Assignment: NURS 6531 Examining Chest X-Rays

Assignment: NURS 6531 Examining Chest X-Rays
Chest x-rays are an invaluable diagnostic tool as they can help identify common respiratory disorders such as pneumonia, pleural effusion, and tumors, as well as cardiovascular disorders such as an enlarged heart and heart failure. As an advanced practice nurse, it is important that you are able to differentiate a normal x-ray from an abnormal x-ray in order to identify these disorders. The ability to articulate the results of a chest x-ray with the physician, radiologist, and patient is an essential skill when facilitating care in a clinical setting. In this Forum, you practice your interprofessional collaboration skills as you interpret chest x-rays and exchange feedback with your colleagues.
Consider the three patient case studies and x-rays
Note: By Day 1 of this week, your Instructor will assign you to post on one of these patient case studies and x-rays:
Case Study 1
35-year-old Asian male presents to your clinic complaining of productive cough for two weeks. Stated he has had mild intermittent fever with myalgia, malaise and occasional nausea.
SH: works as a law clerk
PE: NP noted low grade fever (99 degrees), with very mild wheezing and scattered rhonchi.
An x-ray film is presented which shows a cloudy lung that appears slightly distended.
Case Study 2
This is a 44-year-old Caucasian male being seen at your clinics with complaints of complaints of cough for 4 days and worsening. Stated he has had high grade fever. States he feels weak and has been in bed most of the last two days. Complains of exertional dyspnea, followed by dyspnea at rest, non-productive cough and pleuritic chest pain
MEDS: Zovirax, Diflucan, magic mouth wash, Zofran, mycostatin, filgrastin
PMH: HTN, Hep C, HIV/AIDS, thrush
SH: Past IV Drug abuse; lives in a group home;
Assignment: NURS 6531 Examining Chest X-Rays
PE: VS: Ht: 5’7, Wt: 150#, BMI 23,
Anorexic male, febrile, tachypneic, tachycardic, with rales and rhonchi. You note decreased in breath sounds, dullness, and egophony
An x-ray film is presented which shows petechial markings on the lungs and which are cloudy in appearance.
Case Study 3
A 50 year old Caucasian female presents to the clinic with complaints of cough for almost 2 weeks. Positive productive green sputum with associated chills, sweating, and fever up to 101.5. She manages a daycare and states that many of the children have had upper respiratory symptoms in the last two weeks. PMH: DM diagnosed 7 years ago, controlled on medications.
MEDS: Glyburide 10mg qd
PE: She looks ill with continuous coughing and chills.
BP 100/80, T: 102, HR: 110; O2Sat 97% on RA.
Lungs: +Crackles, increased fremitus
Labs: CBC 17,000 cells/mm3 , blood sugar is 120
An x-ray film is presented which shows cloudiness on the lungs and which also shows some scarring on the lungs.
To prepare:
Review Part 10 of the Buttaro et al. text in this week’s Resources, as well as the provided x-rays.
Reflect on what you see in the x-ray assigned to you by the Course Instructor.
Consider whether the patient in your assigned x-ray has an enlarged heart, enlarged blood vessels, fluid in the lungs, and/or pneumonia in the lungs.