Finding: Reports reaction to dust (Found)Pro Tip: Dust is a common allergen and discovering its effect on asthmatic patients is particularly important. Example Question: Do you have flank pain? Finding: Reports infrequent discharge, crusting or wateriness (Available)Pro Tip: Asking about symptoms, such as eye discharge, is one possible component of a review of systems interview. Educate - Medication: Educate the patient on medications used for pain relief. Student: What are stressors? Gaps in health literacy around asthma control Not Followed Up, Description: Tina describes increased inhaler use and decreased effectiveness, indicating that her asthma is uncontrolled. Example Question: Do you have a history of suicidal thinking? Example Question: Do you have any nose problems right now? . Prioritize the following elements of the critical thinking. Example Question: Do you have a family history of headaches? Discovering a patient's individual response to pain medication is an important factor in your overall treatment plan. Student Response: Differential diagnosis include stroke, dementia, electrolyte imbalance, dehydration, infection and drug toxicity. Example Question: Have you had ear discharge? "No, I can't. It’s always a hassle though, so I try to avoid it unless I really have to like right now. Tina Jones: I try to avoid things that give me breathing problems, but when my asthma starts to act up, I just use my inhaler. Your date of birth. Student: How old were you when your father died? Finding: Reports feeling at peace now (Found)Pro Tip: Asking about Tina's reaction to her father's death is a vital part of patient-centered care. I don't want to miss work or school but now it looks like I'll have to. Student: Do you currently take medicine for your diabetes? The patient's response to these questions may uncover additional problems not discovered during discussion of the patient's chief complaint. The Advanced Health Assessment patient case is a series of single-system examinations of Tina Jones during several clinic visits over the course of a simulated year, which students have found useful in preparing for their clinical. Health Assessment-Chest pain. A family history of hypertension means that you may be at risk for developing it, too, and you’ve had some high blood pressure readings. Finding: Reports wound care regimen of bandaging (Available)Pro Tip: Asking specifically how often a patient changed a bandage will let you know if an infection spread through improper hygiene, or for other reasons such as uncontrolled blood sugar. Example Question: Have you noticed an increase in appetite? Asking Tina if any of her family members had cancer is essential for understanding her risks. A history of hematuria could be a symptom of genitourinary problems. Do this before you attempt to do the actual assignment so that you're prepared. Finding: Denies painful or difficult urination (Available)Pro Tip: Asking about pain during urination is one possible component of a review of systems interview. Finding: Reports infrequent sinus problems (Available)Pro Tip: Asking about symptoms, such as frequent sinus issues, is one possible component of a review of systems interview. Tina Jones: I was changing a light bulb, and I had to use our little stepstool to reach it. Example Question: Have you seen a healthcare provider for this injury? Usually just one in the morning, kind of like some people have a cup of coffee. billie_foote1. The patient's response to these questions may uncover additional problems not discovered during discussion of the patient's chief complaint. Contributing factors are a past history of hospitalization and asthma attacks, as well as sedentary lifestyle and obesity. Example Question: Have you experienced any type of abuse? Tina Jones-Shadow Health- Abdominal. Example Question: Do you have a history of depression? The patient's response to questions about this topic may uncover additional problems not discovered during the discussion of the patient's chief complaint, such as oral infection or recent trauma. Tina Jones: ...Like a 7. Example Question: Do you get light-headed? Pay close attention to this information as it will help guide your exam. Student: How many puffs do you take when using your asthma inhaler? Finding: Reports injury occurred 1 week ago (Available)Pro Tip: Discovering how long ago the pain began is the first step in understanding whether the pain is chronic or acute. Tina Jones: You know, I did notice lately that I've been really thirsty. Complete the Cardiovascular Assignment for Tina Jones before completing the discussion question. Tina Jones: I was diagnosed when I was 24. She's slowing down, but we help her out. Your role in this simulation is that of a healthcare provider who will perform a cardiovascular exam on Ms. Jones. Student: What type of drugs did you use? We will write your work from scratch and ensure it's plagiarism-free, you just submit. Student: Does your family have a history of obesity? Self report. Model Statement: "It sounds like your asthma is giving you some problems, and you're not getting full relief from your inhaler. It's good to hear that you no longer smoke pot. Tina Jones: I don't think I have any problems. I can also walk through some pain management exercises with you that don't involve medication, if you are interested. Example Question: Have you experienced nipple discharge? Example Question: Has your heartbeat been irregular? Finding: Asked about maternal grandfather's health. Finding: Reports last use of inhaler was 3 days ago (Available)Pro Tip: Determining the patient's last use of an inhaler clues you in to any recent breathing problems. Example Question: Do you take any herbal supplements? Example Question: Do you wake up at night to urinate? Example Question: Have you had any family members with cancer? Example Question: Do you have circulation problems? Student: Has your foot been draining any liquids? Tina Jones: Well, Poppa died about five years ago. Example Question: Do you ever have chest pain? Evidence - Relevant: Evidence Pro Tip: Tina's asthma puts her at general risk for breathing problems. Unstable blood glucose levels could increase the patient's risk for falls. She describes being too busy to exercise and reports that her primary activity is being on her feet at work, a belief which demonstrates her misunderstanding of exercise. If the patient reports a history of gas, it could be a symptom of dietary or gastrointestinal problems. Finding: Followed up on stopping diabetes regimen. For the other kinds, I got all the required ones when I was a kid, and for college...I'm sure I have a record somewhere at home. Finding: Denies tingling (Available)Pro Tip: Asking about tingling sensations is one possible component of a review of systems interview. I don't know if it's allergies, but sometimes my asthma acts up around dust. Example Question: Does the wound feel warm? Asking Tina if her father had high blood pressure can reveal generational patterns. Base your response to the discussion questions on the findings in the Shadow Health assessments. Example Question: Do you ever get tingling? Planning - Relevant: Assess - Musculoskeletal: Assess the patient's ability to bear weight and gait. Student: What medications did you take for your diabetes? Example Question: What is your reaction to penicillin? "It's throbbing and like, sharp if I try to put weight on it." Example Question: Have you been hospitalized in the past? Finding: Reports waking up to urinate during the night (Available)Pro Tip: Frequent urination at night can be a sign of uncontrolled blood sugar or UTI. Example Question: How many days have you needed pain medication? Finding: Asked review of systems for neurological. Hello my name is Danielle I will be your provider today. Before I came in, I was just taking Advil. Finding: Reports pain is sharp when she attempts to stand (Found)Pro Tip: Determining what physical activities and movements exacerbate the patient's pain can help you better understand the problems and assess treatment needs. Student: How does this assignment prepare me for the real world? Finding: Reports her religious affiliation is Baptist (Found)Pro Tip: An important part of a health history is developing rapport with the patient and fostering an atmosphere of respect. Example Question: Have you had a mammogram? Student: I can't even imagine how you feel about losing your father, Tina Jones: Dad was a little stricter than Mom growing up. Tina Jones: Grandpa Jones had colon cancer, and that caused all kinds of problems for him. A history of STIs could cause complications with the genitourinary system. Tina Jones: I made sure to clean it and keep it bandaged. Greet 06/27/20 3:27 PM CDT. Cardiovascular tina jones shadow health Transcript Transcript. Tina Jones: Um...I've smoked pot before. In Tina's case, it will help you better understand her asthma and create a timeline. Finding: Denies history of STIs (Available)Pro Tip: Asking about a patient's history of STIs is one possible component of a review of systems interview. Finding: Denies incontinence (Available)Pro Tip: As a currently presenting symptom, incontinence could result in a change to the patient's care plan. Example Question: Does dust trigger your asthma? Diana Shadow: In this assignment, you will be evaluated on your Subjective Data Collection, as well as your Education and Empathy. Example Question: Do you have any breast swelling? Student: When did you last use drugs? When you monitor your sugar, it helps you understand what foods, activities, and times of day contribute to you feeling your best. Supporting evidence comes from her inability to incorporate meaningful dietary changes or increase her exercise. Do you have a family history of heart disease. Establishing that Tina is producing a large amount of urine is important for understanding the current state of her condition and treatment needs. Tina Jones: Nana was 73 when she died of a stroke about five years ago. Consult / Refer: Consult with physical therapist to develop a plan to improve the patient's mobility. Then educate the patient on risks of obesity, recommended dietary changes, and healthy exercise. My foot slid off the bottom step and it got all scraped up. …I’ve never been diagnosed with blood pressure problems. Example Question: When was your last tetanus booster? Finding: Denies excessive flatulence or bloating (Available)Pro Tip: Asking about gas or bloating is one possible component of a review of systems interview. So, I guess at first I just focused on getting things done--groceries, laundry, insurance papers and stuff. Infection can contribute to poorer glycemic control, and so Tina is likely to experience blood glucose levels that are significantly higher than her baseline. I can't put any weight on it without like, shooting pain. Example Question: Are you able to hold your urine? © 2000 - 2021 OnlineNursingPapers All rights reserved. I've been going to the same church since I was a kid, too, so the people at church are practically part of my family. Finding: Reports being barefoot at the time of injury (Available)Pro Tip: Asking about clothing, footwear, and other protective elements being worn at the time of injury helps you discover the totality of the circumstances. Finding: Denies family history of thyroid issues (Found)Pro Tip: Asking about trends such as thyroid issues can help you fill in holes in the history that your patient may have missed, and can allow you insight into other inherited diseases that affect relatives outside of immediate family. Finding: Reports large amount of urine (Found)Pro Tip: Polyuria is a common symptom of diabetes. The evaluation of your interview is dependent on how you word your questions therapeutically and precisely and explore all relevant topics with comprehensive breadth and depth. Example Question: Do you have muscle swelling? Some mornings lately I’ve had two, though. But it's important to keep your blood sugar under control to prevent long-term damage to your health, and medication can really help. Finding: Reports pain prevents bearing weight on foot (Found)Pro Tip: Determining if your patient can bear weight on an injury is important to determine their risk for falls while in your care. Example Question: When was your last asthma attack? Swollen lymph nodes may appear in the neck when an infection is present. Sexual activity without condoms increases a patient's risk of STIs, and can be an indicator of a patient's health literacy. I guess a little over a year ago. Student: What medication allergies do you have? Finding: Reports last alcoholic drink was 3 weeks ago (Available)Pro Tip: Confirming when a patient had her last alcohol intake is important, because she will receive medications while admitted, and alcohol is often contraindicated. Finding: Denies brother having diagnosed health problems (Found)Pro Tip: Family histories might indicate a genetic predisposition. Student: Have you had any prior hospitalizations? The patient's response to questions about this topic may uncover additional problems not discovered during the discussion of the patient's chief complaint, such as vision loss. Hello my name is Danielle I will be your provider today. Student: Do you monitor your blood glucose? Finding: Reports currently working toward undergraduate degree (Found)Pro Tip: Finding out a patient's level of education can give you a baseline for her health literacy. If you would like, I can help you find a monitor that is as painless as possible. 26 terms. Yeah, I have a daily inhaler now that I’ve been using. Example Question: When was your last period? Finding: Denies receiving annual flu vaccine (Found)Pro Tip: The flu virus can be particularly hazardous in a hospital setting. She reports intense pain on a numerical scale and describes pain characteristics. Example Question: Have you had gum problems? Things were only hard like that for a few months. The patient's response to questions about this topic may uncover additional problems not discovered during the discussion of the patient's chief complaint, such as oral infection or recent trauma. Knowing that Tina is diabetic, you will want to explore this classic symptom of the condition. At the end of this prebrief, you will answer a short question about the upcoming assignment. Student: How effective was your pain medication at home? Example Question: What did you eat for breakfast yesterday? Learning about the patient's religious beliefs will allow you to provide the appropriate support and resources. ), I haven’t tried anything specific, other than just trying to relax and breathe deep. Example Question: Can you bear weight on your foot? Student: Did your father die from any disease? Example Question: How old was your father when he died? Intervene - Pain: Administer non-pharmacologic interventions to reduce pain. I've never really had stomach or bowel problems. A potential pregnancy impacts important parts of the patient's care plan, including which medications are administered. Model Statement: "Thank you for sharing that information. Tina Jones: No, I don't think so. A history of incontinence could be a symptom of genitourinary or pelvic problems. Asking Tina if her brother has any health problems can reveal potential risks. Finding: Reports pain affects ability to walk (Available)Pro Tip: Understanding the impact of your patient's wound on daily activities helps inform your plan for care. Neurological Shadowhealth. Finding: Reports urinating every hour or two during the day (Found)Pro Tip: Your patient's urination habits can offer insight into underlying medical conditions and general health. Student: Hello, my name is Catlain, I am your nurse today. If the patient reports a history of nausea, it could be a symptom of a recurring gastrointestinal problem. Drinking high levels of caffeine can make you feel stressed or anxious, and can dehydrate you. You will also be evaluated on your ability to collect data and form nursing diagnoses in the information processing activity. . Cardiovascular GI Genitourinary Musculoskeletal Neurological HSN. Asked about review of systems for cardiovascular Denies cardiovascular issues. Determining your patient's stress level is part of an overall picture of her health. Example Question: Have you taken any prescription pain medications? The patient's response to questions about this topic may uncover additional problems not discovered during the discussion of the patient's chief complaint, such as vision loss. Finding: Asked about paternal grandfather's health. Finding: Asked about review of systems for neck, throat and glands. . Asking Tina if she has ear pain might indicate a possible ear infection and a reason for changes in her hearing. Shadow Health Comp Assessment ... 474 terms. Question 06/27/20 3:27 PM CDT. Example Question: How often did you clean the wound? And my neck is sore too. (Clarified to if I am stressed out.). It wasn’t the cost that was a problem. Planning Pro Tip: Assess how well the patient can bear weight and walk. She states that she feels anxious when they happen. Student: Have you had any gastrointestinal problems? Discussion 5 Question 1 Complete the Cardiovascular Assignment for Tina Jones before completing the discussion question. Search. Priority: High Priority Pro Tip: This is a high priority. Finding: Reports mother diagnosed with high cholesterol (Found)Pro Tip: Family histories might indicate a genetic predisposition. Tina Jones: For as long as I've been around. Finding: Denies change in bowel movements (Available)Pro Tip: Asking about changes in bowel movements can help you understand a patient's baseline patterns. Asking Tina if her paternal grandmother had high blood pressure can reveal generational patterns. he would sometimes get kind of mad at us when we did something wrong. And keeping your sugar down will help your foot wound heal quickly, too. Finding: Asked about frequency of urination. The patient's response to questions about general, constitutional health may uncover additional problems not discovered during the discussion of the patient's chief complaint. Finding: Reports living with mother and sister (Available)Pro Tip: Learning about your patient's living situation helps develop rapport and gives you a broad picture of her lifestyle. Please use the patient information provided below for this paper. Student: I understand your foot hurts, but I need to know this information to make sure I take care of the problem correctly. Finding: Asked about medication allergies. Biology Mary Ann Clark, Jung Choi, Matthew Douglas. Finding: Denies stomach pain (Available)Pro Tip: Asking about stomach pain is one possible component of a review of systems interview. For example, many starchy foods break down into glucose in the body, like pasta, and so you can eat those in moderation, too. I definitely don't anymore, though. Tina Jones: One person in the family, my dad's brother, has an alcohol problem, but we never see him. Example Question: How many puffs do you typically take? As a currently presenting symptom, it could indicate a change in patient status. Finding: Reports right foot is injured (Found)Pro Tip: Confirming which extremity an injury is located is a best practice for your patient's safety. Model Statement: "Staying away from sugar is a great start. Complete the Cardiovascular Assignment for Tina Jones before completing the discussion question. Finding: Asked for details about the pain. Finding: Reports last use was at age 20 or 21 (Found)Pro Tip: When a patient reports drug use, it's important to determine the reason for drug use, as well as the timeline. Student: So that you understand if there are any problems related to their chief complaint. Tina Jones: Well, I used to smoke pot. Finding: Denies nosebleeds (Available)Pro Tip: Asking about symptoms, such as frequent nosebleeds, is one possible component of a review of systems interview. Tina Jones: Um...I've smoked pot before. Finding: Reports asthma triggered by cats (Found)Pro Tip: Discovering occasional environmental triggers, such as animal allergies, gives you insight into exacerbating factors of your patient's condition. Asking Tina if her mother had high blood pressure can reveal generational patterns. Symptoms like these could indicate a yeast or sexually transmitted infection. 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