Causes of Poor Patient Outcome

On physical examination the only findings of note are chest wall tenderness and a faint cardiac murmur. The ECG in the office is normal. The patient is observed for an hour in the office and assessed. He is diagnosed with viral pleurisy and sent home on non-steroidal analgesics.
The following day the patient collapses at home and cannot be resuscitated by the paramedic service. An autopsy reveals a Type 1 aortic dissection with pericardial tamponade.

Written Assignment:
Developing a list of possible conditions that might produce a patient\’s symptoms and signs is an important part of clinical reasoning.
1.As an NP in primary care what would you have done differently?
2.Discuss the importance of creating a list of differentials for this patient. How could it have changed this outcome?

 

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