Morrison (2012) explains that nurses have specialised knowledge to gather comprehensive physical assessments and differential diagnoses. Evidence-based practice utilises the best available evidence and clinician expertise to formulise an evidence based decision (Bickley, 2013). This essay will analyse the diagnostic reasoning behind decisions made in the diagnosis of a client. A brief diagnosis and pathophysiology will be explained, followed by the client’s health history, physical examination and the diagnostic considerations and relevant tests rationalized with evidence-based literature. Diagnostic considerations will be analysed and evaluated based on the assessments and diagnostic testing and evidence based literature to formulate the final diagnosis.
Diagnosis and Pathophysiology
Sheila (fictitious name) was diagnosed with Calculous Cholecystitis (CC). Cholelithiasis, that is …show more content…
Physical findings and tests reduce indecision on whether the patient has the given condition or not (Bickley, 2013b), However sensitivity and specificity should be considered to avoid false diagnosis (Bickley, 2013b). Tests sensitivity refers to accurately being positive in individuals with the disease, while, specificity refers to individuals with out the disease shown as true negatives (Bickley, 2013b). Together, the higher the specificity and sensitivity the more accurate the test is, and the most accurate test is termed “gold standard” (Dennis et al., 2015).
Tokyo guidelines have taken the difficulty out of diagnosing acute cholecystitis, with developing international consensus for diagnosis (Gurbulak et al., 2015). Tokyo’s guideline diagnostic criteria include one local sign or symptom, one systemic finding and confirmatory ultrasound findings (Dennis et al., 2015; Gurbulak et al., 2015; Yokoe et al., 2012).
Diagnosis and Pathophysiology
Sheila (fictitious name) was diagnosed with Calculous Cholecystitis (CC). Cholelithiasis, that is …show more content…
Physical findings and tests reduce indecision on whether the patient has the given condition or not (Bickley, 2013b), However sensitivity and specificity should be considered to avoid false diagnosis (Bickley, 2013b). Tests sensitivity refers to accurately being positive in individuals with the disease, while, specificity refers to individuals with out the disease shown as true negatives (Bickley, 2013b). Together, the higher the specificity and sensitivity the more accurate the test is, and the most accurate test is termed “gold standard” (Dennis et al., 2015).
Tokyo guidelines have taken the difficulty out of diagnosing acute cholecystitis, with developing international consensus for diagnosis (Gurbulak et al., 2015). Tokyo’s guideline diagnostic criteria include one local sign or symptom, one systemic finding and confirmatory ultrasound findings (Dennis et al., 2015; Gurbulak et al., 2015; Yokoe et al., 2012).