NSG 6020 iHuman case: Rachael Hardy V3 PC

NSG 6020 iHuman case: Rachael Hardy V3 PC Assignment

iHuman case: Rachael Hardy V3 PC

Discussion Question 1

History collection of questions, one of the key questions that I missed was If patient felt fatigue, had difficulty sleeping or experienced any weight gain or loss.  The second key question that I missed was to ask if patient had a family history of diseases that run in the family.  Both of these questions are important to improve diagnostic accuracy.  Bickley (2016) summarizes the importance of family history collection to improve diagnostic assessment.

Discussion Question 2


Physical exam was not a focused exam.  Exam needed to be more specific and full head to toe assessment was not needed.  For a conscious adult, I did not palpate a radial pulse as first choice.  The radial pulse is commonly used to assess the heart rate (Bickley, 2016). NSG 6020 iHuman case: Rachael Hardy V3 PC



Discussion Question 3

Breast lump was one key finding that was included in my list.  One important physical exam would be to assess for lymph node involvement with report of breast lump.  As written by Bickley (2016), “Nodes that are large (≥1 to 2 cm) and firm or hard, matted together, or fixed to the skin or underlying tissues suggest malignancy.”


Discussion Question 4

The assessment completed did not include evaluation of family history.  With breast cancer family history can be contributory to patient risk.  As stated in ihuman, “The next step is to consider those clinical factors (here, listed as problems) that should, or may, impact the differential diagnosis (DDx): Family history of breast cancer (mother; diagnosed at age 48)”


Discussion Question 5

Breast abscess is a differential diagnosis that was missed during the assessment of differential diagnosis.  Breast abscess is important because it is a cannot miss diagnosis according to ihuman.  If a patient has a diagnosis of breast abscess and it goes untreated then the patient could suffer worsening infection or death.  According to Bickley (2016), However, any breast mass should be carefully evaluated and usually warrants further investigation by ultrasound, aspiration, mammography, or biopsy. NSG 6020 iHuman case: Rachael Hardy V3 PC.


Bickley, L. (2016). Bates Guide to Physical Examination and History Taking (12th Ed.). Philadelphia, PA: Lippincott, William & Wilkins. NSG 6020 iHuman case: Rachael Hardy V3 PC