Chest pain, shortage of breath, and similar complaints are frequent, but they are broad symptoms that can occur in several disorders. For example, chess pain is a common symptom in angina pectoris, pulmonary embolism, pericarditis, coronary syndrome, lung tumors, aortic dissection, and various other disorders (LeBlond, Brown, & DeGowin, 2009). Because the symptoms of those disorders often overlap or show slight differences, the nurse is responsible for performing a thorough assessment, which includes screening the patient’s medical history, performing a differential diagnosis by performing physical assessments, and recommending further lab tests and examinations. Without a thorough assessment, chances of diagnostic errors are high.
Failing to collect enough information about the patient’s condition leads to misdiagnosis and potential adverse events. When a nurse diagnoses an acute cardiac disorder by mistake, the patient could experience fear and psychological stress in addition to receiving the wrong treatment (Seller & Symons, 2012). On the other hand, failing to discover severe cardiac conditions leads to further health complications, irreversible disorders, and high mortality rates. In both cases, the nurse who fails to perform a thorough assessment violates several ethical principles and legal regulations, which opens the possibility of disciplinary actions and law suits.
Two most important insights I can apply to improve my own assessment abilities after observing a video on advanced health assessments by Laureate Education (2012) are the importance of avoiding early conclusions and exploring possibilities that do not appear relevant immediately. For example, studies suggest that resting electrocardiogram (ECG) results can be within normal limits in patients with coronary arterial disease, so eliminating that disorder based only on ECG results could potentially result in a misdiagnosis. In terms of remaining open to possibilities, patients who experience cold extremities are an excellent example. The first diagnosis that comes to mind in those cases is related to cardiovascular disorders that impact blood circulation, such as peripheral arterial disease or anemia. However, a thorough assessment will also include inspecting the feet for signs of malnutrition because several nutrient deficiencies can be associated with poor circulation. By narrowing down possible diagnoses too much, it is possible to overlook complex interactions between physiological systems and deliver the wrong diagnosis.
Laureate Education, Inc. (Executive Producer). (2012). Advanced Health Assessment and Diagnostic Reasoning. Baltimore, MD: Author.
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009). DeGowin's diagnostic examination (9th ed.). New York, NY: McGraw Hill Medical.
Seller, R. H., & Symons, A. B. (2012). Differential diagnosis of common complaints (6th ed.). Philadelphia, PA: W. B. Saunders Company.