D. Finding analysis:
Ms. BN is a 31-year-old female who presented with a day history of mild dull headache that is aggravated by walking and relieved by resting in a dark room. The headache occurs concomitantly with her menstrual periods. The pain is on 3 pain scale. There is no history of head injury in this patient. The patient weighs 320 lbs and has a height of 5 feet and 5 inches. As such, she is extremely obese. She has normal vision with no blurring and is oriented in time place and person. Her vitals are within normal ranges with a resting blood pressure of 118/78 mmHg.
D1. Lab Tests:
Complete blood count
Urinalysis
Brain CT scan and MRI
Blood sugar levels
D1A. Justification:
A total blood count will be important in this patient to be able to know the white blood cell count and the hemoglobin level. Elevated white blood cells will point to infections which can be a cause of headache. In addition, a reduced hemoglobin, also referred to as anemia can cause headaches. A head CT scan is of critical importance in this patient to rule out brain pathology such as tumors that can cause headaches due to pressure symptoms. A brain MRI offers a better picture in the setting of equivocal CT scan findings. As such, it will be able to provide a good picture for subtle pathologies in the brain parenchyma. A urinalysis is also an important part of the investigation to rule out a urinary tract infection such as pyelonephritis. Diabetes also causes headaches and therefore a blood sugar will be useful for the patient (Guilbeau & Lenahan, 2015) .
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E. Comprehensive Health assessment versus Physical Health Assessment
A comprehensive health assessment is an assessment that includes additional issues related to the patient. It goes beyond evaluating the clinical presentation of a patient through history and physical examination to addressing issues such as health risks, social factors and behaviors and health needs such as insurance for the patient. This assessment looks into the patient in totality and aims at understanding both the physical and social aspects of a patient. For example, in a comprehensive health assessment, one can ask the patient whether he/she uses protection while having sex. This aims at understanding the patient’s potential risks (Jarvis, 2018) . A physical assessment on the other hand is an anatomical evaluation of the patient from head to toe with an aim of finding out whether there are any abnormalities. This type of assessment evaluates all the body system using the four pillars of assessment: inspection, palpation, percussion and auscultation. The findings of this assessment are then correlated with the clinical history to make a diagnosis and a plan of management (Jarvis, 2018) .
References
Guilbeau, J. R., & Lenahan, C. M. (2015). Assessment, Diagnosis and Management of Headaches. Women Health.
Jarvis, C. (2018). Physical Examination and Health Assessment - Canadian E-Book. New york: Elsevier Health Sciences.
