The purpose of the Clinical Decision Tree assignment is to provide students with the opportunity to practice the cognitive art of inductive clinical reasoning. Within the assignments, the student will receive a chosen patient complaint and 3 faculty chosen diagnoses (all of which will correlate with the coinciding weekly module). The student is to create a hypothetical patient case presentation by:
1. Obtain the expected template and accompanied CDT rubric. Ensure that you are working in both for this assignment. Note, you have three columns provided; you will need to provide information in all three columns specific to the three faculty chosen diagnoses provided on the template.
2. Review the faculty provided complaint listed on the provided template. Consider, that all three-faculty chosen diagnoses could present with the provided complaint.
3. Begin to develop and list your “hypothetical patient’s” HPI. You will complete an HPI for each faculty chosen diagnosis. Ensure that within the HPI you are directly identifying and stating your seven variables to include (location, quality, quantity, chronology, setting, aggravating and alleviating factors, associated manifestations; list out in bold each variable).
o Location: XXX
4. From your HPI, complete your ROS by listing out in bold each system that will be involved in your case).
o The ROS systems will come from the HPI and the symptomatology should mirror your HPI.
5. List your “hypothetical patient’s” physical exam findings.
o You will complete a physical exam per each faculty chosen diagnosis. Always include the general, skin, cardiac & respiratory system (list the system in bold); and, further, include any other applicable body systems as expected per your presented case.
6. Identify the pertinent negatives and positives within your “hypothetical patients”
o Remember you will complete this section from referring to your HPI, ROS, and physical examination.
▪ Pertinent positives are the patient’s presenting disease-specific information used to “rule in” a particular diagnosis.
▪ Pertinent negatives are patient information that the healthcare provider extracts from the patient’s HPI, ROS, and physical exam to r/o the potential of differentials.
▪ Example of a Pertinent positives/negatives from Sore throat complaint:
Pertinent positive (Streptococcal Throat diagnosis)-
Location-Throat pain; Chronology- 2 days
Associated Manifestations- Fever, chills, and headache
HEENT- rhinitis, erythema noted to tonsils, grade 3 bilaterally
Pertinent negatives (Mononucleosis, Peritonsillar Abscess)- Associated Manifestations-No difficulty swallowing, no muffled voice, fatigue. General- No drooling and/or difficulty noted during examination.
Neck- Noted full ROM of neck. HEENT- uvula midline. Patient noted to swallow with ease.
Lymph- No cervical chain lymphadenopathy palpated.
ABD- Flat. Bowel sounds present x 4 quadrant. No palpable tenderness, mass, and/or organomegaly. (Clinical Minute, 2018).
▪ Please note: To complete the section above you will need to start formulating your differentials.
7. Choose 3 applicable differentials for each faculty chosen diagnosis. Your differentials should not be the same for each column.
o Differential for Sore Throat Complaint- Streptococcal Pharyngitis (faculty chosen diagnosis) , (Differentials) Mononucleosis, Peritonsillar Abscess, and Retropharyngeal Abscess (American Academy of Family Practice, 2018).
8. Select a supported diagnostic plan. Make sure you understand what a diagnostic plan entails and consult your guidelines to answer this part of the (CDT). Diagnostic Plan (you must be signed into myCSU to access the document)
● Diagnostic Plan- Peritonsillar abscess r/o with HPI and physical examination without any diagnostic interventions. HPI patient denies any swallowing difficulties and/or muffled voice. Physical examination r/o peritonsillar abscess as no drooling, difficulty communicating, and uvula was midline (American Academy of Family Practice, 2018).
● Rapid Strep test- r/in the diagnosis of Streptococcal Pharyngitis (American Academy of Family Practice, 2016).
9. Discuss your Treatment, Education and Follow-up according to the recommended guidelines. Be sure to include both Non-pharmacological and Pharmacological treatment plans.
****Must be APA format and uses 3 or more current, scholarly references to support. Include in-text citations, includes practical applications tips, examples from practice, and have 3 scholarly peer reviewed journal reference no older than 5 years old with DOI hyperlink (not a book).