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NR 509 Week 3 iHuman Virtual Patient Encounter Attempt 3924532 - Rebecca Fields

Chamberlain University Nursing NR 509 Advanced Physical Assessment Laci Peterson 6 pages
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History Notecard by Makayla Bowens on case Rebecca Fields Use this worksheet to organize your thoughts before developing a differential diagnosis list. 1. Indicate key symptoms (Sx) you have identified from the history. Start with the patient's reason(s) for the encounter and add additional symptoms obtained from further questioning. 2. Characterize the attributes of each symptom using "OLDCARTS". Capture the details in the appropriate column and row. 3. Review your findings and consider possible diagnoses that may correlate with these symptoms. (Remember to consider the patient's age and risk factors.) Use your ideas to help guide your physical examination in the next section of the case. HPI Sx = Sx = Sx = Sx = Sx = Sx = Onset Location Duration Characteristics Aggravating Relieving Timing / Treatments Severity Attempt: 3924532 Report generated on 5/21/2026, 11:51:16 AM America/Denver Management Plan by Makayla Bowens on case Rebecca Fields Diagnostic Tests: Rapid strep test - rapid COVID 19 - rapid Influenza - PENDING throat culture* Medications: Penicillin V- 500 mg orally twice daily for 10 days (Ashurt et al., 2026). Acetaminophen 500mg orally every 6 hours as needed for pain/fever. Do not exceed 6 tablets in 24 hours (Ashurst et al., 2026). Consults/Referrals: No referrals needed at this time. However, if patient has persistent enlarged tonsils and no improvement, patient may need to follow up with ENT (Ates et al., 2026). Client Education: Even though Rebecca tested negative for strep, the likelihood of her having it is increasingly high. When rapid antigen detection testing produces a negative result, the use of a second swab for confirmatory culture should be considered to avoid missing a positive infection, particularly if there is a high clinical suspicion of GAS or rheumatogenic strains circulating in the community (Gonsu et al., 2015). Using antipyretics, and antibiotics seeks to provide symptom relief, shorten the duration of illness, prevent nonsupportive and supportive complications, and decrease the risk of contagion, while minimizing the unnecessary use of antibiotics (Mustafa & Ghaffari, 2020). Good hand hygiene and respiratory etiquette can reduce the spread of group A strep bacteria (CDC, 2025). Stay out of classes for at least 24 hours of being fever free and isolate away from roommate and friends until fever free (CDC, 2025). Complete all antibiotics even if feeling better to decrease reinfection rate (CDC, 2025). Stay hydrated and drink plenty of liquids to decrease dehydration risk (Frenck et al., 2023). Patients should also be informed about the small risk of developing conditions such as glomerulonephritis or rhematic fever (Ashurst et al., 2026). Follow Up: Throat culture results should resolve in 24-48 hours, patient should present back or with primary care provider in 72 hours if symptoms do not resolve (Frenck et al., 2023). References: Ashurst JV, Weiss E, Tristram D, et al. Streptococcal Pharyngitis. [Updated 2025 Feb 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525997/ Ates, B., Olt, M. C., Kacar, A., Yeni, N., Guzeloglu, E., & Arabaci, C. (2026). Comparative Evaluation of

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