How do you tell apart similar disease processes

[Blackheartednurse]

Ok so one of fears of being a nurse is not to be able to distinguish between pathologic conditions showing similar signs and symptoms...from top of my head DVT and cellulitis comes to my mind or pneumonia and lung embolism. I know it takes years of experience,but how does a new nurse surive without such an important skill? Thanks..

[Flare, ASN, BSN]

doctors treat the symptoms and diagnose the disease process - nurses treat the patient. Over time experience will tell you what you are dealing with.

[leslie :-D]

i agree with firefightingRN that drs treat the symptoms, make diagnoses...

but it is the nurse who observes and reports these symptoms.

for example, re cellulitis/dvt, you'd report erythema, edema, rom, pain, mobility status, etc.

we never diagnose, nor should we ever feel burdened to do so.

besides, nothing is textbook and every pt can present differently.

so, no need to worry.

i can confidently state, "that's not our job".

leslie

[elkpark]

i agree with firefightingRN that drs treat the symptoms, make diagnoses...

but it is the nurse who observes and reports these symptoms.

for example, re cellulitis/dvt, you'd report erythema, edema, rom, pain, mobility status, etc.

we never diagnose, nor should we ever feel burdened to do so.

besides, nothing is textbook and every pt can present differently.

so, no need to worry.

i can confidently state, "that's not our job".

leslie

:yeahthat:

[webmansx, ASN, RN]

I think what blackheartednurse is concerned with is not diagnosing,..I think she is trying to get that knowedge-based-critical-thinking skill. This is very useful for a nurse in that if you know it may be a DVT and not cellulitis perhaps,(even if the doctor has not diagnosed it) you can anticipate what to do, eg keep the leg still, no physical therapy, no massaging, no cold hot packs. When they order a clot buster after they discover it is ideed a DVT,then as a nurse you know why you are giving the drug and what to teach the patient....I think it just helps to understand.

[diane227, LPN, RN]

You read about disease processes. There are differences but often you cannot make a bedside diagnosis without testing of some type to help you diagnose the problem. The real issue is do you recognize when the patient is sick? Do you know what sick looks like? You don't have to know the diagnosis. You just have to know that the patients status is changing for the worse and when to call.

Most of it comes with experience. A very experienced nurse very often CAN tell you exactly what is wrong with the patient because they have seen it over and over. As you grow in your career and you see more and more it will get easier. When you start to see patients with acute changes due to a certain disease process you won't forget it. So the next time you see it, you will have a good idea what it is.