NRNP 6541 Week 10 Assignment; iHuman Case Lexie Newman
- $20.00
Performance Overview on Case Lexie Newman
The following table summarizes your performance on each section of the case, whether you completed that section or not.
History Notecard on case Lexie Newman
Use this worksheet to organize your thoughts before developing a differential diagnosis list.
Problem Statement on case Lexie Newman
This is a 12 y.o F presenting with symptoms of a throbbing 8/10 headache, neck stiffness, nausea without vomiting, and reports being "mentally foggy" since this morning. She has a history of a recent fall with a head injury, no LOC yesterday. She has a history of headaches and a family history of migraines in her mom and maternal grandmother. Exam reveals positive Romberg test, unstable single foot stand, slightly ataxic gait, mild ecchymosis on the right shoulder, and mild tenderness on paraspinal cervical muscles and sternocleidomastoid muscles.
Management Plan on case Lexie Newman
- 1: Primary Diagnosis with ICD-10 code, rationale and resources.
- Medications including OTC, dosage, pt. education, ancillary tests, referrals, and follow-up:
- Completed Hx notes & Problem Statement in designated area (2.5 each area)
- Social Determinants of Health to consider, Health Promotion and Pt risk factors
REFERENCES
Electronic Medical Record on case Lexie Newman
- History of Present Illness
- Past Medical History
- Medications
- Allergies
- Preventive Health
- Family History
- Social History
- Review of Systems
- Physical Exams
