencies focusing on patient pathways, there is a requirement to support professionals with up to date and relevant tools to support them. Clinical diagnosis can be complex and we know that timely and effective clinical diagnosis delivers optimum outcomes for patients.

This book is designed as a practical guide to support nurses in their decision making. It is well written and has had relevant clinical experts contributing chapters. It is comprehensively written and follows a systems approach providing a logical structure.

The editor must be commended for his foresight in developing this book and I am confident that many nurses will use this excellent guide in supporting their decision making and improving outcomes for patients. I am delighted to recommend this book and wish that this had been available to me many years ago!

Sue Hartley Director of Nursing and Governance Walsall Hospitals NHS Trust

1

An Overview to Clinical Diagnosis

Phil Jevon

LEARNING OUTCOMES

At the end of this chapter, the reader will be able to:

list the objectives of history taking,discuss establishing a rapport with the patient,describe the importance of effective listening skills,discuss the sequence of history taking,provide an overview to clinical examination,discuss the symptoms of disease andoutline the role of tests and investigations.

INTRODUCTION

The term ‘clinical’ originates from the Greek word klinike meaning bedside (Soanes & Stevenson 2006). Diagnosis, which originates from the Greek word diagignoskein meaning distinguish or discern, can be defined as the identification of the nature of an illness or other problem by examination of the symptoms (Soanes & Stevenson 2006).

History taking (discussing the patients’ complaints with them) and clinical examination, together with performing or ordering relevant investigations, are essential for clinical diagnosis (Cox & Roper 2006). Despite the advances in modern diagnostic tests, history taking and clinical examination remain fundamental in determining the most appropriate treatment (if any) for the patient. History taking is considered one of the most important aspects of patient assessment and is being increasingly undertaken by nurses (Crumbie 2006).

History taking and clinical examination require a structured, logical approach to ensure that all the relevant information is obtained and that nothing important is overlooked. History taking and clinical examination skills are difficult to acquire and, above all, require practice (Gleadle 2004).

The aim of this chapter is to provide an overview to clinical diagnosis.

OBJECTIVES OF HISTORY TAKING