Assessment of the Older Adult.

Advanced physical assessment of special populations require in-depth consideration specific to the health development and changes that occur in these populations. The nurse practitioner will conduct well visit clinical assessments, manage health screening and also assess complaints toward development of a diagnosis from patient records, a subjective history and the physical exam using clinical reasoning. Additionally these complaints may require diagnostic labs to be performed for an accurate diagnosis.

Complete one of the three scenarios.

Consider the chief complaint of worsening memory in a 78-year-old. Existing diagnosis of Alzheimer’s
or
Consider the chief complaint of mid back pain in an 82-year-old. Existing diagnosis of osteoporosis.
or
Consider the chief complaint of swelling in ankles in a 67-year-old. Existing diagnosis of hypertension.
Demonstrate clinical judgment with regards to the chief complaint and case.

What pertinent information collected from the history would impact your assessment.
What would be pertinent positives or pertinent negatives found in the exam.
Include at least three differentials.
Include which diagnostics you would order based on your differentials and why.
How might a final diagnosis be determined?
Apply evidence-based support for your choices; including a clinical guideline for one of your differentials.
Finally, what health policy factors might be a consideration during the clinical encounter?