What are four differential diagnoses

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Question

The patient is a 16-year-old young female, who presents today for a checkup and BP evaluation. She was told at a health fair that her BP was elevated.

Emily is a 16 y/o sophomore at the local high school, who is an A student, and she tells you that she feels fine and is healthy.

Past medical history includes subluxation of the lens in the left eye at age 12 [but was corrected by ophthalmology], and her vision is stated as "normal".

Family History-the patient is an only child and the mum states that she and her husband are both healthy. There are no known family history of familial eye, cardiac or respiratory diseases.

Emily has no allergies and she does not take any medications.

Emily and her mum state that she has never had an elevated BP on prior medical visits. They just moved to the Dallas area last year, and it has been about a year since her last medical visit. She says that the BP readings at the health fair [she went on 2 consecutive days] were 150-160 on the top and 86-96 on the bottom. She denies SOB, palpitations, CP or edema.

Exam today:

97.6 - 100- 16 150/90 She is 68 inches tall and weighs 125 pounds

Vision is 20/20 in the right eye and 20/40 in the left eye [she does not wear glasses]

Respiratory/Chest-pectus excavatum; a few basilar crackles and dullness over RLL posteriorly with percussion

Cardiac exam-regular rhythm; S1 S2 audible, with S2 is louder; there is a 2/6 murmur heard in the aortic and tricuspid areas-it sounds as if it is late systolic or early diastolic in nature

Abdomen-slight pulsation above the umbilicus; no venous distension, organomegaly, cyanosis, or ascites.

Extremities/Joints-hyperextensibility of the small joints of the hands; arms and fingers are long and slender; dp and pt pulses 2+/2+ bilaterally; no edema noted

What are the primary diagnoses?

What are four differential diagnoses?

What Nursing Interventions / Education is needed?

Reference no: EM133843713

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