Laurie Goolsby Mary Jo - Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses

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Copyright 2023 by F. A. Davis Company

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Library of Congress Cataloging-in-Publication Data

Names: Goolsby, Mary Jo, editor. | Grubbs, Laurie, 1951- editor.

Title: Advanced assessment : interpreting findings and formulating differential diagnoses / [edited by] Mary Jo Goolsby, Laurie Grubbs.

Description: Fifth edition. | Philadelphia, PA : F.A Davis Company, [2023] | Includes bibliographical references and index.

Identifiers: LCCN 2022029058 (print) | LCCN 2022029059 (ebook) | ISBN 9781719645935 (paperback) | ISBN 9781719648301 (ebook)

Subjects: MESH: Nursing Assessment--methods | Diagnosis, Differential | Diagnostic Errors--prevention & control | Nurse Practitioners.

Classification: LCC RC71.5 (print) | LCC RC71.5 (ebook) | NLM WY 100.4 | DDC 616.07/5--dc23/eng/20220819

LC record available at https://lccn.loc.gov/2022029058

LC ebook record available at https://lccn.loc.gov/2022029059

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A growing body of literature addresses the risks associated with clinical decision making, with diagnostic error described as the blind spot in health-care delivery (National Academy of Medicine, 2015). The original idea for this book arose from our recognition that the many health assessment texts available lacked an essential componentcontent on how to narrow a differential diagnosis when a patient presents with one of the almost endless possible complaints. The response to earlier editions of this text supported our belief in the need for a text that addressed the lack of content designed to support expertise in the assessment and diagnostic process. We hope that this significantly updated edition will continue to aid advanced practice students, new practitioners, and experienced practitioners faced with new presentations.

In spite of the growth in available diagnostic technology and studies, expertise in correctly performing assessment skills, obtaining valid data, and interpreting the findings accurately remains fundamental to the provision of the safe, high-quality, patient-centered, and cost-effective practice for which NPs are known. Even once these skills are accomplished, accurate diagnosis remains a difficult aspect of practice. Novice practitioners often spend much energy and time narrowing their differential diagnosis when they have no clear guidance that is driven by the patient or complaint. For this reason, our aim was to develop a guide in the assessment and diagnostic process that is broad in content and suitable for use in varied settings.

Advanced Assessment: Interpreting Findings and Formulating Differential Diagnoses is designed to serve as both a textbook during advanced health assessment course work and subsequent clinical courses and as a quick reference for practicing clinicians. We believe that studying the text will help students develop proficiency in performing and interpreting assessments, recognizing the range of conditions that can be indicated by specific findings. Once in practice, we believe that the text will aid individualized assessment and narrowing of differential diagnosis.

The book consists of three parts. Part I provides a summary discussion of assessment and some matters related to clinical decision making. In addition to discussing the behaviors involved in arriving at a definitive diagnosis, each chapter in Part I and in subsequent sections covers some pitfalls that clinicians often experience and the types of evidence-based resources that are available to assist in the diagnostic process.

This edition introduces a unique chapter on issues related to integrating laboratory and imaging studies into clinical decision-making. Knowledge regarding selecting, ordering, and interpreting diagnostic studies are critical skills for clinicians.

This section also includes a chapter on conducting a genetic assessment. This component of health assessment has great potential, with recent advances in the information and technology related to genetics and genomics. It is critical that clinicians be able to address the potential of hereditary diseases and genetic variations that may affect their patients. This chapter, like the one on clinical decision-making, is relevant to the content of all subsequent chapters.

Part II serves as the core of the book and addresses assessment and diagnosis using a system and body region approach. Each chapter in this part begins with an overview of the comprehensive history and physical examination of a specific system, as well as a discussion of common diagnostic studies. The remainder of the chapter is then categorized by chief complaints commonly associated with that system. For each complaint, there is a description of the focused assessment relative to that complaint, followed by a list of the conditions that should be considered in the differential diagnosis, along with the symptoms, signs, or diagnostic findings that would support each condition.

Figures within chapters are provided to better depict examination techniques or expected findings. This edition introduces a number of diagnostic algorithms to assist in the differential diagnosis and also includes a number of additional complaints and conditions in several differential diagnosis sections.