In the case at hand, the patient was misdiagnosed to be suffering from viral pleurisy due to presenting the symptom of a sharp pain during inhalation. However, the pain also presents in patients suffering from aortic dissection. As a matter of fact, both viral pleurisy and aortic dissection depict similar symptoms, hence forming the main reason behind the misdiagnosis (Paary, et al 2016). Therefore, as an NP in primary care, my effort towards avoiding a misdiagnosis would involve offering optimal care and thus ensure an accurate diagnosis. Firstly, I would apply comprehensive clinical reasoning skills through observing the patient’s essential data and reflecting on vital signs that require attention. This way, I would be able to recognize deterioration in the patient’s health, thus institute further diagnostic procedures. In turn, it would enable me to administer the needed and correct treatment. An additional thing that I would do differently is not to rely on the initial tests since the symptoms were similar for two conditions. I would consult a more experienced physician, knowing that the failure to recognize my misgivings would reinforce an incorrect diagnosis.
Thirdly, I would utilize presentation checklists. Creating a list of differentials for this patient through following all the important steps would make a huge difference in the diagnosis. It remains crucial to list down each symptom that the patient presented to avoid overlooking important elements. Furthermore, it helps in determining the condition of interest as well as the possibility of a different illness presenting from the symptoms (Fischer, et al 2017). A list of differentials allows for the exclusion of various possibilities, followed by establishing the distinguishing symptoms before asserting the diagnosis. The information in the differential list simplifies the course of ordering further examinations, such as lab tests and imaging. It also supports concerns on the accuracy of the diagnosis, hence prompting consultations. In the case presented, a differential list could have informed the process of diagnosis, thus changing the outcome. It would have enabled the clinicians to make thorough assessments on the two conditions presented by the symptoms, namely viral pleurisy and type 1 aortic dissection.
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References
Fischer, C. E., Qian, W., Schweizer, T. A., Millikin, C. P., & Munoz, D. G. (2017). Featured Article: Determining the impact of psychosis on rates of false-positive and false-negative diagnosis in Alzheimer's disease. Alzheimer's & Dementia: Translational Research & Clinical Interventions, 3385-392.
Hong, Y., Qiufen, L., Maisa, K., & Dianjie, L. (2017). Bibliometric analysis of tuberculosis pleurisy based on a web of science. Biomedical Research (0970-938X), 28(7), 3322-3327.
Paary, T. T., Kalaiselvan, M. S., Renuka, M. K., & Arunkumar, A. S. (2016). Clinical profile and outcome of patients with severe sepsis treated in an intensive care unit in India. The Ceylon Medical Journal , 61(4), 181-184.
