Reference no: EM133656818

Problem: Vanessa is a 24 year old Hispanic female presents to the clinic to see the Family Nurse Practitioner (FNP) for complaints of a three month history of a facial rash over her cheeks and nose. In the past two weeks she has had progressively worsening joint pain, including bilateral metacarpal phalangeal, proximal interphalangeal, elbows, knees, and right ankle. She also complains of fatigue, intermittent fever, oral ulcers, loss of appetite, and unintentional weight loss.Preliminary lab workup includes CBC, CMP, and ANA which are pending. A urine dip in the office is notable for 3+ protein. Identify additional health history (subjective) and physical examination findings (objective) needed in the management of this patient. Formulate a primary (final) diagnosis for this patient, include at least three prioritized (urgent & emergent) differential diagnoses with current and relevant ICD codes based on chief complaint, age, health history, functional (cognitive, developmental, physical capacity) and risk assessment (e.g., genetic, behavioral, lifestyle), and comorbidities. Complete the Diagnostic Reasoning Table for each of your differential diagnoses and upload with your discussion. Discuss the pathogenesis and clinical manifestations of your primary (final) diagnosis. Provide rationale for your answers.