… Finding: Reports weight loss occurred over the past month (Available)Pro Tip:Finding out the timeline for weight loss can indicate if it’s sudden or gradual. Finding: Asked about latex allergy … Finding: Denies latex allergy (Available)Pro Tip: Confirming absence or presence of a latex allergy is essential in a hospital setting, where some instruments have latex parts. Example Question: Have you had changes in your bowel movements? patient on worsening signs & symptoms, such as At that time she used her albuterol inhaler and her symptoms decreased although they did not completely resolve. Finding: Asked about other foot wound symptoms … Finding: Reports swelling around foot wound (Found)Pro Tip: Asking about the presence of swelling helps you gather information about your patient’s complaint, as well as potential related illnesses. Tina Jones: It was last year… I guess a little over a year ago. Example Question: When did you notice the increase in your appetite? Tina Jones: Grandpa Jones had colon cancer, and that caused all kinds of problems for him. The FNP suspects Damage to: When examining the face, the FNP is aware that the two pairs of salivary gland‘s that are accessible to examination are the _____ glands, A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. … Finding: Denies eye pain (Available)Pro Tip: Asking about symptoms, such as eye pain, is one possible component of a review of systems interview. • Order PFTs to be completed after exacerbation to A history of pain during urination could be a symptom of genitourinary problems. Example Question: Have you had mouth sores? Tina Jones: He died in a car accident. . A history of nocturia could be a symptom of genitourinary or endocrine problems such as diabetes. Example Question: How old was your father when he died? Example Question: Do you ever notice blood in your urine? As a currently presenting symptom, it could impact the patient’s care plan. This evidence-based digital simulation experience allows students to interview and examine digital standardized patients. Finding: Reports last dental visit was several years ago (Available)Pro Tip: Asking about a patient’s dental care is one possible component of a review of systems interview. Normal findings would be which of these results? teen for asthma. Example Question: Have you had gum problems? Tina Jones: Um, I have acne, if that counts. Tina Jones Shadow Health Respiratory Quizlets: At Tina Jones Shadow Health Help there has been the realization that despite the discrete characteristics associated with Tina Jones Shadow Health Assignments such as those dealing with cardiovascular, abdominal, neurological and diagnosis evidence-based practices (including those HEENT Answer Keys. spirometry, does not use a peak flow, does not HPI: Ms. Jones is a pleasant 28-year-old African You will also want to review Ms. Jones’ systems, psychosocial history, and family medical history. pneumothorax and also secondary spontaneous Tina Jones: It was last year… I guess a little over a year ago. Student: Can you rate your current pain level on a scale of 0 to 10? Higher levels of pain have been associated with thoughts of self-harm. auscultated bilaterally in patients posterior lobes Adventitious But benefits come at the cost of avoiding data privacy regimes. Updates to Meds: No updates. with a total of 10 episodes in last 2 days per patient. Tina Jones: Tina Jones:. I think it’s gross. The paper must clearly articulate the relevance of advanced physical assessment skills, techniques, application of advanced practice knowledge, and assessment modification (when necessary) to accommodate for specific patient populations. Tina Jones: I usually use two puffs from my inhaler, but sometimes I need three. Finding: Asked if patient has experienced abuse … Finding: Denies experiencing abuse (Found)Pro Tip: Determining if a patient has experienced abuse, whether it be emotional, physical, or financial, is important for understanding the patient’s needs. 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. The patient’s response to questions about this topic may uncover additional problems, such as hearing loss, not discovered during the discussion of the patient’s chief complaint. • Refer to allergy specialist for evaluation and testing The Health History and Interview The purpose of collecting an entailed health history is to paint a picture of how the patient views themselves, as well as how the nurse observes them. As a currently presenting symptom, it could indicate a change in patient status. If the patient reports a history of palpitations, it could be a symptom of a recurring cardiovascular problem. Tina Jones: No, I don’t take anything for my diabetes anymore. Referral/Consultation 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: Does your sister have health conditions? Planning your time: This assignment occurs at noon on Ms. Jones’ second day in the hospital. Tina Jones: No. Student: I can’t even imagine how you feel about losing your father Tina Jones: Thanks. 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. She does not exercise. Finding: Reports receiving meningococcal shot (Available)Pro Tip: Discovering if a patient has received a childhood meningococcal vaccination reveals information about both her medical history and her susceptibility to infectious disease. Above Average- Responds to three of the three reflection post questions; and provides analysis of performance; and reflection posts written using professional language; and reflection posts demonstrate insight. on activities that she may want to avoid that could Ms. Jones has reported having a cough Example Question: How many times a day do you take pain medication? The respiratory exam is an interview and physical assessment that is performed when a patient presents with a respiratory problem or a history that is suggestive of a pathology of the lungs. Example Question: Have you had ear pain? Example Question: Was your weight loss intentional? Tina Jones: No. I am looking for the exact interview questions for the health history of Tina Jones shadow health. Diagnosis 3: Acute bronchitis Finding: Reports inhaler is albuterol (Proventil) (Found)Pro Tip: Finding out the specific medication type or brand is essential in understanding whether it’s a maintenance or rescue medication. In an effort to identify the cause of the node enlargement, the FNP would assess the patient’s: The FNP is aware that the four areas in the body were lymph nodes accessible are the: A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. Example Question: Have you experienced any type of abuse? Student: How is your sister’s health? nausea, no vomiting, no symptoms of GERD or Example Question: When did you last use your inhaler? All areas of the chest wall environmental exposures or irritants at her job or If Tina had mentioned that she was just diagnosed with pneumonia, what would you have expected to find during percussion? Your role in this simulation is that of a healthcare provider who will take Ms. Jones' health history, a key component of her admission process. Finding: Reports normal vaginal discharge (Available)Pro Tip: Asking about vaginal discharge is one possible component of a review of systems interview. Student: What caused your dads accident? Since that incident she notes that she has had ten episodes of wheezing and has shortness of breath approximately every four hours. Example Question: Do you have a rash on your breasts? When you are ready for the discussion, do the following: Remember to submit your work following the file naming convention FirstInitial.LastName_M01.docx. Tina Jones: It’s pretty good, I think. She is alert and oriented. Aggravating factors/Associated Symptoms: Cats, Finding: Reports typically taking 2 puffs (Found)Pro Tip: Discovering how much your patient uses her inhaler at any given time is a good indicator of the efficacy of her medication. Plan Student: Are you allergic to dust, mold, or pollen? It feels like I can’t take in air, like I can’t get enough air into my lungs. If the patient reports a history of vomiting, it could be a symptom of a recurring gastrointestinal problem. SH:Supervisor at Mid-American Copy & Ship, Example Question: When was your last asthma attack? This case study will provide the opportunity to carefully assess lung sounds during the physical examination. Student: Do you have any problems with your head? consist of aspiration via thoracentesis catheter or My chest feels all tight and Review of Systems: General: Denies changes in Example Question: When did your injury occur? Social History: She is not aware of any Student: Have you experienced abuse? 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. NR 509: Shadow Health Respiratory Physical Assessment Assignment. who appears to be her stated age. Education would also be given on She uses a hypoallergenic Example Question: Has your injury prevented you from going to class? Example Question: Has your sense of smell changed? Finding: Denies muscle swelling (Available)Pro Tip: Asking about muscle swelling is one possible component of a review of systems interview. She complains that her current symptoms Diagnosis 2: Primary spontaneous pneumothorax Finding: Asked about childhood immunizations … Finding: Reports receiving measles-mumps-rubella shot (Available)Pro Tip: Discovering what childhood immunizations a patient has received reveals information about both her medical history and her susceptibility to infectious disease. Finding: Reports receiving varicella shot (Available)Pro Tip: Discovering if a patient has received a childhood varicella shot reveals information about both her medical history and her susceptibility to infectious disease. Finding: Denies night sweats (Available)Pro Tip: Asking about additional symptoms, such as night sweats, is one possible component of a review of systems interview. Finding: Denies odor from the wound (Available)Pro Tip: The odor of discharge from a wound can provide insight into its severity and characteristics. Student: How have you treated the wound? asthma symptoms. Student: Have you had any prior hospitalizations? Tina Jones: Thanks. Finding: Reports pain affects ability to stand at work for long periods of time (Available)Pro Tip: Understanding the impact of your patient’s wound on daily activities helps inform your plan for care. Student: How did you hurt your foot? Subjective data or information the patient tells the nurse about … Example Question: Have you ever smoked marijuana? In this activity, you will interview Tina Jones to collect data to assess Ms. Jones’ condition. In addition, the brain is less sensitive to hypoxia (low oxygen) and hypercapnea (higher than normal carbon dioxide) and higher residual volume. Finding: Reports that the wound feels warm (Found)Pro Tip: Asking about warmth will help you understand the timeline for the infection progression. Unsatisfactory- No physical assessment documentation or no treatment plan. Education: Swish and rinse mouth after every use of Example Question: When was your last period? 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: You know, I did notice lately that I’ve been really thirsty. awakens with night-time shortness of breath twice Tina Jones: I was changing a light bulb, and I had to use our little stepstool to reach it. Academic year. Tina Jones: I haven’t smoked pot since I was twenty or twenty-one. evaluation, Social History: She is not aware of any environmental exposures or irritants at her job or home……. Example Question: Do you have muscle pain? for asthma, last at age 16. 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. View Tina Jones Respiratory | Completed | Shadow Health 4.pdf from NSG 516 at Rivier University. Tina Jones: He was driving to work, and it was raining…and his car hydroplaned. . Example Question: Have you ever used a nebulizer? 2019/2020 potentiate another episode such as air travel and Example Question: Do you ever have ringing in your ears? Finding: Asked about patient’s living situation … 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. Finding: Denies lymph node problems (Available)Pro Tip: Asking about a patient’s lymph nodes is one possible component of a review of systems interview. Tina Jones: He’s a healthy guy. Ms. Jones offers information freely and without contradiction. Student: Did your father die from any disease? Finding: Reports receiving polio shot (Available)Pro Tip: Discovering if a patient received a childhood polio vaccination reveals information about both her medical history and her susceptibility to infectious disease. Finding: Denies taking supplements (Available)Pro Tip: Finding out about your patient’s use of supplements will help you get a complete health history and avoid unwanted drug interactions. Notable wheezing You can document your findings, including vital signs, in the Electronic Health Record. Example Question: How often do you check your blood sugar? Finding: Asked about past diabetes medication use … Finding: Reports that she used to take diabetes medication (Found)Pro Tip: Asking about Tina’s medication history for asthma will provide a timeline of treatment. Finding: Asked details of the injury … Finding: Reports she scraped foot on bottom rung of a step stool (Found)Pro Tip: Discovering how an injury happened helps to assess your patient’s risk factors for injury. 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 unspecified allergies. Finding: Reports seeing pus draining from wound (Found)Pro Tip: Asking about discharge helps you determine the characteristics of a wound. Student: When did you last use drugs? Finding: Denies chills (Available)Pro Tip: Asking about additional symptoms, such as chills, is one possible component of a review of systems interview. Tina Jones: I don’t have any food allergies that I know of. Student: Can you walk with your foot being injured? Tina Jones: No, I can’t. Since that Student Documentation Model Documentation Example Question: What did you eat for breakfast yesterday? Tina Jones: It’s on the ball of my foot. Example Question: What caused your father’s death? Finding: Asked about review of systems for mental health … Finding: Denies depression (Available)Pro Tip: Asking about the patient’s history with depression is one possible component of a review of systems interview and may provide insight into their ability to cope in the event of painful physical trauma. I feel a lot better now that I’m just eating healthier than I did when I was taking the pills. What points could you have improved upon? Common significant deviations of the chest for older adults include marked dorsal curvature, kyphosis, increased AP diameter of the chest (barrel chest), and diminished chest expansion (Hogstel & Curry, 2005). Student: Have you used drugs other than marijuana? Avoid resits and get better grades with material written specifically for your studies. Example Question: Have you had dry mouth? Student: How old were you when your father died? Why do you think these were effective? Finding: Denies jaw problems (Available)Pro Tip: Asking about symptoms, such as jaw problems, is one possible component of a review of systems interview. Finding: Reports wound is on the plantar surface of her foot (Found)Pro Tip: Confirming where a wound is located ensures you are aware of your patient’s biggest complaint. Finding: Followed up on drainage … Finding: Reports pus as white or yellow (Found)Pro Tip: The color of discharge from a wound can provide insight into its severity and characteristics. Example Question: How are your lymph nodes? A patient says that she has recently noticed a lump in the front of her neck below her “Adams apple” that seems to be getting bigger. Student: What medications did you take for your diabetes? Tina Jones: No. Student: What is your belief system? posterior lower lobes. Example Question: Did your foot bleed? Denies coughing up mucus and has been afebrile. Example Question: How often do you wake up at night to urinate? Student: How is your maternal grandfather’s health? Tina Jones: Well, I’m here, so I guess it didn’t do its job. Finding: Denies muscle weakness (Available)Pro Tip: Asking about muscle weakness is one possible component of a review of systems interview. Follow-up: Schedule a phone visit in a few days Example Question: Has your heartbeat been irregular? . Ms. Jones is a pleasant, 28-year-old obese African American single woman who presents to establish care and with a recent right foot injury ... you will interview Tina Jones to collect data to assess Ms. Jones’ condition. Finding: Reports receiving Hepatitis A and B shot (Available)Pro Tip: Discovering if a patient has received a childhood Hepatitis A and B vaccination reveals information about both her medical history and her susceptibility to infectious disease. 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